Li Jiarui, Xing Kunyue, Wang Wenzhuo, Sun Li, Xue Linyuan, Xing Jiyao, Wu Xiaolin, Xing Dongming
The Affiliated Hospital of Qingdao University, Qingdao Cancer Institute, Qingdao University, Qingdao, 266071, China.
College of Computer Science and Technology, Qingdao University, Qingdao, 266071, China.
J Orthop. 2024 Nov 5;64:7-12. doi: 10.1016/j.jor.2024.10.057. eCollection 2025 Jun.
This study aims to validate the application effects of a novel theoretical model of dynamic parallel traction in the treatment of femoral neck fractures through three-dimensional finite element analysis. By simulating the femoral neck fracture model, we explore the promotional effect of dynamic parallel traction on fracture healing.
A digital 3D femur model was constructed using high-resolution computed tomography data of the lower limbs of a 70-year-old elderly subject. An axial compression of 500N was applied at different traction angles (0°, 10°, 20°, 30°, 40°, 50°). The equivalent stress distribution and deformation of the femur geometric model were calculated at each angle under the six angles. Statistical analysis was performed using One-Way ANOVA.
At the parallel angle ( = 0°), the maximum stress on the entire femur occurred at the trochanteric fossa, with a value of 7.945 MPa ( = 0°). The maximum deformation was at the fovea capitis, with a value of 104.13 mm ( = 0°). As the traction angle gradually increased ( = 10°, = 20°, = 30°, = 40°, = 50°), the maximum stress shifted gradually to the medial cortex of the femoral shaft, with values of 11.236 MPa ( = 10°), 15.196 MPa ( = 20°), 19.263 MPa ( = 30°), 23.149 MPa ( = 40°), and 26.311 MPa ( = 50°). The maximum deformation remained at the fovea capitis but increased to 131.87 mm ( = 10°), 181.96 mm ( = 20°), 228.2 mm ( = 30°), 271.15 mm ( = 40°), and 307.41 mm ( = 50°). One-Way ANOVA revealed that traction angle significantly influenced the stress distribution (F = 4.419, p = 0.0022) and deformation magnitude (F = 4.023, p = 0.0040) at the proximal femur, indicating that traction angle is a critical factor affecting stress distribution and deformation.
With the increase of the traction angle, the mechanical properties of the proximal femur decrease, indicating an increased risk of non-union and complications. Additionally, the study proves the effectiveness of the "dynamic parallel traction" theory.
本研究旨在通过三维有限元分析验证一种新型动态平行牵引理论模型在股骨颈骨折治疗中的应用效果。通过模拟股骨颈骨折模型，探讨动态平行牵引对骨折愈合的促进作用。
使用一名70岁老年受试者下肢的高分辨率计算机断层扫描数据构建数字化三维股骨模型。在不同牵引角度（0°、10°、20°、30°、40°、50°）施加500N的轴向压缩力。计算在这六个角度下股骨几何模型的等效应力分布和变形情况。采用单因素方差分析进行统计分析。
在平行角度（θ = 0°）时，整个股骨上的最大应力出现在转子窝处，值为7.945MPa（θ = 0°）。最大变形出现在股骨头凹处，值为104.13mm（θ = 0°）。随着牵引角度逐渐增加（θ = 10°、θ = 20°、θ = 30°、θ = 40°、θ = 50°），最大应力逐渐向股骨干内侧皮质转移，值分别为11.236MPa（θ = 10°）、15.196MPa（θ = 20°）、19.263MPa（θ = 30°）、23.149MPa（θ = 40°）和26.311MPa（θ = 50°）。最大变形仍在股骨头凹处，但增加到131.87mm（θ = 10°）、181.96mm（θ = 20°）、228.2mm（θ = 30°）、271.15mm（θ = 40°）和307.41mm（θ = 50°）。单因素方差分析显示，牵引角度对股骨近端的应力分布（F = 4.419，p = 0.0022）和变形量（F = 4.023，p = 0.0040）有显著影响，表明牵引角度是影响应力分布和变形的关键因素。
随着牵引角度的增加，股骨近端的力学性能下降，表明骨不连和并发症的风险增加。此外，该研究证明了“动态平行牵引”理论的有效性。
