股骨颈系统与非滑动固定治疗 Pauwels Ⅲ型年轻股骨颈骨折患者的生物力学评估：有限元分析
Biomechanical evaluation of femoral neck system versus non-sliding fixation in the treatment of young patients with Pauwels type III femoral neck fractures: a finite element analysis.
作者信息
Gao Yang, Lou Zhiyuan, Jia Peng, Chang Xiaohu, Li Xiaoteng, Tang Xin
机构信息
Department of Orthopedics Trauma, First Affiliated Hospital of Dalian Medical University, No.222, Road Zhongshan, Xigang District, Dalian, Liaoning Province, 116011, China.
Department of Orthopedics, Shandong Second Provincial General Hospital, Jinan, Shandong, 250023, China.
出版信息
BMC Musculoskelet Disord. 2025 Jun 7;26(1):575. doi: 10.1186/s12891-025-08761-2.
OBJECTIVE
This study aimed to compare the biomechanical performance of the femoral neck system (FNS) and four cannulated screws (FCS) on treating young patients with Pauwels type III femoral neck fractures.
METHODS
The model of a young Pauwels type III femoral neck fracture with 70° inclination, FNS, and FCS were established, and the fixations were set up. Under an axial load of 2100 N, the finite element anaysis was performed, and the shear force distribution, von Mises stress (VMS), and displacement of each group of models were recorded to analyze the biomechanical effects.
RESULTS
The FNS group exhibited localized shear stress, with a peak value of 181.96 MPa, whereas the FCS group displayed a more dispersed shear stress distribution. In the FCS group, the maximum shear stress values were 71.21 MPa, 66.65 MPa, 59.22 MPa, and 84.23 MPa for the upper anterior parallel, upper posterior parallel, transverse, and lower parallel screws, respectively. The maximum shear stress observed in the femur were 113.98 MPa in the FNS group and 89.39 MPa in the FCS group. VMS in the FNS group was predominantly concentrated at the plate-screw junction, reaching a peak of 326.24 MPa, whereas in the FCS group, it was primarily localized near the fracture site in the mid-screw region, with a maximum value of 166.77 MPa. In the femur, VMS was concentrated at the stress application site on the femoral head, with peak values of 197.54 MPa and 154.85 MPa in the FNS and FCS groups, respectively. The greatest displacement of the internal fixators was observed at the screw heads and the two upper parallel screws, measuring 3.36 mm in the FNS group and 3.28 mm in the FCS group. The maximum displacement of the femur occurred at the stress application site on the femoral head, measuring 3.41 mm and 3.33 mm in the FNS and FCS groups, respectively.
CONCLUSION
Comparative finite element analysis demonstrates superior biomechanical stability of FCS over FNS, indicating its greater suitability for managing young Pauwels type III femoral neck fractures.
CLINICAL TRIAL NUMBER
Not applicable.
目的
本研究旨在比较股骨颈系统（FNS）和四颗空心钉（FCS）治疗 Pauwels Ⅲ型年轻股骨颈骨折患者的生物力学性能。
方法
建立 70°倾斜的 Pauwels Ⅲ型年轻股骨颈骨折模型、FNS 和 FCS，并进行固定。在 2100 N 的轴向载荷下进行有限元分析，记录每组模型的剪切力分布、von Mises 应力（VMS）和位移，以分析生物力学效应。
结果
FNS 组表现出局部剪切应力，峰值为 181.96 MPa，而 FCS 组的剪切应力分布更分散。在 FCS 组中，上前平行、上后平行、横向和下平行螺钉的最大剪切应力值分别为 71.21 MPa、66.65 MPa、59.22 MPa 和 84.23 MPa。FNS 组股骨中观察到的最大剪切应力为 113.98 MPa，FCS 组为 89.39 MPa。FNS 组的 VMS 主要集中在钢板 - 螺钉连接处，峰值为 326.24 MPa，而在 FCS 组中，它主要位于螺钉中部区域的骨折部位附近，最大值为 166.77 MPa。在股骨中，VMS 集中在股骨头的应力施加部位，FNS 组和 FCS 组的峰值分别为 197.54 MPa 和 154.85 MPa。内固定器的最大位移出现在螺钉头部和两颗上平行螺钉处（FNS 组为 3.36 mm，FCS 组为 3.28 mm）。股骨在股骨头应力施加部位的最大位移分别为 FNS 组 3.41 mm 和 FCS 组 3.33 mm。
结论
有限元对比分析表明，FCS 的生物力学稳定性优于 FNS，表明其更适合治疗 Pauwels Ⅲ型年轻股骨颈骨折。
临床试验编号
不适用。
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