股骨轉子部骨折六部分骨折分型產生機制的有限元分析
發(fā)布時間：2018-07-31 05:22
【摘要】：目的:建立股骨上段三維有限元模型,探討股骨轉子部六部分分型的產生機制,并對不同分型的手術方式給出建議。方法:應用64層螺旋CT對1例60歲正常男性志愿者左側股骨近段進行掃描,所得圖像以.jpg格式保存,并導入Photoshop 7.0軟件進行三維模型繪制,將所得三維圖像運用Super 93軟件建立股骨近段三維有限元模型,劃分節(jié)點764個,單元531個(密質骨306個、松質骨225個)。運用該模型模擬人摔倒過程中髖關節(jié)內收、外展、內收內旋、外展外旋及髖關節(jié)內收內旋同時臀中肌、梨狀肌、髂腰肌劇烈收縮狀況下轉子間的應力分布情況。結果:單純髖關節(jié)內收時,應力主要分布于外側骨皮質部并向轉子間區(qū)擴散(二部分骨折)。單純髖關節(jié)外展時,應力主要分布于內側骨皮質部并向轉子間區(qū)擴散(二部分骨折)。髖關節(jié)內收內旋或外展外旋時,應力均在大轉子及轉子部的前側壁及后側壁較為集中,并同時向內、外側骨皮質及轉子間區(qū)擴散(三、四部分骨折)髖關節(jié)內收內旋同時梨狀肌、臀中肌、髂腰肌劇烈收縮時,應力在大轉子、小轉子及轉子部的前側壁及后側壁較為集中,并同時向內、外側骨皮質及轉子間區(qū)擴散(五、六部分骨折)。結論:股骨轉子間六部分分型符合人摔倒時轉子部所受的復雜應力情況,結合CT三維重建,較以往的分型更加直觀,并對不同分型的手術方式給出建議。
[Abstract]:Objective: to establish a three dimensional finite element model of the upper femur, to explore the mechanism of the six parts of the femoral trochanter, and to give some suggestions for different types of operation. Methods: the proximal left femur of a 60-year-old male volunteer was scanned with 64-slice spiral CT. The images were saved in jpg format, and the 3D model was constructed with Photoshop 7.0 software. Three-dimensional finite element model of proximal femur was established by using Super 93 software. The 3D images were divided into 764 nodes and 531 units (306 dense bones and 225 cancellous bones). The model was used to simulate the stress distribution of hip joint adductor, abductor, adductor, abductor and hip adductor, piriformis and iliopsoas muscles during fall. Results: the stress was mainly distributed in the lateral cortex and spread to the intertrochanteric region when the hip was adducted. The stress was mainly distributed in the medial cortex and spread to the intertrochanteric region (two parts of fracture). In the adductive rotation or outreaching of the hip joint, the stress was concentrated in the anterior and posterior walls of the greater trochanter and the trochanter, and diffused simultaneously to the medial, lateral cortex and intertrochanteric region. The stress was concentrated in the anterior and posterior walls of the greater trochanter, the small trochanter and the trochanter when the adductor and piriformis muscles, gluteus medius muscle and iliopsoas muscle of the hip joint contracted violently. Diffusion of lateral cortex and intertrochanteric area (5, 6 parts of fracture). Conclusion: the classification of six parts of femoral trochanter accords with the complex stress of the trochanter when the human falls. Combined with CT 3D reconstruction, the classification is more intuitive than the previous classification, and some suggestions for different types of operation are given.
【學位授予單位】：遵義醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R687.3
[Abstract]:Objective: to establish a three dimensional finite element model of the upper femur, to explore the mechanism of the six parts of the femoral trochanter, and to give some suggestions for different types of operation. Methods: the proximal left femur of a 60-year-old male volunteer was scanned with 64-slice spiral CT. The images were saved in jpg format, and the 3D model was constructed with Photoshop 7.0 software. Three-dimensional finite element model of proximal femur was established by using Super 93 software. The 3D images were divided into 764 nodes and 531 units (306 dense bones and 225 cancellous bones). The model was used to simulate the stress distribution of hip joint adductor, abductor, adductor, abductor and hip adductor, piriformis and iliopsoas muscles during fall. Results: the stress was mainly distributed in the lateral cortex and spread to the intertrochanteric region when the hip was adducted. The stress was mainly distributed in the medial cortex and spread to the intertrochanteric region (two parts of fracture). In the adductive rotation or outreaching of the hip joint, the stress was concentrated in the anterior and posterior walls of the greater trochanter and the trochanter, and diffused simultaneously to the medial, lateral cortex and intertrochanteric region. The stress was concentrated in the anterior and posterior walls of the greater trochanter, the small trochanter and the trochanter when the adductor and piriformis muscles, gluteus medius muscle and iliopsoas muscle of the hip joint contracted violently. Diffusion of lateral cortex and intertrochanteric area (5, 6 parts of fracture). Conclusion: the classification of six parts of femoral trochanter accords with the complex stress of the trochanter when the human falls. Combined with CT 3D reconstruction, the classification is more intuitive than the previous classification, and some suggestions for different types of operation are given.
【學位授予單位】：遵義醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R687.3
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