【摘要】：目的:通過有限元分析比較目前治療股骨轉子間A3型骨折常用的兩種內固定系統(tǒng):PFNA和Inter Tan的生物力學穩(wěn)定性,為臨床應用提供理論依據。方法:分別建立AO3.1、3.2、3.3型股骨轉子間骨折及兩種內固定的三維有限元模型,按骨科要求予以固定,研究不同模型股骨、內固定的應力分布,比較股骨及內固定模型不同區(qū)域的應力峰值,分析生物力學穩(wěn)定性。結果:AO3.1型骨折PFNA組股骨側應力集中在股骨近端外側,Inter Tan組股骨側應力集中在股骨近端內側;AO3.2型骨折兩種內固定系統(tǒng)股骨側各個區(qū)域均無明顯應力集中;AO3.3型骨折PFNA組股骨側應力集中在股骨近端內側及內固定遠端內側,Inter Tan組股骨側無明顯應力集中。六種模型內固定遠端應力均集中在內側,其中PFNA組應力大于Inter Tan組;內固定遠端內外側應力差值PFNA組大于Inter Tan組;除PFNA固定AO3.3型骨折外,其余五種模型應力峰值均位于頭釘與主釘交叉處內側。結論:AO3.1和AO3.3型骨折中,InterTan比PFNA具有更好的穩(wěn)定性,AO3.2型骨折中,二者穩(wěn)定性無明顯差異;運用Inter Tan固定A3型股骨轉子間骨折時應力分布較PFNA更加合理。
[Abstract]:Objective: to compare the biomechanical stability of two kinds of internal fixation systems: PFNA and Inter Tan, which are commonly used in the treatment of intertrochanteric A3 fracture by finite element analysis, so as to provide theoretical basis for clinical application. Methods: three dimensional finite element models of AO3.1,3.2,3.3 type intertrochanteric fracture and two kinds of internal fixation were established and fixed according to the requirements of orthopedic department. The stress distribution of different models of femur and internal fixation were studied. Stress peaks in different regions of femur and internal fixation model were compared and biomechanical stability was analyzed. Results: the stress concentration of femoral side in PFNA group of AO3.1 type fracture was concentrated on the proximal side of femur in, Inter Tan group, and there was no obvious stress concentration in each region of femur side in both internal fixation system of AO3.2 type fracture. There was no significant stress concentration on the femoral side in the PFNA group with AO3.3 type fracture and the proximal femur and the distal medial femur fixation in the, Inter Tan group. The distal stress of the six internal fixation models was concentrated on the medial side, in which the stress in PFNA group was greater than that in Inter Tan group, and the stress difference between PFNA group and Inter Tan group was higher than that in Inter Tan group. With the exception of PFNA fixation of AO3.3 type fractures, the stress peaks of the other five models were located on the medial side of the cross between the head nail and the main nail. Conclusion: InterTan has better stability than PFNA in AO3.1 and AO3.3 fractures, but there is no significant difference between them in AO3.2 type fractures, and the stress distribution of A3 femoral intertrochanteric fractures fixed with Inter Tan is more reasonable than PFNA.
【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R687.3

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