三角股骨近端髓内钉固定不稳定型股骨转子间骨折的有限元分析.doc

三角股骨近端髓内钉固定不稳定型股骨转子间骨折的有限元分析 虎群盛1，姜自伟2，黄 枫2(1广州中医药大学第一临床医学院，广东省广州市 510405；2广州中医药大学第一附属医院创伤骨科，广东省广州市 510405) 引用本文：虎群盛，姜自伟，黄枫. 三角股骨近端髓内钉固定不稳定型股骨转子间骨折的有限元分析[J].中国组织工程研究，2016，20(48):7219-7224. DOI: 10.3969/j.issn.2095-4344.2016.48.011 ORCID: 0000-0001-5277-6757(姜自伟) 文章快速阅读： 文题释义： 三角股骨近端髓内钉：已获国家发明专利(授权公告号：CN203763217U)，它是以辛迪斯公司的PFNA-为基础加以设计改进，由主钉、6.5 mm直径上端抗张力螺钉、10.5 mm直径螺旋刀片、4.9 mm直径远端锁定螺钉组成。距离螺旋刀片孔上缘1.6 cm处做一直径6.5 mm抗张力螺钉孔，螺钉孔的纵轴与主钉近端纵轴呈110°。其余参数与 PFNA-相同。 内固定应力分布：是衡量内固定方式优劣的一个标准，理想的内固定物应该使应力尽可能均匀的分布在内固定物上，而不应过度集中在某一部位。 Finite element analysis of unstable intertrochanteric fracture fixed with triangle proximal femoral nail Hu Qun-sheng1, Jiang Zi-wei2, Huang Feng2 (1the First Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China; 2Department of Traumatic Bone, First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China) Abstract BACKGROUND: Proximal femoral nail antirotation (PFNA) and Asian PFNA (PFNA-II) are the most common internal fixation methods in the treatment of intertrochanteric fractures. But stress concentration and failure of internal fixation are still inevitable. OBJECTIVE: To analyze the biomechanical behaviors of the unstable intertrochanteric fracture fixed with the new designed triangle proximal femoral nail and to testify its feasibility by compared with PFNA-II. METHODS: Three-dimensional finite element model of proximal femur was established by using CT data of femur. Then the Evans IV femoral intertrochanteric fracture was established, followed by fixed with triangle proximal femoral nail and PFNA-II, respectively. The stress distribution and biomechanical stability under the same load were compared between two nails. RESULTS AND CONCLUSION: (1) The stress concentration of the two nails was both located at the junction of the screw blade and the main nail. (2) The maximum stress of PFNA-II and proxima