空心钉与锁定钢板治疗股骨颈骨折的振动特性研究
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1.上海理工大学 医疗器械与食品学院;2.上海交通大学附属第六人民医院 骨科

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Research on vibration characteristics of hollow screws and locking plates in the treatment of femoral neck fractures
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    摘要:

    目的:明确股骨颈骨折术后植入空心钉及钢板后,髋关节的固有/约束模态对内固定的影响。方法:通过采集一名发生股骨颈骨折患者的CT图像数据进行分析,提取髋关节的边界生成髋关节的三维模型,并建立常用内固定模型与髋关节模型装配,进行有限元仿真,重点分析振动特性。结果:振动对于空心钉/钢板的内固定稳定性有一定影响,扭转的发生将破坏空心钉/钢板的固定环境,在骨折断端产生微小位移;在约束的状态下,模态频率范围较低,振型的变形多发生在股骨头近端处,导致内固定以及假体发生松动的现象。从振动特性的角度提出了一种评判内固定稳定性的方法,发现空心钉内固定的稳定性优于近端锁定钢板。结论:本文认为在内固定的选用上需要考虑螺钉/钢板固有频率的影响,避免与股骨的固有频率相近,导致谐振的产生。本文的结论对于指导内固定材料的选用和结构、排列的设计有一定借鉴作用。

    Abstract:

    Objective: To clarify the influence of the natural/constrained modal of the hip joint on internal fixation after the implantation of hollow screws and locking plates after femoral neck fractures. Method: Analyze the CT image data of a patient with femoral neck fracture, extract the boundary of the hip joint to generate a three-dimensional model of the hip joint, and establish the assembly of common internal fixation models and hip joint models. Perform finite element simulation, and then focus on vibration analysis characteristic. Results: Vibration has a certain effect on the internal fixation stability of the hollow screw/locking plate. The occurrence of torsion will destroy the fixation environment of the hollow screw/locking plate, resulting in a small displacement at the fracture end. In a constrained state, the modal frequency range is lower. The deformation of the vibration shape mostly occurs at the proximal end of the femoral head, leading to the phenomenon of internal fixation and loosening of the prosthesis. A method for judging the stability of internal fixation was proposed from the perspective of vibration characteristics, and it was found that the stability of internal fixation with hollow nails was better than that of proximal locking plates. Conclusion: It is believing that the choice of internal fixation needs to consider the influence of the natural frequency of the screw/plate to avoid the natural frequency of the femur, which may cause resonance. The conclusion of this article can be used as a reference for the selection of internal fixation materials and the design of structure and configuration.

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  • 收稿日期:2021-03-04
  • 最后修改日期:2021-04-07
  • 录用日期:2021-04-13
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