两种不同方式固定EvansⅢ型股骨粗隆间骨折稳定性的有限元分析

摘要

Objective To comparatively evaluate dynamic hip screw (DHS) and intramedullary nail by finite element analysis in Evans Ⅲ femoral intertrochanteric fracture fixation, to judge superiority of biomechanical stability in the two methods, and to provide theoretical reference for clinical application.Methods Finite element model was established by Evans Ⅲ femoral intertrochanteric fracture patients for simulation of loaded condition on one leg. Finite element calculation was made on the two difference fixation methods.Results DHS fixation had the similar tension resistance and anti-resistance with intramedullary nail, while it had obviously worse compressive resistance than intramedullary nail. DHS fixation had poor structure stability.Conclusion DHS fixation has worse structure stability than intramedullary nail. Thus it is recommended to apply intramedullary nail for fixation.%目的：通过有限元方法对EvansⅢ型股骨粗隆间骨折的动力髋螺钉(DHS)和髓内钉固定技术进行对比评价，判断何种技术生物力学更稳定，为临床应用提供理论依据。方法以EvansⅢ型股骨粗隆间骨折为研究对象建立有限元模型模拟单脚站立时的受载情况，对两种不同固定技术分别进行有限元计算。结果DHS系统固定，其抗张力性能和抗阻力与髓内钉组相当，而抗压力性能明显差于髓内钉组，其结构稳定性差。结论DHS系统固定时，其结构稳定性比髓内钉系统差，建议临床考虑使用髓内钉系统。