本文選題：股骨近端　切入點(diǎn)：骨干組配式假體　出處：《天津醫(yī)科大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：(1)利用三維建模軟件分別建立正常成人股骨模型和與之匹配的股骨近段骨干組配式假體模型；(2)便于研究分析,設(shè)立對照組、短釘組(假體輔助側(cè)方鋼板聯(lián)合3枚單皮質(zhì)骨螺釘)、長釘組(假體輔助側(cè)方鋼板聯(lián)合1枚經(jīng)頸螺釘和2枚單皮質(zhì)骨螺釘)和三釘組(假體輔助側(cè)方鋼板聯(lián)合3枚經(jīng)頸螺釘和2枚單皮質(zhì)骨螺釘)模型。3、在四組模型中,通過3D有限元分析方法橫向研究比較對照組、短釘組、長釘組和三釘組中整體、假體、鋼板、螺釘?shù)膽?yīng)力分布；在橫向研究的基礎(chǔ)上設(shè)立縱向研究,即在對照組中固定遠(yuǎn)端柄長為8cm,分別設(shè)置近端柄長為1cm、2cm、3cm、4cm、5cm,觀察整體、股骨、假體的應(yīng)力分布。 方法：(1)選擇1例(40歲,70KG)健康男性影像學(xué)數(shù)據(jù),將CT掃描數(shù)據(jù)導(dǎo)入Mimics10.0軟件進(jìn)行股骨初步三維重建,并以STL格式文件導(dǎo)出初步模型。將初步模型導(dǎo)入Geomagic Studio10.0軟件再次完善,建立完整全股骨模型,以IGES格式保存。將完整模型導(dǎo)入ANSYS12.0有限元分析軟件,并在該軟件中建立股骨近端骨缺損模型和與之匹配的股骨近段骨干組配式假體簡化模型。(2)在模型中,利用ANSYS12.0有限元分析軟件模擬正常人行走周期中股骨承受的應(yīng)力峰值,對模型施加相同的載荷和邊界條件。通過分析計算,最終獲得整體、假體、螺釘和股骨的應(yīng)力分布。觀進(jìn)一步察并記錄目標(biāo)的Von Mises應(yīng)力、Z軸應(yīng)力和剪切應(yīng)力數(shù)據(jù)。 結(jié)果：(1)股骨近端骨干組配式假體適用于股骨骨干近端100mm以內(nèi)的區(qū)域。(2)本次實(shí)驗(yàn)通過有限元分析認(rèn)為：縱向觀察時固定遠(yuǎn)端柄長為8cm時,改變近端柄長長度對整體、假體及骨自身的應(yīng)力、應(yīng)變并無明顯影響,應(yīng)力主要集中在遠(yuǎn)端柄體的內(nèi)、外兩側(cè)；(3)本次實(shí)驗(yàn)通過有限元分析發(fā)現(xiàn)橫向觀察時按對照組、短釘組、長釘組和三釘組的觀察次序,在包括壓應(yīng)力、拉應(yīng)力、剪切應(yīng)力的應(yīng)力分析中,整體的應(yīng)力逐漸減小,假體的應(yīng)力略微增加,螺釘?shù)膽?yīng)力增加,骨體的應(yīng)力逐漸減少。三釘組的穩(wěn)定性要優(yōu)于長釘組,長釘組的優(yōu)于短釘組,短釘組的優(yōu)于對照組。 結(jié)論：(1)股骨近端骨干組配式假體適用于股骨骨干近端100mm以內(nèi)的區(qū)域。股骨近段骨干組配式假體重建股骨近端骨缺損后符合股骨生物力學(xué)特點(diǎn),能夠恢復(fù)了股骨完整性和應(yīng)力傳導(dǎo)。(2)本次實(shí)驗(yàn)通過有限元分析認(rèn)為：縱向觀察時固定遠(yuǎn)端柄長為8cm時,改變近端柄長長度對整體、假體及骨自身的應(yīng)力、應(yīng)變并無明顯影響,應(yīng)力主要集中在遠(yuǎn)端柄體的內(nèi)外兩側(cè)；在殘余髓腔長度允許的范圍內(nèi),盡量使用長且粗的遠(yuǎn)端柄體以提高固定穩(wěn)定性。(3)本次實(shí)驗(yàn)通過有限元分析發(fā)現(xiàn)橫向觀察時按對照組、短釘組、長釘組和三釘組的觀察次序,在包括壓應(yīng)力、拉應(yīng)力、剪切應(yīng)力的應(yīng)力分析中,整體的應(yīng)力逐漸減小,假體的應(yīng)力略微增加,螺釘?shù)膽?yīng)力明顯增加,骨體的應(yīng)力逐漸減少。即三釘組的穩(wěn)定性優(yōu)于長釘組,長釘組的優(yōu)于短釘組,短釘組的優(yōu)于對照組。因此,在重建近端骨缺損時應(yīng)盡量使用經(jīng)頸長釘來固定。
[Abstract]:Objective: (1) using three-dimensional modeling software was used to build model and normal adult femur, proximal femoral shaft matched prosthesis model; (2) analysis for the establishment of the control group, the short nail group (prosthesis assisted lateral plate combined with 3 pieces of unicortical screws), long nail group (auxiliary prosthesis the 1 lateral plate combined with neck screws and 2 pieces of unicortical screws) and three nail group (3 prosthesis aided lateral plate combined with neck screws and 2 pieces of unicortical screws) model.3 in the four groups in the model, through the transverse study of 3D finite element analysis method compared to the control group, the short nail group, long nail group and three in the whole nail group, prosthesis, plate, screw stress distribution; set up a longitudinal study based on transverse research, namely in the control group in the distal fixed length 8cm were set up to handle, proximal length is 1cm, 2cm, 3cm, 4cm, 5cm, observe the whole body. The stress distribution of femur prosthesis.
Methods: (1) 1 cases (40, 70KG) healthy male imaging data, CT scan data into Mimics10.0 software preliminary femoral 3D reconstruction, and to export STL format. The initial model will initially model into Geomagic Studio10.0 software again perfect, establish a complete model of the femur, in IGES format. The complete model into ANSYS12.0 finite element analysis software, and set up in the software in the proximal femoral bone defect model and matching with the proximal femoral shaft group with implants (2) simplified model. In the model, using ANSYS12.0 finite element analysis software to simulate the normal walking stress peak femur bear cycle. The applied load and the same boundary conditions of the model. Through analysis and calculation, finally get the whole prosthesis, the stress distribution of femur and screw. Observe and record the target concept further Von Mises Z stress, axial stress and shear stress Force data.
Results: (1) the proximal femoral shaft matched prosthesis for proximal femoral shaft within 100mm region. (2) this experiment through finite element analysis shows that the longitudinal observation of fixed distal stem length is 8cm, change the proximal length of the overall stress of prosthesis and bone itself. There was no significant effect of strain, stress mainly concentrated in the distal end of a handle body, on both sides; (3) the experiment through the finite element analysis show that transverse observation in control group, short nail group, long nail group and three nail group in order to observe, including compressive stress, tensile stress, shear stress the stress analysis, the overall stress decreases, the stress increased slightly prosthesis, increase the stress of the screw, the stress of the bone body gradually reduced. The stability of three nail group than the long nail group, long nail group than short nail group, short nail group than the control group.
Conclusion: (1) the proximal femoral shaft matched prosthesis for proximal femoral shaft within 100mm region. Biomechanical characteristics with proximal femoral shaft matched prosthesis bone defect of proximal femur, femoral can restore the integrity and stress transmission. (2) the experiment by Co. yuan analysis shows that the longitudinal observation of fixed distal long handle is 8cm, change the proximal length of the prosthesis and the bone stress, the strain is not significantly affected, the stress mainly concentrated in the distal end of a handle body on both sides; in the residual pulp cavity length allowed range, try to use the distal shank long and thick to improve the fixation stability. (3) this experiment through finite element analysis show that transverse observation in control group, short nail group, long nail group and three nail group in order to observe, including compressive stress, tensile stress, stress and shear stress of the whole. Should be Force decreases, the stress increased slightly prosthesis, the stress of screw was significantly increased, the stress of the bone body gradually reduced. The stability is better than three nail group long nail group and long nail group than short nail group, short nail group than the control group. Therefore, in the reconstruction of bone defect of proximal should be try to make the long neck nail.

【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R318.17

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本文編號：1628155