【摘要】：目的:建立股骨上段三維有限元模型,探討股骨轉(zhuǎn)子部六部分分型的產(chǎn)生機制,并對不同分型的手術(shù)方式給出建議。方法:應(yīng)用64層螺旋CT對1例60歲正常男性志愿者左側(cè)股骨近段進行掃描,所得圖像以.jpg格式保存,并導(dǎo)入Photoshop 7.0軟件進行三維模型繪制,將所得三維圖像運用Super 93軟件建立股骨近段三維有限元模型,劃分節(jié)點764個,單元531個(密質(zhì)骨306個、松質(zhì)骨225個)。運用該模型模擬人摔倒過程中髖關(guān)節(jié)內(nèi)收、外展、內(nèi)收內(nèi)旋、外展外旋及髖關(guān)節(jié)內(nèi)收內(nèi)旋同時臀中肌、梨狀肌、髂腰肌劇烈收縮狀況下轉(zhuǎn)子間的應(yīng)力分布情況。結(jié)果:單純髖關(guān)節(jié)內(nèi)收時,應(yīng)力主要分布于外側(cè)骨皮質(zhì)部并向轉(zhuǎn)子間區(qū)擴散(二部分骨折)。單純髖關(guān)節(jié)外展時,應(yīng)力主要分布于內(nèi)側(cè)骨皮質(zhì)部并向轉(zhuǎn)子間區(qū)擴散(二部分骨折)。髖關(guān)節(jié)內(nèi)收內(nèi)旋或外展外旋時,應(yīng)力均在大轉(zhuǎn)子及轉(zhuǎn)子部的前側(cè)壁及后側(cè)壁較為集中,并同時向內(nèi)、外側(cè)骨皮質(zhì)及轉(zhuǎn)子間區(qū)擴散(三、四部分骨折)髖關(guān)節(jié)內(nèi)收內(nèi)旋同時梨狀肌、臀中肌、髂腰肌劇烈收縮時,應(yīng)力在大轉(zhuǎn)子、小轉(zhuǎn)子及轉(zhuǎn)子部的前側(cè)壁及后側(cè)壁較為集中,并同時向內(nèi)、外側(cè)骨皮質(zhì)及轉(zhuǎn)子間區(qū)擴散(五、六部分骨折)。結(jié)論:股骨轉(zhuǎn)子間六部分分型符合人摔倒時轉(zhuǎn)子部所受的復(fù)雜應(yīng)力情況,結(jié)合CT三維重建,較以往的分型更加直觀,并對不同分型的手術(shù)方式給出建議。
[Abstract]:Objective: to establish a three dimensional finite element model of the upper femur, to explore the mechanism of the six parts of the femoral trochanter, and to give some suggestions for different types of operation. Methods: the proximal left femur of a 60-year-old male volunteer was scanned with 64-slice spiral CT. The images were saved in jpg format, and the 3D model was constructed with Photoshop 7.0 software. Three-dimensional finite element model of proximal femur was established by using Super 93 software. The 3D images were divided into 764 nodes and 531 units (306 dense bones and 225 cancellous bones). The model was used to simulate the stress distribution of hip joint adductor, abductor, adductor, abductor and hip adductor, piriformis and iliopsoas muscles during fall. Results: the stress was mainly distributed in the lateral cortex and spread to the intertrochanteric region when the hip was adducted. The stress was mainly distributed in the medial cortex and spread to the intertrochanteric region (two parts of fracture). In the adductive rotation or outreaching of the hip joint, the stress was concentrated in the anterior and posterior walls of the greater trochanter and the trochanter, and diffused simultaneously to the medial, lateral cortex and intertrochanteric region. The stress was concentrated in the anterior and posterior walls of the greater trochanter, the small trochanter and the trochanter when the adductor and piriformis muscles, gluteus medius muscle and iliopsoas muscle of the hip joint contracted violently. Diffusion of lateral cortex and intertrochanteric area (5, 6 parts of fracture). Conclusion: the classification of six parts of femoral trochanter accords with the complex stress of the trochanter when the human falls. Combined with CT 3D reconstruction, the classification is more intuitive than the previous classification, and some suggestions for different types of operation are given.
【學(xué)位授予單位】：遵義醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R687.3

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