Computer Methods and Programs in Biomedicine ( IF 4.9 ) Pub Date : 2020-05-06 , DOI: 10.1016/j.cmpb.2020.105491 Matthew Jian-Qiao Peng 1 , HongWen Xu 2 , Hai-Yan Chen 3 , Ze Lin 1 , XinXu Li 4 , ChuLong Shen 5 , YongQiang Lau 5 , ErXing He 1 , YueMing Guo 5
|
Background and objectives
There are many fixation methods for Pauwels- III fracture, the most common implants are Locking Plate (LP), Dynamic Hip Screw (DHS), Multiple Lag Screw (MLS), and mixed fixture (DHS+MLS) implants, the common procedure is HemiArthroplasty (HA). However, how these fixtures biomechanically function is not clear. The aims of this study are to compare the mechanical behaviors of these five implants by finite element modeling and determinate the most suitable procedure for individuals with Pauwels- III fractures.
Methods
We gathered 20 sets of femur images from CT scans in the *.dicom format first, and then processed them by using reverse engineering software programs, such as Mimics, Geomagic Studio, UG-8, Pro-Engineer and HyperMesh. Finally, we assembled and analyzed the five types of fixture models, the LP, DHS, MLS, DHS+LS and HA models, by AnSys.
Results
These numerical models of Pauwels III fractures, including fixators and a simulative HA, were validated by a previous study and a cadaver test. Our analytical findings include the following: the displacements of all fixtures were between 0.3801 and 1.0834 mm, and the differences were not statistically significantly different; the resulting average peaks in stress were e(Ha) = 43.859 ≤ d(LP) = 60.435 ≤ b(MLS) = 68.678 < c(LS+DHS) = 98.478 < a(DHS) = 248.595 in Mpa, indicating that the stress of DHS and DHS+LS are greater than those of LP, HA and MLS, while the last 3 models were not significantly different.
Conclusions
To optimize the treatment for Pauwels III factures clinically, HA and LP should be proposed.
中文翻译：
通过有限元建模对五种Pauwels-III骨折固定技术的生物力学分析。
背景和目标
Pauwels-III骨折的固定方法很多，最常见的植入物是锁定板（LP），动力髋螺钉（DHS），多颗滞后螺钉（MLS）和混合固定物（DHS + MLS）植入物，常见的手术方法是半髋关节置换术（HA）。但是，这些固定装置的生物力学功能如何尚不清楚。这项研究的目的是通过有限元建模比较这五种植入物的力学行为，并确定最适合Pauwels-III骨折患者的手术方法。
方法
我们首先以* .dicom格式从CT扫描中收集了20组股骨图像，然后使用Mimics，Geomagic Studio，UG-8，Pro-Engineer和HyperMesh等反向工程软件程序对其进行了处理。最后，我们通过AnSys组装并分析了五种夹具模型，即LP，DHS，MLS，DHS + LS和HA模型。
结果
这些Pauwels III骨折的数值模型，包括固定器和模拟HA，已通过先前的研究和尸体测试得到了验证。我们的分析结果包括：所有夹具的位移在0.3801和1.0834 mm之间，并且差异在统计学上没有显着差异。得到的平均应力峰值为Mpa的e（Ha）= 43.859≤d（LP）= 60.435≤b（MLS）= 68.678 <c（LS + DHS）= 98.478 <a（DHS）= 248.595 DHS和DHS + LS的特征值大于LP，HA和MLS的特征值，而后3个模型没有显着差异。
结论
为了在临床上优化对Pauwels III骨折的治疗，应提出HA和LP。
京公网安备 11010802027423号