中国组织工程研究

中国组织工程研究 ›› 2026, Vol. 30 ›› Issue (21): 5411-5420.doi: 10.12307/2026.757

• 骨与关节生物力学 bone and joint biomechanics • 上一篇    下一篇

基于疲劳寿命计算PauwelsⅢ型骨折两种内固定方式生物力学的有限元分析

曲爱丽1，余俊辉1，孙建斌2，叶  鹏2，安维军2   

  1. 1宁夏大学机械工程学院，宁夏回族自治区银川市  750021；2宁夏医科大学总医院，宁夏回族自治区银川市  750004
  • 接受日期:2025-06-30 出版日期:2026-07-28 发布日期:2026-03-04
  • 通讯作者: 安维军，主任医师，宁夏医科大学总医院创伤骨科，宁夏回族自治区银川市 750004
  • 作者简介:曲爱丽，女，1974年生，宁夏回族自治区银川市人，汉族，2020年上海交通大学毕业，博士，副教授，主要从事生物力学方面的研究。
  • 基金资助:
    宁夏自然科学基金(2020AAC03419)，项目负责人：安维军；宁夏自然科学基金(2023AAC03083)，项目负责人：曲爱丽

Finite element analysis of biomechanics of two internal fixation methods for Pauwels type III fractures based on fatigue life calculation

Qu Aili1, Yu Junhui1, Sun Jianbin2, Ye Peng2, An Weijun2   

  1. 1School of Mechanical Engineering, Ningxia University, Yinchuan 750021, Ningxia Hui Autonomous Region, China; 2General Hospital of Ningxia Medical University, Yinchuan 750004, Ningxia Hui Autonomous Region, China
  • Accepted:2025-06-30 Online:2026-07-28 Published:2026-03-04
  • Contact: An Weijun, Chief physician, General Hospital of Ningxia Medical University, Yinchuan 750004, Ningxia Hui Autonomous Region, China
  • About author:Qu Aili, MD, Associate professor, School of Mechanical Engineering, Ningxia University, Yinchuan 750021, Ningxia Hui Autonomous Region, China
  • Supported by:
    Ningxia Natural Science Foundation, No. 2020AAC03419 (to AWJ); Ningxia Natural Science Foundation, No. 2023AAC03083 (to QAL)

PDF

10

摘要：


文题释义：

疲劳寿命：材料或结构在重复载荷作用下发生断裂破坏的循环次数。
Pauwels Ⅲ型股骨颈骨折：冠状面内骨折线与髋臼上缘之间的夹角大于50°，也称垂直不稳定型股骨颈骨折。

摘要
背景：对于无法进行闭合复位的 Pauwels Ⅲ型股骨颈骨折患者，传统的倒三角空心钉内固定方法无法有效地对抗较大剪切力。为了解决这一问题，此次研究个性化设计了一种内支持钢板，并将其与倒三角空心钉内固定方案联合使用，以提高治疗效果。
目的：在步态载荷作用下，针对 Pauwels Ⅲ型股骨颈骨折“倒三角”排列3钉、“倒三角”排列3钉结合内侧支持板两种内固定方式，通过有限元计算方法比较生物力学表现。
方法：根据CT扫描数据，首先使用Mimics软件进行逆向建模，生成股骨的点云模型。随后，利用Geomagic软件对模型进行精细化处理，优化其几何结构并确保模型的准确性。最后，将处理后的模型导入NX软件建立Pauwels角为70°的股骨颈骨折模型，基于Ansys软件计算步态载荷下“倒三角”排列3钉全螺纹、无螺纹模型、“倒三角”排列3钉+个性化内支持板(全螺纹、无螺纹)模型的力学、疲劳寿命结果。
结果与结论：①在步态载荷作用下，引入内支持板与单独3钉固定方式相比，股骨平均应力减小，其中断端和残端应力分别下降6.6 MPa和11.0 MPa，位移分别下降0.24 mm和0.12 mm，且骨折面相对移位减小；②内固定方式降低了骨系统的疲劳寿命，加入内支持板后，疲劳寿命降低更多；③提示有限元分析对螺纹参数较为敏感，因此在模型构建时应考虑螺钉的螺纹类型及特征；与仅采用螺纹3钉固定方案相比，加入内支持板的固定方式会降低应力和变形水平，能提供更稳定的骨愈合力学环境；从疲劳寿命看，内固定方法降低了股骨系统寿命，且内植物数量越多，寿命越低，加入了内支持板后的固定方案疲劳寿命最低；④说明临床在设计固定方案时应充分考虑植入物对远期愈合效果的影响，内植物的数量与固定方式应综合考量。


中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

关键词: 股骨颈骨折, 有限元, 疲劳寿命, 倒三角空心钉内固定, 内支持钢板, 生物力学

Abstract: BACKGROUND: In patients with Pauwels type III femoral neck fracture who are unable to undergo closed reduction, the traditional cannulated compression screw internal fixation method cannot effectively counteract the large shear force. To solve this problem, this study personalized an internally supported plate and used it in conjunction with the cannulated compression screw internal fixation protocol to improve treatment outcomes.
OBJECTIVE: To compare the biomechanical performance of two internal fixation methods for Pauwels type III femoral neck fractures under gait loading: an "inverted triangle" arrangement of three screws and an "inverted triangle" arrangement of three screws combined with a medial support plate by finite element calculation.
METHODS: Based on the CT scan data, inverse modeling was first performed using Mimics software to generate a point cloud model of the femur. Subsequently, the model was refined using Geomagic software to optimize its geometry and ensure the accuracy of the model. Finally, the processed model was imported into NX software to establish a femoral neck fracture model with a Pauwels angle of 70°. The mechanical and fatigue life results of the 3-nail [fully threaded (model 1), unthreaded (model 2)] model, 3-nail + personalized internal support plate [fully threaded (model 3), unthreaded (model 4)] model were computed based on the Ansys software for the gait loading.
RESULTS AND CONCLUSION: (1) Under gait loading, the introduction of an internal support plate reduced the mean femoral stress compared with the 3-nail fixation approach, including a decrease in fracture and stump stresses of 6.6 MPa and 11.0 MPa, respectively; a decrease in displacement of 0.24 mm and 0.12 mm, respectively, and a decrease in relative displacement of the fracture surface. (2) The internal fixation method reduced the fatigue life of the bone system, and the life was reduced even more with the addition of the internal support plate. (3) It is concluded that finite element analysis is more sensitive to thread parameters, so the thread type and characteristics of the screws should be considered in model construction. The fixation method with the addition of an internal support plate reduces the level of stress and deformation and provides a more stable mechanical environment for bone healing compared with the threaded triple-nail fixation scheme only. In terms of fatigue life, the internal fixation method reduces the life span of the femoral system, and the higher the number of internal implants, the lower the life span, and the incorporation of the internal support plate resulted in the lowest longevity of the fixation scheme. (4) This suggests that the impact of implants on long-term healing should be fully considered when designing the fixation program, and the number of implants and fixation methods should be taken into account.

Key words: femoral neck fracture, finite element, fatigue life, inverted triangular cannulated compression screw internal fixation, internal support plate, biomechanics

中图分类号: