Biomechanical study of cannulated screws internal fixation with different spatial distribution in the treatment of Pauwels Ⅱ femoral neck fractures

XIAO Wei; ZHU Hao-ran; ZHANG Lei

doi:10.11659/jjssx.11E024141

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Biomechanical study of cannulated screws internal fixation with different spatial distribution in the treatment of Pauwels Ⅱ femoral neck fractures

Clinical Research | 更新时间：2025-09-24

- Biomechanical study of cannulated screws internal fixation with different spatial distribution in the treatment of Pauwels Ⅱ femoral neck fractures
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 34, Issue 9, Pages: 789-794(2025)
- 作者机构：
  
  1.陆军军医大学第一附属医院急救部，重庆 400038
  2.上海市浦东新区浦南医院急诊科，上海 200125
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.11E024141
  CLC： R683.42
- Received：26 November 2024，
  
  Published：25 September 2025
- 稿件说明：
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肖伟,朱浩然,张雷.不同空间分布空心钉内固定治疗股骨颈Pauwels Ⅱ型骨折的生物力学研究[J].局解手术学杂志,2025,34(09):789-794.

XIAO Wei,ZHU Hao-ran,ZHANG Lei.Biomechanical study of cannulated screws internal fixation with different spatial distribution in the treatment of Pauwels Ⅱ femoral neck fractures[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(09):789-794.
肖伟,朱浩然,张雷.不同空间分布空心钉内固定治疗股骨颈Pauwels Ⅱ型骨折的生物力学研究[J].局解手术学杂志,2025,34(09):789-794. DOI： 10.11659/jjssx.11E024141.

XIAO Wei,ZHU Hao-ran,ZHANG Lei.Biomechanical study of cannulated screws internal fixation with different spatial distribution in the treatment of Pauwels Ⅱ femoral neck fractures[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(09):789-794. DOI： 10.11659/jjssx.11E024141.

摘要

目的

利用有限元方法分析股骨颈PauwelsⅡ型骨折治疗中不同空间分布的空心钉内固定模型的生物力学性能。

方法

选择1名健康男性志愿者作为研究对象，采用128层螺旋CT对其进行股骨头至股骨远端薄层扫描，初步构建股骨的三维网格模型，并通过后续处理获得符合人体解剖学特征的空心钉内固定模型。以股骨干中心线为基准绘制水平线，设定骨折线位于股骨颈中心，且与水平线成50°角，构建股骨颈PauwelsⅡ型骨折模型。在SolidWorks 2021软件中，模拟设计5种不同空间分布的空心钉内固定模型，将装配模型导入Ansys 2021R1软件，建立有限元模型。对5种模型股骨及其内固定物的应力分布情况进行评估，并分析股骨颈骨折截面在X、Y、Z轴方向上的位移情况，以及股骨和内固定物的总体位移情况。

结果

5种模型的股骨近端应力集中于股骨颈骨折线的下方，其中倒等边三角形构型的应力峰值最小（19.179 MPa）。5种模型的内固定物总体应力均集中于股骨近端的腹侧空心钉中段区域，其中倒等边三角形构型的应力峰值最小（61.742 MPa）。5种模型的股骨颈骨折截面在X、Y轴方向上的最大位移均出现在截面的前上方区域，其中倒等边三角形构型的位移最小（X轴：0.446 54 mm、Y轴：0.704 21 mm）。5种模型股骨颈骨折截面在Z轴方向上的最大位移均出现在截面后上方，其中倒等边三角形构型的位移最小（0.225 62 mm）。5种模型的股骨近端总体位移均集中于股骨头应力加载区域，其中倒等边三角形构型的位移最小（0.721 16 mm）。5种模型内固定物最大位移均位于股骨颈上方靠近后壁固定的空心钉尖端，其中倒等边三角形构型的位移最小（0.686 83 mm）。

结论

在股骨颈PauwelsⅡ型骨折的5种不同空心钉内固定模型中，倒等边三角形构型的应力分散效果最佳，骨折断端位移最小，治疗股骨颈Pwuwels Ⅱ型骨折的生物力学稳定性最好。

Abstract

Objective

To analyze the biomechanical characteristics of cannulated screws internal fixation models with different spatial distribution in the treatment of PauwelsⅡ fracture of the femoral neck through finite element analysis.

Methods

One healthy male volunteer was selected as the research subject. A thin-layer scan from the femoral head to the distal femur of the volunteer was performed using 128-slice spiral CT to preliminarily construct a three-dimensional mesh model of the femur. Through subsequent processing， a cannulated screw internal fixation model conforming to human anatomical characteristics was obtained.A horizontal line was drawn based on the center line of the femoral shaft， and the fracture line was set at the center of the femoral neck with an angle of 50° to the horizontal line to construct the Pauwels Ⅱ femoral neck fracture model. Five kinds of cannulated screw internal fixation models with different spatial distribution were simulated and designed in SolidWorks 2021 software， and the assembly models were imported into Ansys 2021R1 software to establish the finite element model.The stress distribution of the femur and its internal fixator in the five models were evaluated， and the displacement of the femoral neck fracture cross-section in the X， Y， and Z directions， as well as the overall displacement of the femur and the internal fixator were analyzed.

Results

The stresses of the proximal femur of the five models concentrated below the femoral neck fracture line， and the stress peak of the inverted equilateral triangle configuration was the smallest （19.179 MPa）.The total stresses of the internal fixator in the five models all concentrated in the middle region of the ventral cannulated screw at the proximal femur， and the stress peak of the inverted equilateral triangle configuration was the lowest （61.742 MPa）.The maximum displacement of the femoral neck fracture cross-section in the X and Y directions of the five models all appeared in the anterior and upper regions of the cross-section， and the displacement of the inverted equilateral triangle configuration was the smallest （X axis： 0.446 54 mm， Y axis： 0.704 21 mm）.The maximum displacement of the femoral neck fracture cross-section in the Z direction of the five models all occurred in the posterior upper part of the cross-section， among which the displacement of the inverted equilateral triangle configuration was the smallest （0.225 62 mm）.The overall displacement of the proximal femur of the five models concentrated in the stress-loading area of the femoral head， and the displacement of the inverted equilateral triangle configuration was the smallest （0.721 16 mm）. The maximum displacement of the internal fixator of the five models located at the tip of the cannulated screw fixed at the top of the femoral neck near the posterior wall， and the displacement of the inverted equilateral triangle configuration was the smallest （0.686 83 mm）.

Conclusion

Among the five different cannulated screws internal fixation models for Pauwels Ⅱ femoral neck fractures， the inverted equilateral triangle configuration has the best stress dispersion effect， the smallest displacement of fracture end， and the best biomechanical stability.

关键词

Keywords

references

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