中文摘要：

目的：应用三维有限元分析法比较松质骨粒和结构性松质骨块植骨重建股骨头负重区缺损对股骨近段应力分布的影响。方法：实验于2005-06／2006-03在解放军总医院骨科研究所完成。采用Taddei的基于连续CT断层构建的人股骨三维有限元模型，在ANS、佑5-7分析软件中划分52350个四面体单元．模拟单腿站立时髋臼在股骨头表面负重区施加的面载荷．合力指向股骨头形心，与股骨干长轴的夹角成25。，大小2100N．分别在正常状态时、股骨头负重区缺损时及原位松质骨植人、异位松质骨植人和松质骨粒植人时计算股骨近段的应力分布。结果：①正常股骨近段的应力峰值集中在股骨颈上下方．股骨头表面的应力峰值为2．12MPa．深部应力高于表面应力峰值为6．37MPa。②负重区缺损模型下，股骨头表面应力增高．峰值达10．39MPa，股骨头内部应力低于表面。⑧在松质骨粒植入后．表面应力有所下降，但仍然高于内部．应力峰值达8．55MPa。④异位结构性松质骨植人后表面应力峰值为2．43MPa．与正常时差别不大；而原位松质骨块植人后的应力曲线几乎与正常应力曲线重合。结论：结构性松质骨块的植入对恢复股骨头表面及内部的应力水平要优于松质骨粒。

英文摘要：

AIM：To compare the effects of cancellous bone granules and structural bone graft in the reconstruction of at femoral head＇s defect on proximal stress distribution of femoral bone with three-dimensional finite element analysis method. METHODS：The expedment was performed at the Institute of Orthopaedics, General Hospital of Chinese PLA from June 2005 to March 2006. The throe-dimensional finite element model that was constructed from CT image was provided by Taddei and analyzed using ANSYS5.7. The model was divided into 52 350 tetrahedron elements. To simulate the single-leg stance stage, a distribution load was applied on the femoral head. The resultant force was 2 100 N in amplitude and pointed to the center of the femoral head and applied at 25° to the long axis of the femur shaft. The proximal femur stress distnbution was analyzed at the intact status, femoral head＇s defect model, bone graft in situ, heterotopic bone graft and cancellous bone granules impaction, respectively. RESULTS： ①At intact model, the peak value of stress was centralized at the upper and lower part of the femoral neck. The maximum stress of the surface of the femoral head was 2,12 MPa. The maximum stress of the deep part of the femoral head was 6.37 MPa. ②At femoral head＇s defect model, the surface stress was increased and reached 10.39 MPa. Whereas the stress of the deep part was lower than that of the surface. ③After the cancellous bone granules implanted, the surface stress was decreased to some extent, but still higher than the deep part and the maximum stress in the surface was 8.55 MPa. ④After the heterotopic bone graft, the maximum stress of the surface was 2.43 MPa and there was little difference compared with the intact femur. After the bone graft in situ, the stress curve was almost coincided with that of the intact femur. CONCLUSION; At the point of stress level recovery of the surface and internal femoral head, the structural bone graft is better than the cancellous bone granule implant.