FINITE ELEMENT ANALYSIS OF FEMORAL INTRAMEDULLARY NAIL INSERTION

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 髓内钉通常用于提供骨折固定。在股骨，顺行髓内钉通过近端的入口孔被插入。进入孔的位置通常是梨状窝或大转子尖端。尽管梨状窝与髓管排列得更紧密，但术中更容易定位大转子。这一手术的一个已知并发症是股骨医源性骨折，一些研究表明，这取决于入口孔的位置。这项研究的目的是显示当髓内钉插入时股骨内的应力是如何发展的，以及不同进钉孔位置的应力是如何变化的。在我们到目前为止的工作中(由TeraGrid资助号MCB060034T支持)，我们已经成功地比较了标准股骨实体模型中入口孔之间的应力。为了解释人体股骨的巨大解剖差异，该项目的下一阶段将研究从医学成像数据获得的实际人体股骨模型中的钉子插入。将使用对下肢的CT扫描来创建有限元模型，从该有限元模型可以虚拟地插入髓内钉。这项研究的结果将显示，股骨的哪些形态特征会影响植入过程中的应力，以及这些形态特征如何与外科医生选择的入口孔相互作用。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Intramedullary nails are commonly used to provide fracture fixation. In the femur, antegrade intramedullary nails are inserted through a proximal entry hole. The location of the entry hole is typically either the piriformis fossa or the tip of the greater trochanter. Although the piriformis fossa is aligned more closely with the medullary canal, the greater trochanter is easier to locate intraoperatively. A known complication of this procedure is iatrogenic fracture of the femur, which some studies have shown depends on the entry hole location. It is the goal of this study to show how the stresses in the femur develop as the intramedullary nail is inserted, and how the stresses vary between entry hole locations. In our work to date (supported by Teragrid Grant Number MCB060034T), we have successfully compared the stresses between entry holes in a standardized solid model of the femur. To account for the considerable anatomic variation in human femurs, the next phase of this project will study the nail insertion in models of actual human femurs obtained from medical imaging data. CT scans of the lower extremity will be used to create finite element models from which intramedullary nails may be virtually inserted. The results of this study will show which, if any, morphological features of the femur impact the stress during insertion, and how these morphological features interact with a surgeon's choice of entry hole.