FINITE ELEMENT ANALYSIS OF FEMORAL INTRAMEDULLARY NAIL INSERTION

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 髓内钉通常用于提供骨折固定。在股骨中，通过近端入口孔插入顺行髓内钉。入孔的位置通常是梨状肌窝或大转子的尖端。虽然梨状肌窝与髓管对齐更紧密，但术中更容易定位大转子。这种手术的一个已知并发症是医源性股骨骨折，一些研究表明这取决于入孔位置。本研究的目的是显示在插入髓内钉时股骨中的应力是如何发展的，以及应力在入孔位置之间是如何变化的。在我们迄今为止的工作中（由Teragrid资助号MCB 060034 T支持），我们成功地比较了股骨标准化实体模型中入孔之间的应力。考虑到人类股骨的解剖变异性，该项目的下一阶段将研究从医学成像数据中获得的实际人类股骨模型中的髓内钉插入。下肢的CT扫描将用于创建有限元模型，髓内钉可以从该模型中虚拟插入。本研究的结果将显示股骨的哪些形态特征（如果有的话）会影响插入过程中的应力，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.