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背景：对于良性骨病变患者，经过外科手术治疗后通常可获得良好的生存周期，通过不断对手术方式进行改进，利用有限元分析技术研究良性骨病变术后股骨近端受力情况，预测并降低术后病理骨折、二次骨折风险，探讨最佳术式与预后，对延长并改善患者生活质量存在重要意义。

目的：利用三维有限元技术对股骨近端良性病变的不同术式模型进行受力分析，比较不同术式模型差异性并验证钢板置入内固定的合理性与有效性，并针对术后患者随访验证有限元模型的可靠性。

方法：对符合纳入标准的10 例股骨近端良性病变患者行术前CT 检查，采用MIMICS 分别建立患肢刮除术后(A)、空腔内置钉再灌注骨水泥(B)与空腔内灌注骨水泥联合钢板螺钉内固定(C)3 种模型，在模拟条件下测量出3 种骨皮质模型开窗部位前侧、后侧的最大应力数值并进行对比。所有患者对试验方案均知情同意，且得到医院伦理委员会批准。

结果与结论：①3 组模型中骨皮质开窗部前侧、后侧最大应力数值比较结果为A＞B＞C，两两比较，差异有显著性意义(P＜ 0.05)，说明A 组骨折风险高，B 组部分模型骨折风险较高，C 组应力均可控制在合理范围内，骨折风险低；②因此10 名受试者均采用C 种术式进行治疗，术后随访复查预后良好，未出现二次骨折；术后1年国际骨与软组织肿瘤协会评分为27-30 分；③提示股骨模型皮质开窗后易出现局部应力数值增高现象，在添加骨水泥与钢板后，模型开窗处应力数值显著降低。股骨近端良性病变刮除后，通过置入骨水泥与钢板，可有效降低开窗部位的应力，手术部位发生骨折概率明显降低，说明钢板置入具有合理性。

BACKGROUND:For the patients with benign osteopathy, the patients usually get a good life cycle after surgical treatment. Through continuous improvement of the operation mode, the stress of the proximal femur after the operation of benign osteopathy is studied by using the finite element analysis. The risk of pathological fracture and secondary fracture is predicted and reduced. To explore the best operation and prognosis is of great significance for prolonging and improving the quality of life of patients.

文章来源：《肿瘤药学》 网址: http://www.zlyxzz.cn/qikandaodu/2020/0813/439.html