文献类型：期刊文献

中文题名：有限元法在儿童发育性髋关节发育不良及治疗中的作用

英文题名：Effect of finite element method in treatment of developmental dysplasia of the hip in children

作者：孙晓君[1,2];王华明[2];张德宏[2];宋学文[2];黄晋[2];张辰[2];裴生太[2]

第一作者：孙晓君

机构：[1]甘肃中医药大学,甘肃省兰州市730000;[2]甘肃省中医院(甘肃中医药大学第一附属医院),甘肃省兰州市730050

第一机构：甘肃中医药大学

年份：2025

卷号：29

期号：9

起止页码：1897

中文期刊名：中国组织工程研究

外文期刊名：Chinese Journal of Tissue Engineering Research

收录：CSTPCD;;Scopus;北大核心:【北大核心2023】；

基金：甘肃省自然科学基金项目(22JR11RA203),项目负责人:王华明。

语种：中文

中文关键词：发育性髋关节发育不良;髋关节发育不良;有限元;髋关节;应力;生物力学;儿童;骨盆截骨术

外文关键词：developmental dysplasia of the hip;dysplasia of the hip;finite element;hip joint;stress;biomechanics;children;pelvic osteotomy

摘要：背景:发育性髋关节发育不良常易导致患儿肢体畸形,其诊疗的相关研究已逐渐明确;近来有限元法因其优势在发育性髋关节发育不良的相关研究中受到学者重视。目的:通过文献检索综述有限元法在儿童发育性髋关节发育不良及治疗中的研究进展,分析总结其优势与不足,并探讨未来进一步研究的方向及应用前景。方法:应用计算机在Pub Med、SCI、CBM和中国知网数据库中检索2014年1月至2023年11月发表的相关文献,以“developmental dysplasia(dislocation) of the hip,dysplasia of the hip,finite element analysis(method),pavlik harness,fixation in herringbone position,biomechanics,pelvic osteotomies,pemberton,salter,dega,periacetabular osteotomy,children”为英文检索词,以“发育性髋关节发育不良,发育性髋关节脱位,髋关节发育不良,儿童,有限元,Pavlik吊带,人字型固定,生物力学,骨盆截骨术,髋臼周围截骨术”为中文检索词,同时纳入少量远期文献,通过筛选最终纳入62篇文献进行分析。结果与结论:(1)儿童发育性髋关节发育不良髋关节力学环境异常,髋臼内部压力不均匀、应力增大并集中,关节接触面积减小,股骨颈局部应力集中;(2)在Pavlik吊带及人字型固定位患髋力学环境改善,集中的高应力区域消失,关节接触面积增加,但外展角度过大会导致髋臼及股骨头外侧应力增加;(3)骨盆截骨术治疗后髋关节及骶髂关节应力环境得到改善,3种截骨术没有单一的铰链,其应力负载部位因患儿年龄而存在差异;(4)髋臼周围截骨术治疗后关节接触压力接近正常,而非球形股骨头者恢复困难;(5)术后X射线片表现不能说明关节接触力学达到最佳;(6)提示利用有限元法可以获得体内无法测量的信息,其在虚拟环境中操作不受时间和伦理的限制;能直观地看到正常与发育性髋关节发育不良患者髋关节应力变化的区域,从力学角度说明治疗的有效性,为需要截骨手术治疗的患者建立特定的有限元模型、量身定做手术计划;发育性髋关节发育不良的有限元建模及儿童髋关节材料特性参数尚无规范、统一的标准,由于有限元固有的局限性,目前还不能分析同时包含骨骼、软骨、韧带、肌肉等元素的模型;有限元分析操作难度较大,虽有优势但不具普适性,且目前的研究样本量较少,还需进一步扩大及验证。
BACKGROUND:Developmental dysplasia of the hip often leads to limb deformities in children,and the research related to its diagnosis and treatment has been gradually clarified.Recently,the finite element method has been paid attention to by scholars in the research related to developmental dysplasia of the hip because of its advantages.OBJECTIVE:Through literature search and review of the relevant research progress of finite element method in children’s developmental dysplasia of the hip and treatment,analyze and summarize its advantages and disadvantages,and explore the direction of further research in the future.METHODS:PubMed,SCI,CBM,and CNKI were searched for relevant articles published from January 2014 to November 2023 with the key words of“developmental dysplasia(dislocation)of the hip,dysplasia of the hip,finite element analysis(method),pavlik harness,fixation in herringbone position,biomechanics,pelvic osteotomies,pemberton,salter,dega,periacetabular osteotomy,children”in Chinese and English.A small number of long-term articles were included,and 62 articles were finally included for analysis through screening.RESULTS AND CONCLUSION:(1)The mechanical environment of hip joint in children with developmental dysplasia of the hip was abnormal.The pressure in acetabulum was uneven.The stress increased and concentrated;the joint contact area decreased,and the local stress concentrated in femoral neck.(2)In the Pavlik sling and herringbone fixation,the mechanical environment of the hip was improved;the concentrated high stress area disappeared and the joint contact area increased,but the excessive abduction angle led to the increase of stress in the acetabulum and the lateral femoral head.(3)After pelvic osteotomy,the stress environment of hip joint and sacroiliac joint was improved.There was no single hinge in the three kinds of osteotomy,and the stress load position was different according to the age of the children.(4)After peri-acetabular osteotomy,the joint contact pressure was close to normal,but it was difficult to recover in patients with non-spherical femoral head.(5)The postoperative X-ray film findings could not show that the joint contact mechanics was the best.(6)It is indicated that the information that cannot be measured in the body can be obtained by using the finite element method,which can be operated in a virtual environment without the limitation of time and ethics.It can directly see the stress change area of normal and developmental dysplasia of the hip,explain the effectiveness of treatment from the point of view of mechanics,establish a specific finite element model and tailor-made operation plan for patients who need osteotomy.There is no standard or unified standard for the finite element modeling of developmental dysplasia of the hip and the material characteristic parameters of children’s hip joint.Due to the inherent limitations of finite element method,it is impossible to analyze the model that contains bone,cartilage,ligament,muscle and other elements at the same time.The operation of finite element analysis is difficult,although it has advantages,it is not universal,and the current research sample size is small,which needs to be further expanded and verified.