臺灣博碩士論文加值系統

動態髖骨螺絲是用於治療股骨轉子間骨折中常見的固定器之ㄧ，且針對手術的方便性也發展出不同規格邊板的動態髖骨螺絲，而在臨床觀察上仍發現許多動態髖骨螺絲破壞的情形，但是當植入物破壞失效時往往會造成骨折固定的失敗導致患處延遲癒合或無法癒合，而動態髖骨螺絲臨床上的失效模式主要是遲滯螺絲的斷裂與邊板上固定螺絲破斷，對於遲滯螺絲的部份已有許多文獻的研究與探討，然而在邊板上的著墨相對較少。因此本論文的目的為針對動態髖骨螺絲邊板部份建立各種形式的有限元素模型，藉以評估固定器的穩定性和失效模式。
首先以市售動態髖骨螺絲建立有限元素模型，並做為參考標準，力學測試模擬依照ASTM美國材料與試驗協會的標準測試方法設定，在動態髖骨螺絲設計數種不同型態之邊板，包括不同長度、厚度、孔洞數量與大小以及孔洞分布位置的差異，從數值分析結果探討設計變數的影響與各種形式的優劣。結果發現，四孔邊板有最佳降低應力的效果，且孔洞直線排列並平均分布更能降低受力情形；同時由結果發現兩孔短邊板的動態髖骨螺絲在穩定性上有極高破壞的風險，在手術選擇上須慎重考慮。
本論文之研究成果可給予工程領域的設計人員於研發新型植入物的設計依據與改良方向，或提供給醫學領域的骨科醫師於臨床應用的選擇依據。

Dynamic hip screw fixation has been extensively used to treat femoral neck fracture respectively. In clinical application, the strength of side-plate and lag screw would affect the stability for recuperating. Implant failure may cause loss of fracture fixation, delayed union and non-union. For lag screw, it has been discussed in many documents, however, the side-plate has received little attention as compared with the fixation mechanism. Therefore, the purposes of this research were to evaluate the strength of the implant and to find the optimization design of side-plate by finite element analyses.
In analyses of side-plate of DHS, the three-dimensional finite element models were established and then the effect of different types of side-plate was discussed. The results showed that the four-hole side-plate has better performance; but the two-hole short side-plate has high risk of fixation failure.
The results of this research could offer engineers with a reference to improve or develop new implants and help surgeons in selecting suitable devices.

中文摘要................................................Ⅰ
英文摘要................................................Ⅱ
誌謝....................................................Ⅲ
目錄....................................................Ⅳ
圖表索引................................................Ⅶ
第一章 緒論.........................................1
1.1 研究背景、動機與目的.........................1
1.2 股骨的解剖學構造.............................2
1.3 動態髖骨螺絲手術簡介.........................3
1.4 文獻回顧.....................................4
1.5 本文架構.....................................9
第二章 材料與方法..................................13
2.1 有限元素法..................................13
2.2 應用軟體簡介................................15
2.2.1 SolidWorks簡介..............................15
2.2.2 COSMOS簡介..................................15
2.3 美國材料與試驗協會標準測試簡介..............16
2.4 市售動態髖骨螺絲實體之幾何尺寸..............16
2.5 動態髖骨螺絲之邊板有限元素分析..............17
2.5.1 動態髖骨螺絲之模型建立......................17
2.5.2 邊界條件及參數設定..........................18
2.5.3 網格化......................................19
2.5.4 收斂性分析..................................19
2.6 破壞理論簡介................................20
第三章 結果........................................29
3.1 收斂性分析結果..............................29
3.2 同長度不同孔數分析結果......................30
3.3 不同長度不同孔數分析結果....................30
3.4 不同橫向間距分析結果........................30
3.5 孔洞直線排列不同孔數分析結果................31
3.6 不同孔洞尺寸分析結果........................31
3.7 不同邊板厚度分析結果........................32
3.8 不同縱向間距分析結果........................32
3.9 不同材料分析結果............................32
第四章 討論........................................77
第五章 結論與未來展望..............................81
5.1 結論........................................81
5.2 未來展望....................................82
參考文獻................................................83
作者簡介................................................88

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