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[目的]研究后内侧骨折对近端股骨的生物力学影响.[方法]利用CT扫描图像建立高度仿真的完整近端股骨的三维有限元模型,并在此基础卜建立累及小粗隆和内侧皮质的后内侧骨折模型,并对模型进行有限元分析.[结果]后内侧骨折后股骨最大应力出现在骨折缺损的前内侧.单独小粗隆骨折后股骨颈七下、内外侧皮质应力无明显变化;骨折累及1/2内侧皮质后,内侧皮质最大等效应力显著升高约47%,外侧皮质应力升高约12%;内侧皮质完全累及时,内侧皮质应力升高约247%,外侧升高约66%.[结论]不同大小的后内侧骨折块对近端股骨的应力大小及分布影响不同.从力学角度考虑,用动力髋螺钉治疗粗隆间骨折时,可根据后内侧骨折块大小作适当处理.“,”[Objective]To research the biomechanical influence of posteriomedial fractures on proximal femur. [Method]Three dimensional finite element models of intact and osteotomied proximal femurs were established from computerized tomograph-ic(CT) scanning images, and finite element analysis was undertaken. [Result]The maximum equivalent stress was located at the anteriomedial of the defection of the proximal femur. The stress of femoral neck, as well as the medial and lateral femoral cortex was not significantly changed after isolated lesser trochanteric fracture. However, with half of the medial cortex involved, the stress of the medial and lateral femur increased by 47% and 12%, respectively. If the entire medial cortex was involved, the stress of medial and lateral femur increased by 247% and 66%, respectively. [Conclusion]Different types of posteriomedial fragments have different effects on the stress distribution and quantity of proximal femur. When treating intertrochanteric fractures using dy-namical hip screw, the fragments should be differently treated based on its types considering for biomechanical effects.