摘要
背景:DHS是治疗股骨转子间骨折的标准内固定,对于伴有骨质疏松的骨折,容易发生拉力螺钉切割。国内外文献建议骨水泥强化DHS以达到坚强内固定,但是对于正常骨质,骨水泥强化是否有效还缺少报道。目的:选取正常骨密度的股骨转子间骨折标本,观察骨水泥强化对DHS固定的生物力学影响。设计、时间及地点:同一标本两侧对比观察实验,于2005-03/05在河北省骨科研究所生物力学实验室完成。材料:选取河北医科大学解剖教研室提供的成年男性防腐尸体双侧股骨上段标本。X射线证实无结核、畸形、肿瘤。方法:取成年男性防腐尸体双侧股骨上段标本24对48侧,制备A2型股骨转子间骨折模型。右侧标本行骨水泥强化DHS固定(在股骨头近端钉道用刮匙扩大,股骨头朝下,注入2mL低黏稠度骨水泥,拧入拉力螺钉,保持位置不变直至骨水泥凝固。置入套筒,拧紧尾钉适当加压,皮质骨螺钉固定钢板),为强化组;左侧行DHS常规固定,为对照组。两组标本进行弯曲强度试验及扭转强度试验。主要观察指标:两组标本的最大负荷及最大扭矩。结果:强化组最大负荷及最大扭矩与对照组比较,差异均无统计学意义[最大负荷分别为:(3852.1602±143.6031)N和(3702.9667±133.8601)N;最大扭矩分别为(15.5±2.6)N·m,(14.7±3.4)N·m,P>0.05]。结论:对于正常骨密度的股骨转子间骨折,骨水泥强化对DHS固定强度及骨折整体稳定性无显著的影响。
BACKGROUND： Dynamic hip screw （DHS） is a standard internal fixation for intertrochanteric fracture, whereas the patient combined with osteoporosis, cut-out incidence of lag screw is common. The articles in China and abroad indicate bone cement augmentation of DHS to achieve firm fixation. As for normal bone, no reports is published that whether bone cement augmentation is effective. OBJECTIVE： To investigate the biomechanics of DHS with bone cement augmentation for the fixation of intertrochanteric fracture specimen that has a normal bone density. DESIGN, TIME AND SETTING： Bilateral contrast observation study of the same sample was performed in the Laboratory of Biomechanics, Hebei Orthopaedic Research Institute （Shijiazhuang, Hebei Province, China） between March and April in 2005. MATERIALS： Bilateral upper femora from the embalmed male cadaver were provided by Anatomy Department of Hebei Medical University （China）. X-ray scan results proved the absence of tuberculosis, anatomical deformity and tumor. METHODS： Twenty-four matched pairs of the upper femora （48 sides） were used to make the specimens of the intertrochanteric fracture of type A2. The right femur specimens were fixed with DHS augmented by bone cement, as the augmentation group （The screw track of femoral neck was expended by curette, and the femoral head facing upwards were injected with 2 mL low viscosity bone cement. Then lag screw was wrested to keep the position unchanged till the bone cement coagulated. Placing barrel, compressing through tighten tail screw, and cortical screw fixing side-plate were followed）. And the left femur specimen was fixed with DHS conventional fixation, as the control group. The bending and torsional tests were performed in the two groups. MAIN OUTCOME MEASURES： The maximum load and the maximum torque in the two groups. RESULTS： The maximum load and the maximum torque were （3 852.160 2±143.603 1） N and （15.5±2.6） Nm in the augmentation group, and （3 702.966 7±133.860 1） N
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2008年第19期3783-3785,共3页
Journal of Clinical Rehabilitative Tissue Engineering Research
