摘要
目的:观察股骨颈带侧孔空心钉添加骨水泥促进骨折愈合的效果。方法:实验于2006-07/2008-11在河北北方学院附属第三医院完成。取60具成人尸体的股骨颈标本,死亡时间在1年内,平均年龄70岁,X射线检查均有显著的骨质疏松,但无其他异常。股骨颈空心钉由上海三友医疗器械公司提供;强化修复材料为上海第二医科大学口腔材料厂生产的自凝聚甲基丙烯酸甲酯骨水泥。最大轴向拔出力实验分组,10个股骨颈在轴向正中钻孔后直接置入空心钉,另10个股骨颈在轴向正中钻孔后注入聚甲基丙烯酸甲酯骨水泥,然后置入带侧孔的空心钉。拔出实验在AGS-10KN材料实验机上进行,测定空心钉最大轴向拔出力,以及周期抗屈实验中螺钉松动时的最大负荷。结果:①置入空心钉10个股骨颈的最大轴向拔出力为471.5～1070.5N,平均(855.0±207.5)N;而添加聚甲基丙烯酸甲酯侧孔空心钉后最大轴向拔出力在2023.7～3572.1N,平均(2943.3±535.8)N。加入聚甲基丙烯酸甲酯侧孔空心钉的最大轴向拔出力明显高于单纯空心钉的最大轴向拔出力(P<0.05)。②单纯置入空心钉的股骨颈在最大负荷介于50～200N时开始松动,位移2.0mm。而添加聚甲基丙烯酸甲酯侧孔空心钉在最大负荷200N时未松动,位移<1mm。结论:髋部骨质疏松的骨折中,应用添加聚甲基丙烯酸甲酯侧孔空心钉固定骨折端,可明显地降低内固定物的松动、脱落及股骨头被切割、穿透的风险性,给骨折端提供了可靠的稳定性,对促进骨折更早的愈合提供坚强的内固定。
OBJECTIVE： To observe the effect of the side-hole hollow bone cement nail on promoting bone fracture healing. METHODS： This experiment was performed in the Third Hospital of Hebei North College from July 2006 to December 2008. Femoral neck samples were obtained from 60 adult corpses of which the patients were dead one year at most with the mean age of 70 years. X-ray examination showed a significant osteoporosis, but no other abnormalities. Hollow nail was provided by Sanyou Medical Apparatus Co., Ltd., Shanghai; self-cohesion methyl methacrylate bone cement was provided by Dental Material Factory, the Second Medical University of Shanghai. In the maximal axial pulling-out force group, the hollow nails were directly implanted into 10 femoral neck samples after drilling at the axial center. The poiymethyl methacrytate bone cement was inserted into other 10 femoral neck samples after drilling at the axial center, and the side-hole hollow nail were then implanted. The pulling out experiment was performed by AGS-10KN material testing machine to measure the maximal axial pulling-out strength of hollow nail and the maximal loading when the nail was loose during anti-bending cycle experiments. RESULTS：①The maximal axial pulling-out force of 10 femoral neck samples implanting the hollow nail was 471.5-1070.5 N, with the mean value of （855.0±207.5） N; the maximal axial pulling-out strength of femoral neck samples implanting the side-hole hollow nail added by poly-methyl methacrylate bone cement was 2023.7-3572.1 N, with the mean value of （2943.3±535.8） N. The maximal axial pulling-out strength in the combined group was significantly greater than hollow nail implantation group （P 〈 0.05）.②The hollow nail was loose when it was loaded 50200 N, and the displacement was 2.0 mm. The side-hole hollow nail added by poly-methyl methacrylate bone cement was not loose at maximal loading of 200 N, and the displacement was 〈 1mm. CONCLUSION： Side-hole hollow bone cement nail can significantly relieve the
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2009年第43期8458-8460,共3页
Journal of Clinical Rehabilitative Tissue Engineering Research
