摘要
背景:交锁髓内钉是治疗股骨骨折的常用内固定器械,术中是否常规提拉加压,以及术后是否及时动力化,对骨折愈合起着至关重要的作用,如何通过干扰各种因素来提高骨折愈合率是人们研究的重点。目的:观察股骨静力交锁髓内钉生物力学性能及对骨折愈合的影响。方法:采用甲醛浸泡的成人尸体股骨标本8对,制成中段横形骨折模型后分别用静力型交锁髓内钉(髓内钉组)、TiNi环抱式接骨板(环抱器组)、有限接触动力加压接骨板(加压钢板组)固定,测试抗轴向压缩、抗三点弯曲和抗扭转力学性能,计算应力遮挡率。结果与结论:髓内钉组与加压钢板组相比,抗轴向压缩性能和抗三点弯曲性能相当(P>0.05),但抗扭转性能较弱(P<0.05);与环抱器组相比,抗轴向压缩性能和抗三点弯曲性能较强(P<0.05),而抗扭转性能差异无显著性意义(P>0.05);髓内钉组的应力遮挡率与加压钢板组差异无显著性意义(P>0.05),明显高于环抱器组(P<0.01)。提示交锁髓内钉的生物力学稳定性可靠,但应力遮挡率较高,临床应用时需及时对其动力化,促进骨折愈合。
BACKGROUND：Interlocking intramedullary nails （SIiN） is frequently used to treat femoral fracture.Routine pulling and compression and postoperative motorization are important for fracture healing.To improve fracture healing rate has been focused using various factors.OBJECTIVE：To explore the biomechanical performance of static SIiN in fixation of femoral fracture,and the effect on fracture healing.METHODS：A total of 8 pairs of femurs from adult cadavers immersed in formalin were used to prepare models of midpiece transverse fracture.The fracture was respectively fixed using static SIiN,TiNi shape-memory sawtooth-arm embracing internal fixator （TiNi SMA）,and dynamic compression plate （DCP）.The anti-compression,anti-bending,and anti-torsion rigidity were measured,and the stress shielding rate was calculated.RESULTS AND CONCLUSION：SIiN was similar to DCP group in anti-compression rigidity and anti-bending rigidity （P 0.05）,but the anti-torsion was lower than DCP group （P 0.05）.Compared with TiNi SMA group,SIiN displayed greater anti-compression rigidity and anti-bending rigidity （P 0.05）,but similar anti-torsion （P 0.05）.SIiN was similar to DCP group in stress shielding rate （P 0.05）,but significantly greater than TiNi SMA group （P 0.01）.The biomechanics of SIiN was stable,but the stress shielding rate was high.Changing static interlocking into dynamic interlocking in time is necessary in clinic to promote fracture healing.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2010年第17期3123-3126,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
基金
湖北省宜昌市科研基金项目(A05302-02)~~
