摘要
目的 比较髋臼方形区骨折4种内固定方法的生物力学差异。方法 取8具16个成年男性半骨盆标本,制作髋臼横形骨折模型,根据内固定方法不同随机分成4组（n=4）,分别行骨盆缘下重建接骨板内固定（A组）、骨盆缘下锁定重建接骨板内固定（B组）、前柱重建接骨板结合方形区螺钉内固定（C组）、前柱重建接骨板加后柱拉力螺钉内固定（D组）。通过对骨折模型进行连续垂直加载,测试骨折水平位移、纵向位移,计算轴向刚度,比较各组内固定方式的稳定性。结果 同一载荷下,A、B、C、D组水平、纵向位移均逐渐减小,其中加载至1800 N时A组纵向位移〉3.00 mm,达到失效标准;而轴向刚度则逐渐增大。加载至200 N时各组水平、纵向位移及轴向刚度比较,差异均无统计学意义（P〉0.05）;600-1800 N时,除C、D组间水平位移差异无统计学意义（P〉0.05）外,其余各组水平、纵向位移及轴向刚度比较,差异均有统计学意义（P〈0.05）。结论 采用前柱重建接骨板加后柱拉力螺钉内固定髋臼方形骨折稳定性最高,其次为前柱重建接骨板结合方形区螺钉内固定,均优于骨盆缘下锁定重建接骨板和重建接骨板内固定。
Objective To compare the biomechanical difference of 4 kinds of internal fixations for acetabular fracture in quadrilateral area. Methods The transverse fracture models were created in 16 hemipelves specimens from 8 adult males, and were randomly divided into 4 groups according to different internal fixation methods （n=4）： infrapectineal buttress reconstruction plate （group A）, infrapectineal buttress locking reconstruction plate （group B）, reconstruction plate combined with trans-plate quadrilateral screws （group C）, and anterior reconstruction plate-lag screw （group D）. Then the horizontal displacement, longitudinal displacement of fractures, and axial stiffness were measured and counted to compare the stability after continuous vertical loading. Results Under the same loading, the horizontal and longitudinal displacements of groups A, B, C, and D were decreased gradually; when the loading reached 1 800 N, the longitudinal displacement of group A was more than 3.00 mm, indicating the failure criterion, while the axial stiffness increased gradually. Under 200 N loading, there was no significant difference （P〉0.05） in horizontal displacement, longitudinal displacement, and axial stiffness among 4 groups. When the loading reached 600-1 800 N, significant differences were found in horizontal displacement, longitudinal displacement, and axial stiffness among 4 groups （P〈0.05） except the horizontal displacement between groups C and D （P〉0.05）. Conclusion For acetabular fracture in the quadrilateral area, anterior reconstruction plate-lag screw for internal fixation has highest stability, followed by reconstruction plate combined with trans-plate quadrilateral screws, and they are better than infrapectineal buttress reconstruction plate and infrapectineal buttress locking reconstruction plate.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2015年第10期1235-1239,共5页
Chinese Journal of Reparative and Reconstructive Surgery
基金
河北省卫生厅医学科学研究重点课题计划(20130665)~~
关键词
髋臼方形区骨折
内固定
重建接骨板
拉力螺钉
生物力学
Acetabular fracture in quadrilateral area
Internal fixation
Reconstruction plate
Lag screw
Biomechanics
