摘要
目的探讨动力髋螺钉(DHS)、股骨近端防旋髓内钉(PFNA)、Inter Tan 3种内固定材料固定股骨粗隆下骨折生物力学性能,为临床选择有效内固定方式提供科学依据。方法采购人工股骨标本18根,按照Seinsheimer分型Ⅲa型予以截骨制作成粗隆下骨折模型,分别用3种内固定材料固定,进行股骨的强度、刚度、稳定性、承载能力测式等生物力学实验,分析比较3种内固定方式固定股骨粗隆下骨折的生物力学性能。结果实验力学结果表明:Inter Tan髓内钉固定强度为(1.84±0.15)MPa,DHS为(1.39±0.11)MPa,PFNA为(1.36±0.12)MPa内固定的强度,Inter Tan组内固定强度大于DHS组和PFNA组,差异有统计学意义(P<0.05);Inter Tan组刚度EF为(945.35±82.01)N/mm,DHS为(638.54±78.21)N/mm,PFNA为(755.33±86.32)N/mm,Inter Tan组刚度大于DHS组和PFNA组,差异有统计学意义(P<0.05);Inter Tan组的抗剪、抗扭的稳定性、承载能力均明显优于DHS、PFNA组,差异有统计学意义(P<0.05);其动态力学性能疲劳寿命也相应比DHS、PFNA组优越。结论 Inter Tan及PFNA均是固定Ⅲa型股骨粗隆下骨折的理想方法,其中Inter Tan整体生物力学性能优于PFNA髓内钉固定,而DHS不适用于此型股骨粗隆下骨折。
Objective To investigate biomechanical performance of three kinds of internal fixation material for femoral subtrochanteric fractures and provide scientific basis for selecting effective internal fixation material. Methods Eighteen artificial femur specimens, after osteotomy by Seinsheimer Type IIIa, were made into subtrochanteric fracture models with three kinds of internal fixation material which categorized the models into three groups for biomechanical experiments. The strength, rigidity, stability, and carrying capacity of the femurs from three groups were measured to compare and analyze the biomechanical performance of the three methods of fixation of femoral subtrochanteric fracture. Results Biomechanical experiments indicated the following results： the strength of femur specimens from group InterTan was （1.84±0.15）MPa, higher than those from group DHS and group PFNA, i.e. （1.39±0.11）MPa and （1.36±0.12）MPa, the difference was statistically significant （P 〈0.05）; The rigidity EF of femur specimens from group InterTan were （945.35±82.01）N/mm, higher than those from group DHS and group PFNA, i.e. （638.54±78.21）N/mm and （638.54±78.21）N/mm, the difference was statistically significant （P 〈0.05）; The stability of shear and torsional strength and carrying power of femur specimens from group InterTan were significantly superior to the group DHS and group PFNA, the difference was statistically significant （P 〈0.05）; The dynamic mechanical performance of fatigue life of group InterTan was better than that of group DHS and group PFNA accordingly. Conclusion Both InterTan and PFNA are ideal methods for fixation of femora/ subtrochanteric fractures while the overall biomechanical performance of InterTan is superior to PFNA. And DHS is not applicable for this type of femoral subtrochanteric fracture.
出处
《中国骨与关节损伤杂志》
2016年第10期1039-1042,共4页
Chinese Journal of Bone and Joint Injury
基金
上海市金山区科学技术委员会创新基金项目(2013-06)
关键词
股骨粗隆下骨折
生物力学
内固定
Femoral subtrochanteric fractures
Fixation
Biomechanical test
