摘要
目的探讨"轴心加压+侧方支撑"理念下新型空心螺钉固定PauwelsⅡ型股骨颈骨折的生物力学性能。方法将10根Sawbones仿真股骨标本首先制作成Pauwels角为50°的Ⅱ型股骨颈骨折模型,编号后随机分为两组(n=5):实验组与对照组。实验组标本采用"轴心加压+侧方支撑"理念下新型空心螺钉组合固定:轴心螺钉直径为8.5 mm,侧方螺钉直径为6.5 mm;对照组标本采用传统倒三角形空心螺钉平行加压固定:3枚螺钉直径均为7.3 mm。将标本置于生物力学试验机上,依次测试静态轴向刚度、5000个循环60~600 N载荷下位移、极限载荷和极限刚度参数,比较两组的差异。结果实验组标本的静态轴向刚度[(1492.00±87.86)N/mm]显著高于对照组标本[(1200.22±228.06)N/mm],差异有统计学意义(P<0.05)。实验组和对照组标本循环载荷下的位移分别为(0.44±0.01)、(0.57±0.17)mm,差异无统计学意义(P>0.05),但实验组呈现出较低趋势。实验组标本的极限载荷和极限刚度分别为(4292.61±804.29)N、(1623.55±180.94)N/mm,对照组分别为(4383.64±1423.24)N、(1433.77±289.93)N/mm,两组比较差异均无统计学意义(P>0.05)。结论"轴心加压+侧方支撑"理念下新型空心螺钉固定PauwelsⅡ型股骨颈骨折较传统倒三角形空心螺钉平行加压固定的生物力学性能更优。
Objective To investigate the biomechanical properties of cannulated screws fixation in a configuration of"axial compression and lateral buttress"in the treatment of Pauwels typeⅡfemoral neck fractures.Methods Ten specimens of Sawbones artificial femur were first made into models of typeⅡfemoral neck fracture with a Pauwells angle of 50°and then randomized into 2 equal groups(n=5).The specimens in the experimental group were subjected to fixation with cannulated screws in a configuration of"axial compression and lateral buttress"in which the axial screw was 8.5 mm in diameter and the lateral screw 6.5 mm in diameter.The specimens in the control group were subjected to conventional fixation with cannulated screws in a configuration of"inverted triangle and parallel compression"in which the 3 screws was 7.3 mm in diameter.Finally,the specimens were placed onto a biomechanical testing machine to determine the parameters of static axial stiffness,displacement under 60 to 600 N load for 5,000 cycles,ultimate load and ultimate stiffness in turn.The 2 groups were compared to find out their differences.Results The static axial stiffness was(1,492.00±87.86)N/mm,significantly higher than that in the control group[(1,200.22±228.06)N/mm](P<0.05).There was no significant difference between the 2 groups in the cyclic load displacement[(0.44±0.01)mm versus(0.57±0.17)mm](P>0.05),but the experimental group showed a lower trend.The ultimate load and ultimate stiffness were(4,292.61±804.29)N and(1,623.55±180.94)N/mm in the experimental group and(4,383.64±1,423.24)N and(1,433.77±289.93)N/mm in the control group,showing no significant difference between the 2 groups(P>0.05).Conclusion In the treatment of Pauwels typeⅡfemoral neck fractures,fixation with cannulated screws in a configuration of"axial compression and lateral buttress"may exhibit better biomechanical properties than that in a conventional configuration of"inverted triangle".
作者
钟志辉
林焱斌
庄研
沈兆庆
苏志涛
庄福毅
陈小霞
吴春玲
Zhong Zhihui;Lin Yanbin;Zhuang Yan;Shen Zhaoqing;Su Zhitao;Zhuang Fuyi;Chen Xiaoxia;Wu Chunling(Department of Orthopaedics,The Second Fuzhou Hospital Affiliated to Xiamen University,Fujian Provincial Clinical Medical Research Center of First Aid and Rehabilitation in Orthopaedic Trauma,Fuzhou Trauma Medical Center,Fuzhou 350007,China)
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2022年第3期253-257,共5页
Chinese Journal of Orthopaedic Trauma
基金
福建省创伤骨科急救与康复临床医学研究中心项目(2021)
福州市卫生健康科技创新平台建设项目(2019-S-wp2)
福州市创伤医学中心项目(2018080303)。
关键词
股骨颈骨折
骨折固定术
内
骨钉
生物力学
轴心加压
侧方支撑
Femoral neck fractures
Fracture fixation,internal
Bone nails
Biomechanics
Axial compression
Lateral buttress
