摘要
目的探讨自行设计新构型四枚空心钉固定极不稳定型股骨颈骨折的生物力学性能。方法将12个成年防腐人尸体股骨标本编号后随机分为4组(n=3),制作成PauwelsⅢ型合并粉碎性骨折块的极不稳定型股骨颈骨折模型。A组标本采用"双轴加压+双支撑稳定"固定方式,B组标本采用"正三角平行加压+小角度螺钉"固定方式,C组标本采用"倒三角平行加压+小角度螺钉"固定方式,D组标本采用"菱形排列螺钉"固定方式。在生物力学试验机上先后进行静态压缩测试、循环载荷测试和极限载荷测试。结果A组、B组、C组和D组轴向压缩刚度分别为(995.29±34.16)、(509.89±138.90)、(559.28±111.25)、(610.18±232.35)N/mm,极限载荷分别为(3225.33±461.31)、(2008.67±237.27)、(2705.67±496.39)、(2395.33±403.71)N,以上项目4组间比较差异均有统计学意义(P<0.05)。A组、B组、C组和D组位移分别为(0.46±0.10)、(1.47±0.72)、(1.14±0.24)、(1.22±0.22)mm,极限测试刚度分别为(1139.28±342.09)、(843.56±408.91)、(585.98±81.60)、(729.96±251.37)N/mm,以上项目4组间比较差异均无统计学意义(P>0.05)。结论采用四枚空心钉治疗极不稳定型股骨颈骨折时,"双轴加压+双支撑稳定"新构型具有生物力学优势,而"正三角平行加压+小角度螺钉"固定方式生物力学性能最差。
Objective To investigate the biomechanical properties of our self-designed 4 cannulated screws in 4 configurations for fixation of extremely unstable femoral neck fractures. Methods Twelve adult cadaveric femoral specimens were randomly divided into 4 equal groups (n=3) and made into models of extremely unstable femoral neck fracture combined with comminution (Pauwels type Ⅲ).Group A was subjected to fixation in configuration of "double axial compressions plus double stabilizations" ,group B to configuration of "positive triangle parallel compression plus small angle screwing" ,group C to configuration of "inverted triangle parallel compression plus small angle screwing" ,and group D to configuration of "diamond pattern screwing" .Static compression tests,cyclic loading tests and limit load tests were carried out for the 4 groups on a biomechanical testing machine. Results For groups A,B C and D,the axial compression stiffness was respectively 995.29±34.16 N/mm,509.89±138.90 N/mm,559.28±111.25 N/mm and 610.18±232.35 N/mm,and the limit load was respectively 3,225.33±461.31 N,2,008.67±237.27 N,2,705.67±496.39 N and 2,395.33±403.71 N,showing significant differences between the 4 groups (P<0.05).For groups A,B C and D,the displacement was respectively 0.46±0.10 mm,1.47±0.72 mm,1.14±0.24 mm and 1.22±0.22 mm,and the limit stiffness was respectively 1,139.28±342.09 N/mm,843.56±408.91 N/mm,585.98±81.60 N/mm and 729.96±251.37 N/mm,showing no significant differences between the 4 groups (P>0.05). Conclusions In the fixation of extremely unstable femoral neck fracture with our self-designed 4 cannulated screws,the configuration of "double axial compressions plus double stabilizations" may lead to the greatest biomechanical advantage while the configuration of "positive triangle parallel compression plus small angle screwing" may result in the poorest biomechanical properties.
作者
林焱斌
余光书
钟志辉
沈兆庆
郑伟
庄研
许阳凯
Lin Yanbin;Yu Guangshu;Zhong Zhihui;Shen Zhaoqing;Zheng Wei;Zhuang Yan;Xu Yangkai(Department of Orthopaedics,The Second Fuzhou Hospital Affiliated to Xiamen University,Fuzhou 350007,China)
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2019年第2期160-165,共6页
Chinese Journal of Orthopaedic Trauma
基金
福建省卫生系统中青年骨干人才培养项目(2014-ZQN-JC-34).
关键词
股骨颈骨折
骨折固定术
内
骨钉
生物力学
Femoral neck fractures
Fracture fixation, internal
Bone nails
Biomechanics
