摘要
背景:闭合间断骨钻孔截骨方法在临床运用较多,目前却缺少该造模方法的基础实验研究。目的:建立一种旋前-外旋型三踝骨折模型造模新方法,为闭合截骨造模提供一种新思路、新方法。方法:对16例典型的旋前-外旋型三踝骨折X射线片骨折线测量来确定钻孔位置,借助微创截骨导向器沿着骨折线在体表投影进行闭合间断骨钻孔后根据其损伤机制徒手暴力造模,同时测量造模过程中的力学参数,通过X射线摄片对模型进行验证。结果与结论:(1)16个踝关节尸体标本骨折线符合旋前-外旋型三踝骨折,外踝骨折成功率100%,内踝骨折成功率100%,后踝骨折成功率43.75%,下胫腓分离成功率62.50%;(2)骨折脱位8例,脱位率50%,其中外后脱位2例,外后脱位率12.5%,外脱位6例,外脱位率37.5%;(3)结果表明,该造模方法成功率高,具有很好的可重复性和可操作性,同时能很好的保留肌肉、肌腱、皮肤等软组织的完整,为三踝骨折手法复位及生物力学研究提供软组织完整的骨折模型,也能为制作闭合骨折模型提供一种新思路、新方法,供他人借鉴参考。
BACKGROUND:Closed osteotomy has been widely applied in the clinic,but little is reported on its basic experiment.OBJECTIVE:To establish the novel modeling method of pronation-external rotation trimalleolar fracture,so as to provide a new idea for closed osteotomy model.METHODS:The drilling position was determined by measuring the fracture line on X-ray films of 16 cases of typical pronation-external rotation trimalleolar fracture.According to its damage mechanism,unarmed violence was carried out after the closed bone drilling by minimally invasive osteotomy guider along the fracture line in the body surface projection.The mechanical parameters in the modeling process were measured and the model was validated by X-ray.RESULTS AND CONCLUSION:The fracture line of 16 specimens met the criteria of pronation-external rotation trimalleolar fracture.The success rate of lateral or internal malleolus fracture was 100%,that of posterior malleolus fracture was 43.75%,and that of tibiofibular separation was 62.50%.Fracture and dislocation occurred in eight cases(50%),including two(12.5%)cases of posterior-lateral dislocation,and six(37.5%)cases of external dislocation.These results suggest that the modeling method has high success rate,good repeatability and operability,and can completely retain the muscle,tendon,fascia,and skin,which provides a fracture model with complete soft tissues for the manual reduction of trimalleolar fracture and biomechanical study,and provides a new idea for establishing closed fracture model.
作者
邱鹏
成永忠
刘广伟
贺达
祝建飞
程灏
温建民
吴丽艳
Qiu Peng;Cheng Yongzhong;Liu Guangwei;He Da;Zhu Jianfei;Cheng Hao;Wen Jianmin;Wu Liyan(Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China;Beijing Key Laboratory of Chinese Manipulative Technique,Beijing 100102,China)
出处
《中国组织工程研究》
CAS
北大核心
2018年第36期5828-5832,共5页
Chinese Journal of Tissue Engineering Research
基金
北京市自然科学基金(7172243)
首都临床特色应用研究与成果推广(Z161100000516111)~~
关键词
骨钻孔
暴力
旋前-外旋
造模
组织构建
Fractures,Closed
Ankle Joint
Fractures,Bone
Tissue Engineering
作者简介
邱鹏,男,1991年生,江西省上饶市人,汉族,中国中医科学院在读硕士,医师,主要从事中西医临床骨与关节疾病的临床研究;通讯作者:成永忠,博士,主任医师,中国中医科学院望京医院,北京市100102
