【摘要】 目的研究不同程度髋臼后壁骨折及后侧关节囊对关节稳定性的影响。方法采用配对设计将7具骨盆的14个髋关节标本,随机分成A、B两组,A组去除髋关节周围所有软组织,B组保留关节囊。分别按髋臼后壁总面积的20%、30%、40%、50%、60%从外缘向内纵向截骨,建立不同比例的后壁骨折模型,90°屈髋位对骨折模型分别进行生物力学测试,载荷下测量各组髋臼的形变位移和轴向刚度以及导致股骨头脱位时的载荷。结果载荷下,髋臼形变位移随截骨比例的增加而增大,统计显示截骨20%和30%组之间差异不显著(P>0.05),而30%组与40%、50%、60%组之间的统计学差异非常显著(P<0.01),轴向刚度的变化趋势与之相同;载荷800N时,截骨40%、50%、60%组均发生股骨头脱位,而20%、30%组未发生股骨头脱位;A组与B组间无显著差异。结论髋臼后壁骨折<30%时不影响髋关节的稳定,>40%时髋关节不稳,需行内固定治疗;后侧关节囊在维持关节的稳定方面与髋臼相比所起作用不大。更多还原

【Abstract】 Objects To study the effects of fractures of various proport ions of the posterior wall of acetabulum on the hip stability and the function o f posterior capsule of hip. Methods Fourteen preserved cadaveric hip joints were divided into two groups randomly. All the soft-tissue structures were stripped in group A while the posterior capsule was left intact in group B. The simulate d posterior wall fracture models were created by osteotomy respectively accordin g to the proportions of 20%, 30%, 40%, 50%, 60% of the posterior wall. The n tests were performed on each model at the position of 90° flexing of the hip . The deformations of the acetabulum and its axial stiffness and the loadings we re measured when the femoral heads dislocated. Results The acetabular deformatio n increased as the proportions of osteotomy were added under loading. There was no significant difference between the 20% group and the 30% group (P >0.05), while there were significant differences between the 30% group and the 40% group, the 50% group, and the 60% group (P< 0.01). The variances of axial st iffness showed the same trend. All joints dislocated, except in the 20% and th e 30% osteotomy groups, when the load was 800N. There was no significant diffe rence between group A and group B, either in deformation or in axial stiffness. Conclusions Fragments of posterior acetabulum involving 30% or less do not a ffect the stability of hip while fragments involving 40% or more do and need m anagement of internal fixation. Posterior capsule has no more effect on maintain ing the stability of hip than acetabulum.更多还原