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股骨近端骨折内固定头颈钉不同位置置放的生物力学研究

Biomechanical study of positions of femoral head-and-neck nail in fixation of proximal femoral fracture

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【作者】 刘磊周建伟王以进李文生许庆利张传寅梁钟鸣蒋毅张亮张燕鹏

【Author】 LIU Lei,ZHOU Jian-wei,WANG Yi-jin,et al.Department of Orthopedics,Huashan Hospital Baoshan Branch,Fudan University,Shanghai 200431,China

【机构】 上海复旦大学附属华山医院宝山分院骨科上海大学生物力学研究所上海复旦大学医学院解剖室

【摘要】 [目的]通过生物力学实验应力分析,论证头颈钉不同置放位置的生物力学性能,固定牢固,有利于骨折愈合以指导临床手术。[方法]采集24具新鲜股骨标本,分别造成股骨粗隆间稳定和不稳定骨折,用r钉、DHS固定,头颈钉分别置放不同位置,测定股骨抗压、抗弯、抗剪和抗扭等力学性能,分析比较不同位置头颈钉内固定的优劣。[结果]从股骨强度、刚度、稳定性和承载能力测试结果表明,对于稳定型股骨粗隆间骨折,头颈钉应放在股骨头颈中下1/3偏后处,骨质致密,有股骨距支撑,承载能力大为增强,有利于早期下床活动且不易发生切割;对于不稳定型股骨粗隆间骨折,头颈钉应放入股骨头颈中间,有强斜力学效应,有利于骨折早期愈合。[结论]通过生物力学测试,确认股骨近端骨折头颈钉最佳固定位置,是提高现代器械临床固定效果,提高股骨近端骨折手术疗效的关键。

【Abstract】 [Objective]To analyze the biomechanics of different positions of femoral head-and-neck nail in fixation of proximal femoral fracture.[Method]Stable and unstable fracture models were made from 24 fresh femur specimens,and fixed with r-nail and DHS.Head-and-neck nails were placed in different positions to test their mechanical properties of anti-compression,anti-bending,anti-shearing and anti-torsion,and compared with each other.[Result]Mechanical properties of the femoral strength,stiffness,stability and loading capacity were tested and compared.To the stable fracture group,head-and-neck nail should be placed in middle-lower and posterior 1/3 of femoral neck,which leads to the best loading capacity.To the unstable fracture group,it should be placed between femoral head and neck,which lead to strong obliquity mechanics and valuable for bone union.[Conclusion]Confirm of the best position of femoral head-and-neck nail could improve the effect of fixation and enhance the surgical treatment of proximal femoral fracture.

【基金】 上海市宝山区科学发展基金(08-E-17)
  • 【文献出处】 中国矫形外科杂志 ,Orthopedic Journal of China , 编辑部邮箱 ,2010年04期
  • 【分类号】R687.3;R318.01
  • 【被引频次】10
  • 【下载频次】230
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