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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
【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.
【Key words】 intertrochanteric fracture; 2 types of internal fixation; best fixation position; biomechanics;
- 【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