中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (17): 3123-3126.doi: 10.3969/j.issn.1673-8225.2010.17.021

• 骨科植入物 orthopedic implant • 上一篇    下一篇

股骨静力交锁髓内钉生物力学性能及对骨折愈合的影响

严雪港1，鲍同柱2，赵卫东3，鄢  飞2，梁栋柱3，丁志兵4   

  1. 1三峡大学第一临床医学院，湖北省宜昌市  443003；2宜昌市中心人民医院，湖北省宜昌市  443003；3南方医科大学医学生物力学重点实验室，广东省广州市  510515；4三峡大学医学院解剖教研室，湖北省宜昌市  443002
  • 出版日期:2010-04-23 发布日期:2010-04-23
  • 通讯作者: 鲍同柱，主任医师，宜昌市中心人民医院，湖北省宜昌市 443003 baotongzhu1963@163.com
  • 作者简介:严雪港★，男，1983年生，浙江省绍兴市人，汉族，三峡大学在读硕士，主要从事创伤骨科的研究。
  • 基金资助:

    湖北省宜昌市科研基金项目(A05302-02)。

Biomechanical performance and effect of static interlocking intramedullary nails on femoral fracture healing

Yan Xue-gang1, Bao Tong-zhu2, Zhao Wei-dong3, Yan Fei2, Liang Dong-zhu3, Ding Zhi-bing4   

  1. 1 First College of Clinical Medical Science, Three Gorgers University, Yichang  443003, Hubei Province, China; 2 Yichang Central People’s Hospital, Yichang  443003, Hubei Province, China; 3 Key Laboratory of Medical Biomechanics, Southern Medical University, Guangzhou  510515, Guangdong Province, China;    4  Laboratory of Anatomy, Three Gorges University Medical School, Yichang  443002, Hubei Province, China
  • Online:2010-04-23 Published:2010-04-23
  • Contact: Bao Tong-zhu, Chief physician, Yichang Central People’s Hospital, Yichang 443003, Hubei Province, China baotongzhu1963@163.com
  • About author:Yan Xue-gang★, Studying for master’s degree, First College of Clinical Medical Science, Three Gorgers University, Yichang 443003, Hubei Province, China yanxg297@163.com
  • Supported by:

    the Scientific Research Program of Hubei Province, No. A05302-02*

PDF

654

被引次数

21

摘要：

背景：交锁髓内钉是治疗股骨骨折的常用内固定器械，术中是否常规提拉加压，以及术后是否及时动力化，对骨折愈合起着至关重要的作用，如何通过干扰各种因素来提高骨折愈合率是人们研究的重点。
目的：观察股骨静力交锁髓内钉生物力学性能及对骨折愈合的影响。
方法：采用甲醛浸泡的成人尸体股骨标本8对，制成中段横形骨折模型后分别用静力型交锁髓内钉(髓内钉组)、TiNi环抱式接骨板(环抱器组)、有限接触动力加压接骨板(加压钢板组)固定，测试抗轴向压缩、抗三点弯曲和抗扭转力学性能，计算应力遮挡率。
结果与结论：髓内钉组与加压钢板组相比，抗轴向压缩性能和抗三点弯曲性能相当(P > 0.05)，但抗扭转性能较弱(P < 0.05)；与环抱器组相比，抗轴向压缩性能和抗三点弯曲性能较强(P < 0.05)，而抗扭转性能差异无显著性意义(P > 0.05)；髓内钉组的应力遮挡率与加压钢板组差异无显著性意义(P > 0.05)，明显高于环抱器组(P < 0.01)。提示交锁髓内钉的生物力学稳定性可靠，但应力遮挡率较高，临床应用时需及时对其动力化，促进骨折愈合。

关键词: 应力遮挡率, 生物力学, 静力型交锁髓内钉, 动力化, 提拉加压

Abstract:

BACKGROUND: Interlocking intramedullary nails (SIiN) is frequently used to treat femoral fracture. Routine pulling and compression and postoperative motorization are important for fracture healing. To improve fracture healing rate has been focused using various factors.
OBJECTIVE: To explore the biomechanical performance of static SIiN in fixation of femoral fracture, and the effect on fracture healing.
METHODS: A total of 8 pairs of femurs from adult cadavers immersed in formalin were used to prepare models of midpiece transverse fracture. The fracture was respectively fixed using static SIiN, TiNi shape-memory sawtooth-arm embracing internal fixator (TiNi SMA), and dynamic compression plate (DCP). The anti-compression, anti-bending, and anti-torsion rigidity were measured, and the stress shielding rate was calculated.
RESULTS AND CONCLUSION: SIiN was similar to DCP group in anti-compression rigidity and anti-bending rigidity (P > 0.05), but the anti-torsion was lower than DCP group (P < 0.05). Compared with TiNi SMA group, SIiN displayed greater anti-compression rigidity and anti-bending rigidity (P < 0.05), but similar anti-torsion (P > 0.05). SIiN was similar to DCP group in stress shielding rate (P > 0.05), but significantly greater than TiNi SMA group (P < 0.01). The biomechanics of SIiN was stable, but the stress shielding rate was high. Changing static interlocking into dynamic interlocking in time is necessary in clinic to promote fracture healing.

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