Chinese Journal of Tissue Engineering Research ›› 2013, Vol. 17 ›› Issue (39): 6954-6961.doi: 10.3969/j.issn.2095-4344.2013.39.015
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Huang Xuan-huai, Liao Ying, Fan Wei-jie, Chen Zhi-wei
Online:
2013-09-24
Published:
2013-09-24
Contact:
Liao Ying, Professor, Chief physician, Department of Orthopedics, First Affiliated Hospital of University of South China, Hengyang 421001, Hunan Province, China
liaoying8281462@163.com
About author:
Huang Xuan-huai★, Master, Attending physician, Department of Orthopedics, First Affiliated Hospital of University of South China, Hengyang 421001, Hunan Province, China
huangxuanhuai@163.com
Supported by:
Program of China Hunan Science & Technology Department, No. 2009SK3136*
CLC Number:
Huang Xuan-huai, Liao Ying, Fan Wei-jie, Chen Zhi-wei . Biomechanical factors in the design of new femoral neck screw in children[J]. Chinese Journal of Tissue Engineering Research, 2013, 17(39): 6954-6961.
2.1 大体标本观察结果 本年龄段儿童股骨近端发育变化差异较大。和成人相比,儿童的股骨颈较为细小,狭窄,尚且发育不完善,小转子的位置较成人更为偏向后方。股骨头大部分为关节软骨所覆盖,股骨大、小转子没有完全骨化,股骨头关节软骨和大小转子的软骨在股骨颈的后方连接到一起。颈干角明显较成人偏大。 2.2 大体标本、CR片解剖学测量结果及统计学分析 所测量的儿童股骨近端各项指标均符合正态分。将大体标本所得数据左右两侧配对进行t检验,结果显示左右两侧股骨标本在关节转子间距、头颈轴长、股骨颈最小上下颈、M点到股骨颈最小上下颈的距离、这些指标上差异并无显著性意义(P > 0.05),而左右两侧在颈干角差异有显著性意义(P < 0.05),但并不排除因为测量工具限制所导致系统误差(P > 0.01),具体数据见表1。"
按其生物力学意义:EF=P/DL,式中EF表示刚度,P为轴向载荷,DL为压缩位移。在500 N载荷作用下,儿童股骨颈螺钉组的刚度为(190.74±20.88) N/mm,克氏针组的刚度为(138.95±15.19) N/mm,差异有显著性意义(P < 0.05)。在抗压缩能力上儿童股骨颈螺钉要强于克氏针。 在同样加载3 N•m的力矩作用下,儿童股骨颈螺钉组扭转角度为(16.40±0.40)°,克氏针组为(25.14±0.75)°,儿童股骨颈螺钉扭转角度要比克氏针组小,两者比较,差异有显著性意义(P < 0.05)。扭转刚度是指股骨在扭矩载荷作用下,抵抗扭转变形的能力大小,它是反映内固定是否稳定的一重要指标,骨折端的旋转移位常导致骨折畸形愈合或不愈合。见表6。 按其生物力学意义表示:为GJp=Mn/¢,式中GJp表示扭转刚度,Mn为扭矩大小,¢为绝对扭角。在3 N•m扭矩作用下,儿童股骨颈螺钉组的扭转刚度为(0.180± 0.045) N•m/(°),克氏针组的扭转刚度(0.120± 0.036) N•m/(°),两者比较,差异有显著性意义(P < 0.05)。由此看来在抗扭能力上儿童股骨颈螺钉要强于克氏针。 "
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