两种固定方法修复股骨髁上骨折的生物力学及生物学性能比较  

Comparison of biomechanical and biological performances between two fixation methods for repair of femoral supracondylar fractures

作　　者：赖志军[1] 郭汉明[1] 谢唏衷[1] 谢惠缄[1] 蔡宏华[1] 孙春汉[1] 巫洪波[1] 张建民[1] 赵卫东 

机构地区：[1]广东省惠州市中心人民医院骨科,广东省惠州市516001 [2]解放军第一军医大学解放军医学生物力学实验室,广东省广州市510515

出　　处：《中国临床康复》2005年第22期126-127,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:探讨逆行交锁钉与动力髁螺钉固定股骨髁上骨折的生物力学及生物学性能。方法:实验于2003-12-03/19在解放军第一军医大学医学生物力学实验室完成。取成人新鲜尸体股骨下半部标本12具(家属同意),人为造成股骨髁上骨折,用逆行交锁钉行骨折复位内固定与动力髁螺钉行骨折复位内固定,对内固定的标本进行生物力学测试,用SPSS10.0统计软件对实验数据进行分析。结果:逆行交锁钉的垂直压缩位移大于动力髁螺钉犤(1.950±0.568),(0.258±0.071)mm,P<0.0001犦,逆行交锁钉的扭转位移大于动力髁螺钉犤(15.165±2.500),(2.647±0.228)mm,P<0.0001犦,逆行交锁钉的弯曲度数大于动力髁螺钉(4.568±1.186),(3.052±0.501)°,P<0.0001犦。结论:动力髁螺钉的抗压缩、抗弯曲、抗扭转性能比逆行交锁钉大。逆行交锁钉在生物力学性能方面远不如动力髁螺钉,但该器械在手术中可行骨折闭合复位内固定术,骨折愈合快,出血少,可达到骨折的生物学固定要求。AIM: To investigate the biomechanical and biological properties of retrograde nail and dynamic condylar screw in the treatment of femoral supracondylar fractures. METHODS:The experiment was carried out in the medical biomechanical laboratory of the First Military Medical University of Chinese PLA from December 3 to 19,2003.Fresh moist femoral samples of lower part were obtained 12 adult cadavers(with the permission of the relatives) to produce fracture models of the femoral supracondylar fracture,the fractures were treated with reduction internal fixation by retrograde nail or open reduction internal fixation by dynamic condylar screw respectively, the biomechanical parameters of the fixed samples were tested, and the experimental data were analyzed with the SPSS statistical software. RESULTS:The vertical compressive displacement of retrograde nail was greater than that of dynamic condylar screw[(1.950±0.568), (0.258±0.071) mm, P< 0.000 1]; The torsion displacement of retrograde nail was greater than that of dynamic condylar screw[(15.165±2.500),(2.647±0.228) mm,P< 0.000 1]; The bent angle of retrograde nail was greater than that of dynamic condylar screw [(4.568±1.186), (3.052±0.501) °,P< 0.000 1]. CONCLUSION: Dynamic condylar screw possesses better properties against compression, bend and torsion than retrogade nail. The biomechanical properties of dynamic condylar screw are far better than those of retrogade nail, but retrogade nail can be used in the closed reduction internal fixation for fracture with faster healing and less bleeding, and it meets the requirement of the biological fixation for fracture.

关 键 词：股骨骨折 骨折固定术 生物力学 髓内 

分 类 号：R683[医药卫生—骨科学]