交锁髓内钉治疗胫骨中下段骨折的生物力学研究  

Biomechanical study on interlocking intramedullary nailing for middle and distal tibial fractures

作　　者：杨建成[1] 吕继宏[2] 

机构地区：[1]南方医科大学珠江医院骨科,广东广州510280 [2]解放军第264医院骨科,山西太原030000

出　　处：《临床骨科杂志》2005年第4期367-368,共2页Journal of Clinical Orthopaedics

基　　金：广东省医学科学技术研究基金资助项目(编号:A2000405)

摘　　要：目的探讨胫骨交锁髓内钉治疗不同平面胫骨骨折的生物力学特性.方法以成人新鲜胫骨标本为试验对象,每具标本先后模拟骨折愈合、胫骨中段骨折及胫骨下段骨折3种状态,远端采用1枚或2枚锁钉固定,MTS轴向加载0～1 000 N,测试远端锁钉应力应变变化.结果胫骨下段骨折组远端锁钉应力应变较中段骨折组明显增大,在远端2枚锁钉中,靠近侧的锁钉应力应变更大.远端改用1枚锁钉固定后,锁钉承受的应力应变进一步显著增加.结论胫骨骨折越靠下端,越易发生内固定失败,应以2枚锁钉固定远端并远离骨折线.Objective To investigate the biomechanic characteristics of interlocking intramedullary nailing for middle and distal tibial fractures. Methods Fresh adult cadaveric tibiae were used to simulated 3 different states： healed, middle and distal tibial fractures with interlocking intramedullary nailing. 1 or 2 bolts were used for distal locking. The stress and strain of distal locking bolts were assessed under MTS axial loading of 0 - 1 000 N. Results Higher stress and strain of distal locking bolts were found in distal tibial fracture compared with middle fracture. In the two distal bolts, the proximal one showed more higher stress and strain. Additional significant stress and strain increasing was found when only 1 blot was used for distal locking. Conclusions The more distal the fracture is, the more likely the fixator fails. 2 bolts should be used for distal locking as far as possible away from the fracture line.

关 键 词：胫骨骨折 交锁髓内钉 生物力学 

分 类 号：R318.01[医药卫生—生物医学工程] R683.42[医药卫生—基础医学]