经皮导入内固定治疗肱骨近端骨折合并肩关节前脱位的力学分析  

Mechanical analysis of proximal pumeral fracture and anterior dislocation of shoulder treated by percutaneous internal fixation

作　　者：杨茂清[1] 谭远超[1] 毕宏政[1] 孙献武[1] 戴振国[1] 黄明利[1] 李健[1] 

机构地区：[1]山东省文登整骨医院山东文登骨伤研究所,山东文登264400

出　　处：《医用生物力学》2006年第1期62-65,共4页Journal of Medical Biomechanics

摘　　要：目的通过力学分析研究经皮导入内固定方法治疗肱骨近端骨折合并肩关节前脱位的可行性。方法实验分二部分进行:一是用尾部加压调角空心螺纹钉按手术操作进行拉脱试验,测定将螺纹钉从肱骨头内拉出所需最小力(Pmin);二是利用生物力学测试机测定志愿者单纯肩关节前脱位麻醉下牵引复位所需的最大力(Pmax)。实验按年龄分为A、B两组,A组25～45岁,B组>45岁。对两组测试数据进行数据分析。结果当尾部加压调角空心螺纹钉拧入肱骨头20mm时,螺钉自肱骨头内拉出所需最小拉力PminA=284N,PminB=198N,牵引复位单纯肩关节前脱位所需最大拉力PmaxA=206N,PmaxB=195N,通过比较极值,得出Pmin>Pmax,即牵引复位单纯肩关节前脱位所需最大拉力小于螺钉自肱骨头内拉出的最小拉力。结论尾部加压调角空心螺纹钉对肱骨头的固定作用可满足经皮导入内固定治疗肱骨近端骨折合并肩关节前脱位过程中的要求。Objective To Study the availability of manual reduction and the method of internal fixation in the treatment of anterior shoulder joint dislocation and proximal humeral fracture by percutaneous intemal fixation. Methods To measure the force that pull tail-pressed angle-adjusted hollow screw out of the head of humerus （Pmin）and the force that needed in the traction reduction of acute anterior dislocation of shoulder joint under local anesthesia （Pmax）. Stastical analysis has been made. Results When the screw put into the head of humerus 20 mm,PminA=284 N,PminB=198 N;Pmax=A=206 N,PmaxB=195 N. The act of comparing Pmin with Pmax, Pmin is more than Pmax Traction force that needed by traction reduction of anterior dislocation of shoulder joint is less than the minimum force that pull tail-pressed angle-adjusted hollow screw out of humeral head. Conclusion Using tail-pressed angle-adjusted hollow screw can meet the need of percutaneous internal fixation in the treatment of proximal humeral fracture and anterior dislocation of shoulder joint.

关 键 词：肱骨近端骨折 肩关节前脱位 生物力学 治疗 

分 类 号：R318.01[医药卫生—生物医学工程]