人工肱骨头置换术后并发症的相关研究：双目三维测量装置的应用  

Application of Ioading and digital measurement apparatus in four-part fracture model of proximal humerus

作　　者：朱以明[1] 姜春岩[1] 鲁谊[1] 王满宜[1] 荣国威[1] 于柳平[2] 姚学锋[2] 孟利波[2] 

机构地区：[1]北京大学医学院第四临床医学院(北京积水潭医院)运动损伤科,100035 [2]清华大学力学系

出　　处：《中华创伤骨科杂志》2007年第4期367-371,共5页Chinese Journal of Orthopaedic Trauma

基　　金：北京市科技新星计划资助项目（2004809）

摘　　要：目的通过制备肱骨近端四部分骨折模型及成熟的加载测量装置，以进行有关肱骨近端人工关节置换的相关生物力学研究。方法采集新鲜成人肩关节尸体标本8对16具，应用截骨的方法制成肱骨近端四部分骨折模型，对其进行人工假体重建，并分为解剖重建组和重叠重建组。设计并制作模型加载装置及光学测量装置。测定在肩关节处于不同运动角度时，大结节相对于肱骨干骺端的位移情况。检验整套装置是否具有稳定的可重复性。结果成功制成肱骨近端四部分骨折模型。各个标本在肩关节运动至各个不同角度时，多次重复相同的肩关节运动，其大结节的位移值基本一致或相差很小。检测中发现大结节在肩关节活动过程中有明显移位，在个别标本中甚至超过20mm。结论本试验所设计的加载及测量方式可成功模拟肱骨头置换术后肩关节在进行被动活动的过程中，大结节所受的生物力学作用及在此作用下大结节的位移情况。现有的针对人工肱骨头置换的大结节固定方法，在术后即刻的关节被动活动中，仍可导致大结节相对骨干的明显位移。Objective To conduct a biomechanical study of proximal humerus related to prosthetic replacement in four-part fracture models of human shoulder specimen with a set of loading and digital measurement apparatus. Methods Specimens of fresh frozen human shoulder were collected to create the four-part fracture models of proximal humerus by osteotomy. Prosthetic reconstructions were conducted on the models before a set of specially designed loading apparatus was fixed onto the specimens to simulate the passive motion of the shoulder joint, The Binocular 3-D Computer Vision metrical method was employed to measure the displacements of greater tuberosity relative to the humeral diaphysis when the shoulder joint moved at different angles, The apparatus was tested for its stability and repeatability. Results The four-part proximal humeral fracture model was created successfully. The loading apparatus and digital measurement accomplished the study precisely and steadily, Prominent displacement of the greater tuberosity with regard to the diaphysis was detected during the study. In some specimens the displacement was even greater than 20 mm, Conclusions Our loading apparatus can simulate the passive motion of the shoulder joint after replacement of humerus and measure the biomechanical effects on the greater tuberosity in the four-part fracture model of proximal humerus. Profound displacement between the greater tuberosity and the diaphysis is detected during exercise of passive range of motion of shoulder joint immediately after the replacement.

关 键 词：肱骨骨折 关节成形术 置换 人工关节 生物力学 

分 类 号：R686[医药卫生—骨科学]