异体皮质骨板不同固定方式的生物力学比较  

A BIOMECHANICAL STUDY ON DIFFERENT FIXATION OF CORTICAL BONE PLATE ALLOGRAFT

作　　者：张仁明[1] 廖瑛[1] 李宝兴 李朝旭[1] 肖新跃[3] 马援利[3] 

机构地区：[1]南华大学附属第一医院骨科 [2]山西奥瑞生物有限公司 [3]南华大学力学实验室

出　　处：《中国修复重建外科杂志》2007年第8期793-796,共4页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨异体皮质骨板采用不同固定方式的强度差异及机制。方法由南华大学解剖室提供的14具(男8具,女6具)尸体上取下股骨27根,X线排除骨病后,用游标卡尺测量,取各骨最细部分的直径,制作27个不稳定骨折模型,随机分成A、B、C组,每组9个,分别采用3种方式固定:A组:用2块大小为110mm×10mm×3mm异体皮质骨板嵌合固定;B组:用2块110mm×10mm×3mm异体皮质骨板和5枚骨螺钉固定;C组:用1块110mm×10mm×3mm骨板和5枚骨螺钉固定。分别进行生物力学实验,测试其压缩、弯曲及扭转刚度和极限载荷。结果不同固定方式显示不同的力学特征。A组的轴向刚度与B组相似,且高于C组,但抗弯和扭转刚度显著高于B、C两组,差异有统计学意义(P<0.05)。A组的压缩、弯曲、扭转极限载荷分别为1.65±0.34kN,554.33±49.34N,7.78±0.82Nm;B组分别为1.12±0.37kN,428.00±37.40N,3.39±0.22Nm,两组比较有统计学意义(P<0.05),而C组分别为0.71±0.46kN,218.67±36.53N,1.74±0.12Nm,与A组比较差异有统计学意义(P<0.01)。结论异体皮质骨板固定的强度与固定方式有关。双板嵌合固定比骨板骨螺钉固定具有更大的强度和刚度,可满足临床需要。Objective To explore the biomechanical difference between the different fixations of cortical bone plate allograft. Methods Twenty-seven cadaveric femurs were harvested and were made into the simulated fracture models, which were equally divided into Groups A, B and C. In Group A, the models were fixed with 2 bone plate allografts （110 mm× 10 mm× 3 mm）; in Group B, the models were fixed with 2 struts （110 mm × 10 mm × 3 mm） and 5 bone screws; in Group C, the models were fixed with 1 strut （110 mm× 10 mm× 3 mm） and 5 bone screws. The biornechanical tests for the three-piont bending, torsion, and compression were performed. The parameters studied included the values of the displacements in the three-piont bending tests and the compression tests, and the maximum loads during the bending, the compression, and the torsion. Results As for all the stiffness parameters tested, Group A showed the greatest displacements among the three groups （P〈0. 05）, except the compressive stiffness parameter, which was similar to that in Group B. The maximum loads of the three-point bending, the torsion, and the compression in Group A were 1.65±0. 34 kN, 554.3±49.34 N, and 7.78 ±0. 82 Nm, respectively; in Group B, they were 1.12± 0. 37 kN, 428.00±37.40 N, and 3.39±0. 22 Nm, respectively： in Group C, they were 0. 71± 0.46 kN, 218.67± 36.53 N, and 1.74±0. 12 Nm, respectively. Group A had a significantly greater strength than the other 2 groups（P〈 0. 05 ）. Conclusion The strength of the cortical bone plate allograh is related to its different fixations. The two cortical bone plate allografts have a greater strength and stiffness than the struts fixed with the bone screws, which can meet the clinical requirement.

关 键 词：同种异体骨板 生物力学 固定方式 

分 类 号：R687.3[医药卫生—骨科学] R318.01[医药卫生—外科学]