股骨转子间骨折新型内固定器的研制及其生物力学研究  

Design and biomechanical evaluation of a new internal fixation system for intertrochanteric fracture

作　　者：水小龙[1] 孔建中[1] 翁益民[1] 陈龙[1] 王向阳[1] 王振文[1] 陈华[1] 徐华梓[1] 郭晓山[1] 

机构地区：[1]温州医学院附属第二医院骨科,325027

出　　处：《中华创伤杂志》2007年第12期912-916,共5页Chinese Journal of Trauma

基　　金：温州市科技局基金资助项目（S2002A043）专利号：ZL200520071540.5（20050078）

摘　　要：目的研制应用于股骨转子间骨折的新型内固定器械，并对其生物力学特性进行研究。方法根据股骨转子间骨折的发病特点及动力髋螺钉（DHS）的优缺点，设计由2枚加压螺栓、套筒及可拆卸钢板、拉力螺钉组成的钉板系统[（微创动力髋钢板MIDHP）]。采用新鲜尸体，与DHS作标本的生物力学比较测试。结果MIDHP组的压缩刚度为（1612．2490±237．1478）N／mm，扭转刚度为（4．4157±0．6739）N·m／deg，与DHS组比较，差异有统计学意义（P〈0．01）；循环加载后的MIDHP组的主钉切割值为（2．5320±1．1961）r／mm，DHS组为（8．1640±1．8998）mm（P〈0．01）。结论股骨转子间骨折新型内固定器有较好的生物力学特性，有效克服了DHS抗旋转作用差及易发生主钉切割的缺点，为股骨转子间骨折内固定一个较好的选择。Objective To design a new internal fixation system for treatment of intertrochanterie fracture and explore its biomeehanieal properties. Methods A new internal fixation system （minimal invasion dynamic hip plate, MIDHP）was established with two main dynamic compressive screws, an unscrewable bush, tensile screw and detachable plate considering the clinical features of intertrochanteric fracture, and advantages and disadvantages of dynamic hip screw （DHS）. Ten fresh human cadaver femur specimens were used to compare the biomechanical properties of the new system with DHS. Results The compression rigidity and torsional rigidity were （1612.249 0 ± 237. 147 8） N/ram and （4.415 7 ± 0.673 9） N · m/degrespectively in MIDHP group, which were significantly higher than those of DHS group （P 〈 0.01 ）. The mean value of host screw cutting force in MIDHP group was （2. 532 0 ± 1. 196 1 ） ram, significantly lower than（ 8. 164 0 ± 1. 899 8 ） mm in DHS group （ P 〈 0.01 ）. Conclusions The new MIDHP system can overcome DHS＇s weaknesses, poor anti-rotation ability and host screw cutting and is proved a superior internal fixation for intertrochanteric fracture with excellent biomechanieal properties.

关 键 词：股骨骨折 内固定器 生物力学 

分 类 号：R686[医药卫生—骨科学]