前下后上型齿突骨折螺钉内固定的生物力学研究  

A biomechanical study of anterior screw fixation for type Ⅱ odontoid fracture with anteroinferior-posterosuperior fracture line

作　　者：方弘伟 李建军 吴增晖[2] 欧阳钧[3] 钟世镇[3] 林文录[4] 蒋良俊[4] 赵俊强 于继华 王向阳[5] 

机构地区：[1]金华市中医医院骨科,浙江金华321017 [2]广州军区总医院 [3]广州第一军医大学 [4]金华市公安局 [5]温州医学院附属第二医院

出　　处：《中国骨伤》2008年第4期279-281,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的:评价前下后上型齿突骨折螺钉内固定的生物力学效果。方法:收集20具新鲜成人上颈椎标本,分为3组,模拟齿突Ⅱ型骨折模型,骨折线为前下后上,截骨角度分别为0°6具,17°8具,25°6具,并进行齿突螺钉固定。进行旋入力矩、最大轴向拔出力和刚度测试。结果:各组最大螺钉旋入力矩、抗拔出力差异无统计学意义。骨折端错位程度随着截骨角度的增加而增加,在17°组平均移位1.61mm,25°组平均移位2.88mm。抗扭转力矩随着截骨角度的增加而增加。各组剪切刚度差异无统计学意义。结论:一定角度范围内的前下后上型骨折可使用齿突螺钉固定进行治疗。Objective：To investigate the biomechanical effect of anterior screw fixation on the type Ⅱ fractured odontoid process. Methods：Twenty fresh human C1-C2 vertebrae specimens were harvested and randomly divided into three groups. The angle of type Ⅱ fracture line was 0° in group I（n=6）,17° in group Ⅱ（n=8） and 25° in group Ⅲ（n=6）. The fractures were treated by anterior screw fixation. Insertion torque,maximal axial pullout force and stiffness of the bone-screw were tested. Results：There was no significant difference of screw insertion torque and the pull-out strength between each group. The displacement of the odontoid fragment had an association to the angle of the fracture line,the displacement of the small angle was significantly higher than that of the large one（P〈0.5）. No significant difference of structure stiffness of the bone-screw was found between e-ach group. Conclusion：Anterior screw fixation is feasible for type Ⅱ odontoid fracture with certain fracture line extends from anteroinferior to posterosuperior.

关 键 词：颈椎 齿突尖 骨折 骨折固定术 内 生物力学 

分 类 号：R683.2[医药卫生—骨科学] R318.01[医药卫生—外科学]