梅花形髓内针开口方向力学研究及影响股骨干骨折手术疗效的因素  

Mechanical Analysis of Intermedully Nailing of Plum Blossom Types with Different Direction of Open and Affecting Factors of the Surgical Efficacy of Fracture of the Femoral Shaft

作　　者：黄长明[1] 杨立民[1] 童星杰[1] 

机构地区：[1]解放军第174医院骨科,厦门市361003

出　　处：《骨与关节损伤杂志》1997年第5期280-283,共4页The Journal of Bone and Joint Injury

摘　　要：作者应用有限元法软件SAP91对V形针、梅花针开口方向进行力学分析,结果发现V形针开口面向张力侧时抗弯能力最强,而梅花针开口背向张力侧时抗弯能力最强。体外载荷实验也得到相同的结果。同时报告梅花针固定股骨干骨折疗效不佳27例,其中断针2例,弯针5例,针外移7例,膝关节粘连9例,骨不连1例,骨延迟愈合3例。主要原因为:术前适应证选择不当8例,术中操作失误8例,术后管理不严11例。结合力学分析及相关文献,提出正确掌握手术适应证,术中仔细操作,术后准确功能练习和严格管理是提高手术疗效的关键。We used limited -basie software SAP91 to analysis mechanice of open direction in V intermedully nailing and in plum blossom intermedully nailing, the result showed that bending strength is strongest under open in face tension direction in V intermedully nailing and open back tension direction in plum blossom intermedully nailing. We got the same result in the loaded test. In this paper, we reported 27 cases of fracture of femoral shaft with poorly surgical efficacy, included 2 nailing broken, 5 naling bend, 7 nailing outwarded, 9 knee joint adhesioned, 1 non- union, 3 delayed-u-nion. Main factors affecting the surgical efficacy include: 8 operative indication choice unsuitable, 8 operating mistake, 11 post - operative mangment unstrict. Based on mechanics analysis and reviewed relative literature, we suggest that surgical indication choice striding, carefully operating and proper instructions concerning functional rehabilitation are very important for inceaseing surgical efficacy.

关 键 词：股骨骨折 骨折固定术 梅花针 髓内针 

分 类 号：R683.420.5[医药卫生—骨科学]