髌骨骨折镍钛合金丝内固定的生物力学特点  

Biomechanical features of Ni-Ti alloy wire fixation for patellal fracture

作　　者：陈执平[1] 周金水[2] 庄孝荫[2] 陈日齐[3] 

机构地区：[1]福建农林大学机电工程学院,福建省福州市350002 [2]福州市第二医院骨科,福建省福州市350007 [3]福州大学土建学院力学实验室,福建省福州市350003

出　　处：《中国组织工程研究与临床康复》2008年第44期8606-8609,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：福建省科技三项经费资助(K96045)~~

摘　　要：背景:目前临床广泛使用不锈钢丝进行髌骨骨折内固定。根据镍钛合金的超弹性材料特性,设想改用镍钛合金丝进行固定,从生物力学角度,预期可获得更佳疗效。目的:评价镍钛合金丝环形加"8"字固定髌骨骨折的生物力学稳定性,并与不锈钢丝进行比较。设计、时间及地点:生物力学分析,于2002-07/2003-03在福建省骨伤研究所生物力学实验室完成。材料:新鲜、无病变、保留股四头肌肌腱和髌韧带的髌骨,为7名因车祸及其他外伤而截肢的成年男性患者自愿捐献。方法:股四头肌拉力以50,100,150,200,250,300N加载和卸载两种方式作用于受试髌骨,应用电测法测量不完全横形髌骨骨折未经金属丝固定、钢丝环形加"8"字内固定及镍钛合金丝环形加"8"字内固定后的髌骨前面应力。主要观察指标:镍钛合金丝内固定和不锈钢丝内固定对髌骨断面的加压作用。结果:股四头肌拉力从150N增加到300N时,不锈钢丝固定对髌骨骨折断面的加压作用由0.2894MPa剧增至0.4544MPa,增加57.01%;同样情况下,镍钛合金丝固定对髌骨骨折断面的加压作用则仅由0.2270MPa缓增至0.2851MPa,增加25.59%。当股四头肌拉力从300N降至150N时,不锈钢丝固定对髌骨骨折断面的加压作用由0.4365MPa骤减至0.2448MPa,减少43.91%;而镍钛合金丝固定对髌骨骨折断面的加压作用则仅由0.2316MPa减至0.1737MPa,减少25.00%。结论:与不锈钢丝固定相比,镍钛合金丝固定能对髌骨骨折断面提供持续的、小幅变化的加压作用。BACKGROUND： Stainless steel wire is commonly used to treat patellar fracture fixation. According to hyperelasticity of Ni-Ti alloy, a hypothesis is proposed to fix the fracture with Ni-Ti alloy wire to obtain favorable effect. OBJECTIVE： To evaluate the mechanical functions of the figure of eight and circular Ni-Ti Alloy wire fixation in the treatment of patella fracture, and to compare the effect with stainless steel wire. DESIGN, TIME AND SETTING： Biomechanical analysis was performed at the Biomechanics Laboratory, Fujian Institute of Orthopedics between July 2002 and March 2003. MATERIALS： Patella with fresh quadriceps femoris and patellar ligament with no pathological changes, which was voluntarily provided by seven adult males undergoing amputation due to road accident or other trauma. METHODS： These patela were fixed and tested in the measure rack using electrometric technique under 50, 100, 150, 200, 250, and 300 N load. The anterior patella stress without fixation, and following stainless steel wire fixation or Ni-Ti Alloy wire fixation was measured. MAIN OUTCOME MEASURES： Effects of stainless steel wire fixation or Ni,Ti Alloy wire fixation on patellar Section. RESULTS： The pressure effect on frature Section of patella that was fixed by stainless steel wire increased violently from 0.289 4 MPato 0.454 4 MPa with an increase by 57.017% when quadriceps force increased from 150 N to 300 N. Whereas, under the Ni-Ti Alloy wire fixation, the pressure effect increased from 0.227 0 MPa to 0.285 1 MPa with an increase by 25.59%. The pressure effect on fracture section of patella that was fixed by stainless steel wire decreased violently from 0.436 5 MPa to 0.244 8 MPa with a decrease by 43.91% when quadriceps force decreased from 300 N to 150 N. Whereas, under the Ni-Ti Alloy wire fixation, the pressure effect decreased from 0.231 6 MPa to 0.173 7 MPa with a decrease by 25.00%. CONCLUSION： The Ni-Ti alloy wire fixation could provide continuous and slightly changing pressure for the f

关 键 词：髌骨骨折 内固定 镍钛合金丝 生物力学 

分 类 号：R318[医药卫生—生物医学工程]