髋臼双柱骨折继发性匹配的生物力学研究  

The vitodynamics study of acetabular dual-column fracture with secondary congruence

作　　者：王志红[1] 张英泽[2] 张奉琪[2] 彭阿钦[2] 

机构地区：[1]河北医科大学第三医院康复科,石家庄市050051 [2]河北医科大学第三医院创伤急救中心,石家庄市050051

出　　处：《河北医药》2008年第11期1653-1655,共3页Hebei Medical Journal

摘　　要：目的探讨髋臼双柱骨折继发性匹配下不同骨折间隙情况下髋臼和股骨头之间的生物力学变化。方法将3具成年男性防腐尸体,截取完整骨盆及与之相连的近侧1/3股骨,将按模板剪裁好的压敏片贴于股骨头上,用自制的夹具固定髋臼和股骨头于单足站立骨盆中立位,置于CSS-44020生物力学实验机上,以10N/s的速度加载至500 N,维持120 s,加压过程中,用钝头探针通过标本的定位孔在压敏片上建立标记点,加压着色后的压敏片根据标记点分区,分别测量负重顶区、前壁和后壁的负重面积、应力和应力分布。结果对髋臼双柱骨折继发性匹配,当骨折间隙为2 mm时,虽然在负重顶区骨折线两侧出现应力集中,但对髋关节的接触特性影响不大,而当骨折间隙为5 mm时,髋关节的接触特性产生了显著的变化。负重面积、平均应力和峰值应力在负重顶区均明显增大;在前壁均明显减小;后壁负重面积减小,但平均应力和峰值应力均显著增大。结论髋臼双柱骨折继发性匹配改变了髋臼和股骨头之间的接触特性,尤其当间隙为5 mm时,髋臼的负重面积、负重和应力分布发生了重新分配。Objective To evaluate the vitodynamics consequence of acetabular dual-column fracture exhibiting secondary congruence with different gaps.Methods Three embalmed cadaveric pelvis and their respective proximal 1/3 femora were harvested.The pressure sensitive films were fixed to the surface of femoral head.The specimens were fixed in an anatomic position by simulating single leg standing using self-made fixture,and were loaded on to CSS-44020 Biomechanical machine.The pressure was increased at the rate of 10 Newtons/second until 500 Newtons and keeping for 120 seconds.During loading,a pointless probe was used to mark the pressure-sensitive film through the hole to establish a reference point of the film,The pressure sensitive film was divided into three parts according to the markers： dome,anterior articular region and posterior articular region.The loading area,the pressure and the distribution of the pressure were measured,respectively.Results For acetabular dual-column fracture with secondary congruence,when the gap between the columns was 2 mm,there was a small effect on the contact characteristics between the acetabulum and femoral head although there was a concentrated stress at the two sides of fracture line.But when the gap was 5 mm,there was a remarkable change to the contact characteristics of hip joint.The contact area,the mean and peak pressure increased significantly in the dome,while they were decreased in anterior articular region.In the posterior articular region,the contact area decreased while the mean and peak pressure increased significantly.Conclusion Acetabular dual-column fracture with secondary congruence changes the contact characteristics between the acetabulum and femoral head,especially when the gap between the columns reach to 5 mm,the loading area,pressure and distribution of the pressure of the hip joint are all redistributed.

关 键 词：髋臼双柱骨折 继发性匹配 生物力学 

分 类 号：R683.3[医药卫生—骨科学] R684.7[医药卫生—外科学]