I.CO.S.螺钉治疗股骨颈骨折的生物力学研究  

BIOMECHANICAL RESEARCH OF IDEAL COMPRESSION SCREW FOR TREATMENT OF FEMORAL NECK FRACTURE

作　　者：陆慧[1] 倪卫东[1] 高仕长[1] 

机构地区：[1]重庆医科大学附属第一医院骨科,重庆400016

出　　处：《中国修复重建外科杂志》2009年第5期566-569,共4页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨I.CO.S.(ideal compression screw)螺钉在治疗股骨颈骨折中的生物力学作用,为临床选择此类螺钉治疗股骨颈骨折提供理论依据。方法取甲醛固定成年(45～60岁)尸体股骨标本48个,选骨密度及股骨颈长度相似的标本30个,制备股骨颈头下型骨折模型,随机分为I.CO.S.螺钉组(实验组)和普通空心加压螺钉组(对照组),实验组根据植钉数量及位置不同又分为A(水平位2枚)、B(垂直位2枚)、C(倒三角位3枚)3个亚组,对照组分为D(水平位2枚)、E(垂直位2枚)、F(倒三角位3枚)3个亚组,每亚组5个标本。以速率1.2mm/min线性载荷0～600N分级加载,测定各组载荷下股骨上段应变值、股骨头水平位移和垂直位移,并进行屈服力学性能测试。结果在生物力学稳定性方面:A、B、C组水平位移和屈服载荷均较D、E、F组好(P<0.05),A、D组应变、水平位移和屈服载荷均较B、E组好(P<0.05),而C、F组间以及A、C组间应变、水平位移、垂直位移、屈服位移和屈服载荷差异均无统计学意义(P>0.05)。结论I.CO.S.螺钉固定股骨颈骨折稳定可靠,且2枚I.CO.S.螺钉水平位固定有较高的生物力学稳定性,可为临床应用提供力学依据。Objective To explore the biomechanical stability of ideal compression screw（I.CO.S.） for treatment of femoral neck fracture and to provide theoretical basis for choosing I.CO.S.in clinical application.Methods Thirty cadaveric human femurs were selected and divided randomly into experimental group（n=15） and control group（n=15）, 15 in each group were divided equally into three sub-groups（n=5） again.The model of subcapital femoral neck fracture was made, then given anatomical reduction and fixed with I.CO.S.（experimental group） and general cannulated compression screw（control group） separately with three different configurations：two horizontal（parallel screws in superior aspect of femoral neck）, two vertical（parallel screws in sagittal plane of femoral neck） and reverse triangle.The different biomechanical performances were evaluated through experimental stress analysis.Results In biomechanical stability aspect：groups A, B, C was better than groups D, E, F in respect of horizontal displacement and yield load（P 〈 0.05）;groups A, D was better than groups B, E in respect of the straining, horizontal displacement and yield load（P 〈 0.05）;and there were not significant differences in all biomechanical indicators between group C and group F, and between group A and group C（P 〉 0.05）.Conclusion I.CO.S.has the good biomechanical stability for treatment of femoral neck fracture, which may provide basis for application.

关 键 词：股骨颈骨折 内固定 I.CO.S.螺钉 生物力学 

分 类 号：R687.1[医药卫生—骨科学] R318.01[医药卫生—外科学]