垂直不稳定型骨盆骨折两种固定方法的生物力学研究  

Biomechanical study on fixed approaches for vertical unstable pelvic fracture

作　　者：刘洋[1] 王冶[2] 陈方舟[1] 梅红军[1] 游浩[1] 杨青[1] 蔡林[2] 张红喜[3] 刘禹钦[3] 

机构地区：[1]武汉市第五医院,江汉大学第二附属医院骨科,湖北武汉430050 [2]武汉大学中南医院骨科,湖北武汉430021 [3]武汉理工大学力学研究中心,湖北武汉430021

出　　处：《生物医学工程与临床》2009年第5期377-381,共5页Biomedical Engineering and Clinical Medicine

基　　金：亚洲创伤骨科学会(Asian Association for Dynamic Osteosyn thesis;AADO)科研基金资助(2007 AADO Research Fund-004)

摘　　要：目的采用传统外固定架和改良外固定架两种外固定方法,研究固定后垂直不稳定型骨盆骨折的生物力学特性。方法7具骨盆标本,其中男性4具,女性3具,年龄17～38岁。制成垂直不稳定型骨盆骨折模型,对骶髂关节均采用前路钢板固定,再分别用传统外固定架及改良外固定架固定后,于静力位测试生物力学数据并进行比较。结果改良外固定架固定时:患侧骶髂关节应变为0～(806.5±76.8)με,骶髂关节纵向位移0～(3.9±0.6)mm,耻骨分离移位0～(5.0±1.3)mm,骨盆整体压缩率2.2%±0.5%,骨盆承受极限压力(1920.0±65.5)N;传统外固定架固定时:患侧骶髂关节应变为0～(1015.3±108.0)με,骶髂关节纵向位移0～(5.2±1.0)mm,耻骨分离移位0～(9.8±2.5)mm,骨盆整体压缩率2.9%±0.6%,骨盆承受极限压力(1513.7±165.7)N。结论改良外固定架固定结合内固定术式较传统术式更符合垂直不稳定型骨盆骨折稳定的要求,为临床提供了一些有参考价值的生物力学依据。Objective To study the biomechanical characteristics of traditional external fixation or modified external fixation in the treatment of vertical unstable pelvic fracture after fixed in 2 approaches.Methods Seven pelvic samples of vertical unstable pelvic fracture model were established.Their sacroiliac joints were fixed by anterior plates,then the traditional external fixation or modified external fixation were performed respectively in the pelvic fracture model.The results of biomechanical static-test data were compared.Results In modified external fixation,the fractured side strain of the sacroiliac joint was 0-（806.5 ± 76.8）με,sacroiliac joint vertical displacement was 0-（3.9 ± 0.6）mm,pubis separation displacement was 0-（5.0 ± 1.3）mm,the rate of pelvic compression was 2.2 % ± 0.5 %,and the maximal load pressure of pelvic was（1 920.0 ± 65.5）N;while in traditional external fixation,the fractured side strain of the sacroiliac joint was 0-（1 015.3 ± 108.0）με,sacroiliac joint vertical displacement was 0-（5.2 ± 1.0）mm,pubis separation displacement was 0-（9.8 ± 2.5）mm,the rate of pelvic compression was 2.9 % ± 0.6 %,and the maximal load pressure of pelvic was（1 513.7 ± 165.7）N.Conclusion Modified external fixation is superior to the traditional external fixation in meeting the vertical unstable pelvic fracture stability requirements and it provides some valuable biomechanic basis for clinical practice.

关 键 词：垂直不稳定型骨盆骨折 外固定架 生物力学 

分 类 号：R687.3[医药卫生—骨科学] R318.01[医药卫生—外科学]