股骨小转子缺损及复位固定的生物力学比较  

Biomechanical comparison between the defect of femur lesser trochanter and the replacement and fixation

作　　者：曹培锋 洪勇平 王以近[2] 李鹏 

机构地区：[1]山东省淄博市淄川区医院外二科,255100 [2]上海大学生物力学工程研究所,201800

出　　处：《中国矫形外科杂志》2009年第22期1722-1724,共3页Orthopedic Journal of China

摘　　要：[目的]测试股骨小转子缺损及复位固定对股骨上端生物力学性能的影响,探讨股骨转子间骨折小转子固定的必要性。[方法]采集国人新鲜股骨上段标本,模拟骨折造成股骨小转子缺损和股骨小转子广泛缺损以及重新将小转子复位螺钉固定,分别测量股骨上端的强度、刚度和扭转力学性能。[结果]股骨小转子缺损和广泛缺损会导致股骨应力集中,强度分别增加31%、37%;股骨刚度分别下降29%、51%;股骨抗扭强度分别下降33%、54%。小转子固定后则应力集中下降25%、28%,刚度提高20%、31%,抗扭强度增加23%、29%,力学性能明显恢复。[结论]股骨小转子缺损或广泛缺损,导致股骨抵御外载荷及抗扭力学性能显著下降。提示股骨转子间骨折治疗中小转子固定是不容忽视的因素。[ Objective] To test the biomechanical performance effect on the upper femur under conditions of the defect of femur lesser trochanter and replacement and fixation; and to discuss the necessity of lesser trochanter fixation of femoral intertro- chanteric fracture. [ Method] Some specimens of the upper sections of fresh Chinese femurs were collected. Through simulating fracturing,some defect and even broader defect of the lesser trochanter were caused. The lesser trochanter was fixed. Last, the strength, rigidity and the twisting force of the upper section of the femur were measured respectively. [ Result ] The defect and even broader defect of femur lesser trochanter would cause stress concentration of femurs. The strength increased 31% and 37% respectively while the rigidity reduced 29% and 51% respectively and the anti - twisting strength reduced 33% and 54%. After the lesser trochanter had been fixed, the stress concentration would reduce 25% and 28%, the rigidity would increase 20% and 31% , and the anti-twisting strength would increase 23% and 29%. The mechanical performance would be obviously recovered. [ Conclusion] The defect and broader defect of the femur lesser trochanter will cause significant decrease in the mechanical performance of the femur when resisting external load and twisting. In the treatment of the femoral intertrochanteric fracture, the fixation of the lesser trochanter is an important factor.

关 键 词：股骨小转子缺损 螺钉固定 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]