髋臼后柱骨折不同方式钢板内固定的稳定性研究  

Biomechanical comparison of 4 plate internal fixation methods for simulated fractures of acetabular posterior column

作　　者：吴啸波[1] 张奇[1] 郭明珂[1] 张英泽[1] 

机构地区：[1]河北医科大学第三医院骨科,石家庄050051

出　　处：《第三军医大学学报》2010年第7期665-668,共4页Journal of Third Military Medical University

基　　金：国家自然科学基金(30440014)~~

摘　　要：目的研究髋臼后柱骨折4种方式钢板内固定的稳定性。方法半骨盆标本20个根据随机数字法分为4组,建立髋臼后柱骨折模型,行4种方式钢板内固定:A组:钢板两端各固定2枚螺钉;B组:钢板两端各固定3枚螺钉;C组:骨折线两侧距骨折线最近的螺孔及钢板每端2个螺孔固定;D组:骨折线两侧各固定4枚螺钉。行轴向压缩实验,观察骨折断端位移和剪切刚度。结果A、B、C、D组位移分别为(4.68±0.35)、(2.80±0.25)、(2.12±0.11)mm和(1.58±0.17)mm,剪切刚度分别为(129.42±9.60)、(228.91±12.05)、(285.21±26.16)N/mm和(414.71±34.29)N/mm。各组位移和剪切刚度差异有统计学意义(P<0.05)。结论髋臼后柱骨折钢板内固定时,危险区内安全置钉能增强内固定的稳定性。Objective To evaluate the stability of 4 different methods of plate internal fixation for simulated posterior column fracture of the acetabulum.MethodsTwenty preserved cadaveric semipelvic specimens were divided into 4 groups randomly.Models of isolated posterior column fractures of acetabulum were established and then fixed with 1 of following 4 methods of plate internal fixation：2 screws at the each end of plate（group A）,3 screws at the each end of plate（group B）,1 screw each side in the closest allowable hole to the fracture and 2 screws at the each end of plate（group C）,and 4 screws on each side of the fracture（group D）.Under vertical compression load of 3 times＇ body weight,the displacements of the fracture site were measured and the shear rigidity of different internal fixation methods were compared.ResultsThe displacements of the fracture site in Group A,B,C,and D were 4.68±0.35,2.80±0.25,2.12±0.11 and 1.58±0.17 mm respectively,with a decreasing trend from Group A to D.The shear rigidity of internal fixation methods in Group A,B,C,and D were 129.42±9.60,228.91±12.05,285.21±26.16 and 414.71±34.29 N/mm respectively,with an increasing trend from Group A to D.The differences of both displacements and shear rigidity between each 2 groups were significant（P〈0.05）.The stability of fixation methods in different groups was reached its maximum in Group D.ConclusionUnder the prerequisite of safe angle of screw placement,holes on the plate in the danger zone of acetabulum,especially the ones being closest to either side of the fracture line,should be fixed in order to attain rigid internal fixation for posterior column fractures of the acetabulum.

关 键 词：髋臼 骨折 内固定 生物力学 

分 类 号：R318.01[医药卫生—生物医学工程] R683.305[医药卫生—基础医学]