可注射磷酸钙骨水泥增强DHS固定骨质疏松性股骨粗隆间骨折的体外生物力学分析  

Biomechanical evaluation of an injectable calcium phosphate cement incorporating DHS for osteoporotic intertrochanteric fracture:an in vitro study

作　　者：喻任[1] 张玉发 倪诚[1] 陆纯德[1] 程俊秋[3] 范红松[3] 

机构地区：[1]上海建工医院骨科,上海200083 [2]上海开元骨科医院,上海200129 [3]四川大学生物材料工程研究中心,成都610014

出　　处：《医用生物力学》2010年第1期51-55,共5页Journal of Medical Biomechanics

基　　金：上海市虹口区卫生局科研课题(0602-07)

摘　　要：目的评价一种可注射磷酸钙骨水泥(Calcium Phosphate Cement,CPC)强化股骨近端对老年骨质疏松性股骨粗隆间骨折内固定的生物力学影响。方法选用5对骨质疏松性股骨近端标本制作粗隆间骨折模型,以DHS固定,分为对照组与CPC强化组进行生物力学检测。结果CPC强化组在500N应力下的轴向刚度为(691.93±18.90)N/mm,水平剪切刚度为(5553.84±27.47)N/mm,内外侧平均强度分别为(5.15±0.35)MPa,(4.13±0.24)MPa,扭转刚度为0.41,极限载荷(3580±286)N;对照组在500N应力下的轴向刚度为(453.45±19.75)N/mm,水平剪切刚度为(3848.87±22.63)N/mm,内外侧平均强度分别为(3.12±0.37)MPa,(1.80±0.21)MPa,扭转刚度为0.35,极限载荷(2512±189)N。CPC强化组的各项力学性能均高于于对照组,差异有显著性意义(P<0.05)。结论以CPC对骨质疏松性股骨头内及内后侧缺损处强化可以有效提高骨质疏松性股骨粗隆间骨折内固定稳定性,降低术后并发症的风险。Objective To evaluate the biomechanical effects of using a new injectable calcium phosphate cement to consolidate the fixation of osteoporotic intertrochanteric fracture.Method Five matched pairs of human cadaver femora were used to produce the model of intertrochanteric fracture.All fractures were fixed with dynamic hip screws（DHS）,and divided into two groups.In the CPC consolidation group of each pair,CPC was used to grout the hip screw and to fill the posteromedial defect.All femora were subjected to biomechanical test.Results Under the loading of 500 N,in the CPC consolidation group,the mean axial stiffness is（691.93±18.90）N/mm and the horizontal shear stiffness is（5553.84±27.47）N/mm.The mean lateral and medial strength is（5.15 ±0.35）MPa and（4.13±0.24）MPa.The torsion stiffness was 0.41 and the ultimate loading is（3580±286）N.In the control group,the mean axial stiffness is（453.45±19.75）N/mm,the horizontal shear stiffness is（3848.87±22.63）N/mm,the mean lateral and medial strength is（3.12±0.37）MPa and（1.80±0.21）MPa,and,the torsion stiffness is 0.35 and the ultimate loading is（2512±189）N.Consolidation fixation with CPC increased each of the biomechanical efficiency（P0.05）.Conclusions CPC consolidation of osteoprotic femoral head and the medial defect of intertrochanteric fracture can significantly improve the overall stability and decrease the rate of postoperative complication.

关 键 词：磷酸钙 骨质疏松 骨折内固定 刚度 术后并发症 

分 类 号：R31[医药卫生—基础医学]