股骨静力交锁髓内钉生物力学性能及对骨折愈合的影响  

Biomechanical performance and effect of static interlocking intramedullary nails on femoral fracture healing

作　　者：严雪港[1] 鲍同柱[2] 赵卫东[3] 鄢飞[2] 梁栋柱[3] 丁志兵[4] 

机构地区：[1]三峡大学第一临床医学院,湖北省宜昌市443003 [2]宜昌市中心人民医院,湖北省宜昌市443003 [3]南方医科大学医学生物力学重点实验室,广东省广州市510515 [4]三峡大学医学院解剖教研室,湖北省宜昌市443002

出　　处：《中国组织工程研究与临床康复》2010年第17期3123-3126,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：湖北省宜昌市科研基金项目(A05302-02)~~

摘　　要：背景:交锁髓内钉是治疗股骨骨折的常用内固定器械,术中是否常规提拉加压,以及术后是否及时动力化,对骨折愈合起着至关重要的作用,如何通过干扰各种因素来提高骨折愈合率是人们研究的重点。目的:观察股骨静力交锁髓内钉生物力学性能及对骨折愈合的影响。方法:采用甲醛浸泡的成人尸体股骨标本8对,制成中段横形骨折模型后分别用静力型交锁髓内钉(髓内钉组)、TiNi环抱式接骨板(环抱器组)、有限接触动力加压接骨板(加压钢板组)固定,测试抗轴向压缩、抗三点弯曲和抗扭转力学性能,计算应力遮挡率。结果与结论:髓内钉组与加压钢板组相比,抗轴向压缩性能和抗三点弯曲性能相当(P>0.05),但抗扭转性能较弱(P<0.05);与环抱器组相比,抗轴向压缩性能和抗三点弯曲性能较强(P<0.05),而抗扭转性能差异无显著性意义(P>0.05);髓内钉组的应力遮挡率与加压钢板组差异无显著性意义(P>0.05),明显高于环抱器组(P<0.01)。提示交锁髓内钉的生物力学稳定性可靠,但应力遮挡率较高,临床应用时需及时对其动力化,促进骨折愈合。BACKGROUND：Interlocking intramedullary nails （SIiN） is frequently used to treat femoral fracture.Routine pulling and compression and postoperative motorization are important for fracture healing.To improve fracture healing rate has been focused using various factors.OBJECTIVE：To explore the biomechanical performance of static SIiN in fixation of femoral fracture,and the effect on fracture healing.METHODS：A total of 8 pairs of femurs from adult cadavers immersed in formalin were used to prepare models of midpiece transverse fracture.The fracture was respectively fixed using static SIiN,TiNi shape-memory sawtooth-arm embracing internal fixator （TiNi SMA）,and dynamic compression plate （DCP）.The anti-compression,anti-bending,and anti-torsion rigidity were measured,and the stress shielding rate was calculated.RESULTS AND CONCLUSION：SIiN was similar to DCP group in anti-compression rigidity and anti-bending rigidity （P 0.05）,but the anti-torsion was lower than DCP group （P 0.05）.Compared with TiNi SMA group,SIiN displayed greater anti-compression rigidity and anti-bending rigidity （P 0.05）,but similar anti-torsion （P 0.05）.SIiN was similar to DCP group in stress shielding rate （P 0.05）,but significantly greater than TiNi SMA group （P 0.01）.The biomechanics of SIiN was stable,but the stress shielding rate was high.Changing static interlocking into dynamic interlocking in time is necessary in clinic to promote fracture healing.

关 键 词：应力遮挡率 生物力学 静力型交锁髓内钉 动力化 提拉加压 

分 类 号：R318[医药卫生—生物医学工程]