可吸收内固定材料植入髌骨横断性骨折局部:与金属植入物生物力学性能的比较  

Fixation of patella transverse fracture with absorbable materials:A biomechanical comparison with mental implant

作　　者：郑金龙[1] 王以进[2] 陈爱民[3] 刘立峰[1] 

机构地区：[1]解放军济南军区总医院全军骨创伤外科中心,山东省济南市250031 [2]上海大学生物力学研究所,上海市201800 [3]上海长征医院骨科,上海市200003

出　　处：《中国组织工程研究与临床康复》2009年第51期10069-10073,共5页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景:可吸收内固定材料具有手术简便、恢复快及无需二次手术等诸多优点,受到骨科界的青睐,并在临床上有一定的应用,但仍缺乏可靠的系统实验依据。目的:通过对可吸收材料(可吸收张力带加可吸收棒或螺钉)和钢丝张力带加克氏针在髌骨横断性骨折修复固定中的生物力学比较,研究可吸收材料替代钢丝张力带加克氏针的可行性。设计、时间及地点:随机分组对照实验,生物力学分析,于2007-03/2008-01在上海大学生物力学研究所实验室完成。材料:采新鲜成年尸体髌骨标本8个,保留完整髌骨、关节囊、髌韧带3.0～4.0cm和股四头肌4.0～5.0cm。方法:随机分成AO钢丝组2个和可吸收张力带组6个,制成横断骨折模型,分别用可吸收张力带、钢丝张力带加克氏针进行内固定,测定它们的生物力学性能,骨折端分离1.0mm为固定失效。主要观察指标:髌韧带拉力、股四头肌拉力、髌骨分离性位移、股四头肌位移、髌韧带位移及髌骨拉应变在外载荷作用下的变化。结果:在外载荷作用下,可吸收张力带组的总体位移与AO钢丝组相差不大(两者相差9%～10%),可吸收张力带组髌骨的应变与AO钢丝组相差不大(两者相差9%～10%),可吸收张力带组的髌股关节力与AO钢丝组基本相似,且髌骨骨折内固定位移1mm时,可吸收张力带组载荷为587N,AO钢丝组载荷为650N,经统计学处理差异均无显著性意义(P>0.05)。结论:可吸收材料具有优越的生物性能和良好的骨折断端稳定性,在髌骨横断性骨折内固定中替代钢丝张力带和克氏针是可行的。BACKGROUND：Absorbable materials for internal fixation have some advantages such as simple surgery,rapid recovery and no need to second surgery,and have been accepted in the circle of orthopaedics,and had been applied in the clinic.However,the system experiment evidences are not reliable.OBJECTIVE：To investigate whether the absorbable material （the absorbable tension band,absorbable stick or screw） is an acceptable alternative to stainless steel wire with Kirschner wire by comparing their biomechanical properties in the fixation of patella transverse fractures.DESIGN,TIME AND SETTING：The randomized controlled study of biomechanical analysis was performed at the Laboratory of Institute of Biomechanics,Shanghai University from March 2007 to January 2008.MATERIALS：Eight fresh patellae specimens were collected,with the complete patella,articular capsule and patellar ligament （3.0-4.0 cm） and quadriceps femoris （4.0-5.0 cm）,and then divided into two groups at random,AO steel wire group （n=2） and absorbable tension band group （n=6）.METHODS：Eight fresh patellae specimens were divided into two groups at random,AO steel wire group （n=2） and absorbable tension band group （n=6） to create models of transverse fractures,which were separately fixed by absorbable tension band,steel wire tension band ＋ Kirschner wire to measure their biomechanics function.If fracture gap reached 1.0 mm,the fixation failed.MAIN OUTCOME MEASURES：The changes in patellar ligament tensile force,quadriceps femoris tensile force,patellar displacement,quadriceps femoris displacement,patellar ligament displacement and patella tensile strain were measured under external load.RESULTS：Under external load,no significant difference was determined in total displacement between the absorbable tension band group and AO steel wire group （9%-10% difference）.No significant difference was detected in patellar strain between absorbable tension band group and AO steel wire group （9%-10% difference）.The patellofemoral

关 键 词：髌骨骨折 可吸收张力带 内固定 生物力学 

分 类 号：R318[医药卫生—生物医学工程]