股骨远端骨折3种内固定方法的生物力学研究比较  

Biomechanical comparison of three methods of internal fixation for distal femoral fractures

作　　者：韩擎天[1] 王以进[2] 汤红伟[1] 

机构地区：[1]上海交通大学医学院附属仁济医院嘉定分院骨科,上海201800 [2]上海大学生物学研究所

出　　处：《中国骨伤》2010年第8期601-604,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的:对股骨远端骨折三种内固定方法进行定量生物力学比较,为临床选择有效的内固定方法提供理论依据。方法:取12具新鲜尸体股骨标本,制成股骨髁间骨折模型(AO分类的C1型),采用股骨交锁髓内钉(A)、"L"形髁钢板(B)、加压钢板(C)3种内固定方法,观察股骨髁上应变、位移、刚度、强度,对股骨远端3种内固定方法进行生物力学分析,并以有限元理论分析论证它的结果。结果:试验发现在受同等载荷条件下,髁上交锁髓内钉固定强度、刚度最佳,而采用"L"形髁钢板和加压钢板固定股骨髁强度、刚度较差。3组应力和髁间位移均有显著差异性(P<0.05)。结论:采用股骨髁上交锁髓内钉固定方法优于其他内固定方法,具有操作简单、锁钉定位准确、固定牢靠等优点,是治疗股骨远端骨折较好的内固定方法。Objective：To compare the biomechanics of three internal fixations for distal femoral fractures,and to choose suitable clinical internal fixation according to experimental date.Methods：The fracture models of femoral condydle were made on 12 fresh cadaver femurs（C1 type of AO classification）.The fractures were fixed by supracondylar intramedullary interlock-ing nails（A）,L shaped condyle plates（B）and compressed plates（C）respectively.The straining,displacement,rigidity and in-tensity of femoral supracondyla of the three internal fixations of distal femoral fractures were observed and analyzed by biome-chanics.These three different internal fixation methods were compared by experimental stress analysis.These results were fur-ther confirmed by theoretical analysis using finite element method（FFM）.Results：Under the same load condition,supra-condylar intramedullary interlocking nail fixation was the best on the intensity and rigidity,while for compressed plate and L shaped condyle plate,the femoral condyle intensity and rigidity were worse（P〈0.05）.There were distinct differences in stress and displacement among three methods（P〈0.01）.Conclusion：Supracondylar intermedullary interlocking nail is the best method among the three internal fixation methods.It has advantage such as screw location,solid fixation and less complication.It is a good internal fixation method for distal femoral fracture.

关 键 词：股骨骨折 骨折固定术 内 生物力学 

分 类 号：R683.42[医药卫生—骨科学]