骨横断骨折不同改良方式张力带钢丝固定的生物力学测试  

Biomechanical Evaluation of Various Forms of Modified Tension Band Wiring for Transverse Patellar Fracture

作　　者：郑季南[1,2] 唐农轩[1,2] 

机构地区：[1]第四军医大学唐都医院全军骨科中心 [2]解放军第180医院

出　　处：《中国矫形外科杂志》1999年第4期268-270,共3页Orthopedic Journal of China

摘　　要：目的：为了评价髌骨骨折不同改良方式张力带钢丝固定的牢靠程度。方法：取截肢后下肢，保留股四头肌腱、髌骨、髌韧带及关节囊。将股骨、胫骨端固定在材料试验机上，维持胫股关节屈曲３６°位，通过牵拉股四头肌腱产生张力，用线性运动传感器测定骨折移位，移位３ｍｍ为固定失效。测ＡＯ张力带钢丝，胥氏张力带钢丝，“８”字张力带钢丝和Ｍａｇｎｕｓｏｎ钢丝４种固定法。结果：胥氏张力带钢丝和“８”字张力带钢丝固定效果最好。ＡＯ张力带钢丝次之，三者均能承受２９４Ｎ以上牵张力，允许术后早期活动，Ｍａｇｎｕｓｏｎ钢丝不能承受２９４Ｎ以上牵张力，固定欠牢靠。结论：治疗髌骨横断骨折首选胥氏张力带钢丝或“８”字张力带钢丝，粉碎性骨折选用“８”Objective:A study was undertaken to evaluate,patella the strength of various forms of modified tension band wiring.Methods:Using cadaver extremities with the quadriceps tendon patellar tendon and an intact capsular apparatus,the tibia and femur were mounted in an Instron Materials Testing System,and the tibiofemoral joint was held at 36° of flexion.Tension was applied to the patella through the quadriceps tendon and fracture displacement was measured with linear motion transducers.Displacement of 3mm was considered to represent failure of fixation.AO tension band wiring,Xus tension band wiring,figure of eight tension band wiring and Magnusson wiring were examined respectively.Results:The Xus and figure of eight tension band wiring were more effective than AO tension band wiring.All of them could bear tensive force over 294N and may provide sufficient fixation to allow immediate range of motion.Magnusson wiring could bear force less than 294N,which appeared not firm enough.Conclusions:Xus or figure of eight tension band wiring should be selected firstly in the treatment of transverse fracture of patella.Fgure of eight tension band wiring was more suitable to the comminuted fracture.

关 键 词：髌骨骨折 髌骨内固定 髌股关节作用力 

分 类 号：R683.420.5[医药卫生—骨科学]