自制加锁梅花针治疗股骨中下段骨折的生物力学测试  

Biomechanics of the distal femoral fracture fixation with bolt locked intramedullary nail

作　　者：刘阳[1] 张明胜 曾凌风 毕振宇[3] 赵卫东[3] 

机构地区：[1]南方医科大学南方医院口腔医学系 [2]佛冈县人民医院骨科,广东清远511600 [3]南方医科大学解剖学教研室,广东省医学生物力学重点实验室,广州510515

出　　处：《中国临床解剖学杂志》2010年第5期582-585,共4页Chinese Journal of Clinical Anatomy

基　　金：广东省自然科学基金(04300684)

摘　　要：目的对自行研制的用于治疗股骨中下段骨折加锁梅花针进行生物力学测试,为临床应用提供生物力学基础。方法用6例新鲜成人股骨标本,制作股骨中上段骨折模型两种,梅花针固定;然后制作股骨下段骨折模型两种,加锁梅花针固定;最后利用股骨下段骨折模型交锁钉固定,每次作下一骨折模型前,用钢片张力带固定前一次的骨折线。依次对正常股骨标本、梅花针固定后的标本、加锁梅花针固定的标本、交锁钉固定的标本进行扭转测试、垂直压缩试验、4点弯曲试验,分析4组试验的实验数据。结果梅花针固定股骨中上段骨折、加锁梅花针固定股骨下段骨折和交锁钉固定的股骨下段骨折抗扭转测试中,均可以达到4Nm抗旋转刚度;轴向压缩试验中最大应变正常组和梅花针组、加锁梅花针组无明显差异,4点弯曲试验中梅花针与加锁梅花针和正常标本的弯曲刚度相近,交锁钉的抗弯曲刚度明显高于其他3者。结论加锁梅花针冶疗股骨中下段骨折,具有良好的生物力学性能,固定效果可靠。Objective To analyze biomechanical properties of a new type of interlocking intramedullary nail,bolt locked intramedullary nail,and provide basis for clinical treatment of the distal femoral fracture fixation.Methods 6 fresh femurs were obtained from adult cadavers to produce two fracture models of the proximal femur,which were reduced with cloverleaf type intramedullary nail,and then distal femoral fracture models were simulated twice.The new fracture model would be performed after the previous fracture line was fixed with steel tension band.The torsional testing,axial compression testing,and 4-point bending testing were performed successively in normal group,cloverleaf type intrame-dullary nail group,bolt locked intramedullary nail group,and interlocking intram edullary nail group.The biomechanical parameters were measured and the results were analyzed with SPSS 13.0 software.Results The rigidity against rotation of the femoral fracture model in the proximal 2/5 part-4mm fixed by the cloverleaf type intramedullary nail and in the 4/5 part-4mm by bolt locked intramedullary nail were over 4Nm torque.The maximum strain of posterior middle of femoral diaphysis in axial compression tests were not different for normal group,cloverleaf type intramedullary nail group,and bolt locked intramedullary nail group.The maximum stiffness of the femur in 4-point bending tests were not different with the cloverleaf type intramedullary nail group,bolt locked intramedullary nail group and normal group,and that of interlocking intramedullary nail group significantly different from others.Conclusions The exploration of biomechanical parameters demonstrate that,the bolt locked intramedullary nail is reasonable and practical.

关 键 词：股骨 梅花针 加锁梅花针 钢片张力带 生物力学 

分 类 号：R318.01[医药卫生—生物医学工程]