不同内固定方式治疗髋臼四方区内移骨折的生物力学研究  

Biomechanical study on different internal fixation of acetabular fracture in quadrilateral surface

作　　者：马海涛[1] 毕大卫[1] 王波[1] 刘道君[1] 杨育生[1] 朱元[1] 祖罡[1] 

机构地区：[1]杭州市萧山区第一人民医院骨科,311200

出　　处：《浙江医学》2010年第11期1628-1631,共4页Zhejiang Medical Journal

摘　　要：目的探讨三种不同的内固定方式固定髋臼四方区内移骨折的生物力学稳定性。方法采集8个国人新鲜固定的髋臼标本，随机分成经髂腹股沟入路重建钢板组、经Stoppa入路重建钢板组、经Stoppa入路带锁定的重建钢板加垫片组和正常对照组。标本固定后置入CSS-44020生物力学试验机，试验前予加载100N压力，然后以14mm／min加载速度模拟准静态加压，加压值取最大生理载荷800N。用压敏片测量接触特性，用应变式弓形磷青铍铜传感器测量髋臼张开位移程度。结果经Stoppa入路带锁定的重建钢板加垫片组髋臼的纵向位移和横向位移，在800N压力下，仅为（1.18±0.12）mm和（0.62±0.06）mm，比经髂腹股沟入路重建钢板组和经Stoppa入路重建钢板组分别小42％和20％（P〈0.05）；同时髋臼的轴向刚度和横向刚度分别高40％以上。带锁定的重建钢板加垫片固定后，髋臼与股骨头之间负重区面积接近正常标本，仅相差7％，差异无统计学意义（P〉0.05），而经髂腹股沟入路重建钢板组和经Stoppa入路重建钢板组分别达25％和16％。结论经Stoppa入路带锁定的重建钢板加垫片固定髋臼四方区内移骨折，在生物力学的刚度和接触性方面，比经髂腹股沟入路重建钢板和经Stoppa入路重建钢板固定有较大优势。Objective To investigate the biomechanicat stability of the quadrilateral surface shift fracture with three different internat fixation methods. Methods Eight fresh fixed acetabular specimens were collected, taken the normal pelvis as the control, they were randomly taken into Ilioinguinal approach with reconstruction plate, Stoppa approach with reconstruction plate, Stoppa approach with reconstruction plate accompanied with locked screws and cushion for fixation. They were all installed into CSS -44020 biomechanical testing machine. Before testing, 100N was loaded to remove the Ioosenese and creep rheology influence of the bone. Then 1.4mm/min loading speed was added to simulate quasi-static loading. The greatest load value was 800N according to the greatest physiological load. Contact characteristics were measured with pressure sensitive film. The acetabular displacements were detected with strain sensors. Results The biomechanical test showed that there was（ 1.18 ±0.21 ）mm vertical and transverse acetabular displacement under 800N hip joint force with Stoppa approach fixed by reconstruction plate accompanied locked screws and cushion （1.18 ±0.21）, which was lesser than that of tlioinguinal approach with reconstruction plate and Stoppa approach with reconstruction plate by 42% and 20% （P 〈0.05） respectively. The axial and lateral stiffness was 40% higher. It also showed that weight-bearing area of the hip joint was close to normal with 7% difference （P 〉0.05）; that for Ilioinguinal approach and Stoppa approach with reconstruction plate was 19% and 10%, respectively. Conclusion The acetabular quartet fracture fixed by reconstruction plate accompanied locked screws and cushion with Stoppa approach has better biomechanical stiffness and contact characteristics than other two methods.

关 键 词：髋臼骨折 内固定生 物力学 

分 类 号：R[医药卫生]