闭合穿针治疗锁骨骨折的解剖学基础及生物力学原理  

The Anatomic Base and the Principles of Biomechanics for Close Reduction and Intramedullary Fixation of Clavicular Fractures

作　　者：白靖平[1] 富学禹[1] 锡林宝勒日 伊力哈木 裴贤俊 王以进[2] 李永丰[2] 胡民 

机构地区：[1]新疆医学院第二附属医院骨科 [2]上海科技大学生物力学实验室

出　　处：《新疆医科大学学报》1997年第1期38-42,共5页Journal of Xinjiang Medical University

摘　　要：为了从解剖及生物力学角度阐明闭合穿针治疗锁骨骨折的合理性，我们分别做了大体应用解剖学观察及12具新鲜尸体锁骨标本对比性生物力学试验，结果显示：（1）锁骨是“S”形管状骨，适合应用具有弹性髓内针特性的克氏针进行曲线型多支点固定。（2）只要正确操作，克氏针不致损伤胸膜、肺及大血管神经。（3）从生物力学试验结果分析，曲线型多支点内固定锁骨明显优于传统的直针固定锁骨。其抗弯强度提高15％；抗扭强度提高17％；抗拉伸强度提高30％；刚度也相应提高20％以上。两组结果具有显著性差异（P＜0．001）。以上说明闭合穿针治疗锁骨骨折即安全、可靠，又符合生物力学原理。General anatomical observations and comparative biomechanical test were studied inclavicular samples from 12 fresh corpses. The results showed: (1)Clavicle is a ' s' shapedtubular bone which is suitable for curvilineal multipointfixation by means of elastic Kirschnerwire like intramedullary nail. (2) So long as the choice of threading point and right threadingdirection is surely mastered,it would not cause any damage to pleura,lung and neurovasculartissue. (3) The results of biomechanical test showed that intramedullar curvilineal multipointfixation of blavicular fractures being obviously superior to the traditional straight wire fixa-tion. Its bending strength was increased by 20%,torsional strength was increased by 17%,tensile strength was increased by 30% and the stiffness was increased by 20% respectively.The differences of two groups were significant- (P<0.001 ). All above experimental resultsdemonstrated that clu5e reduction and intramedullay curvilineal multipoint fixation of clavic-ular fractures is reliable,safe and in line with biomechanical rules.

关 键 词：克氏针 锁骨 解剖 骨折固定 生物力学 

分 类 号：R683.4[医药卫生—骨科学]