空心钉在股骨颈中构型的生物力学研究  

Optimum Configuration of Cannulated Lag Screws for the Fixation of Femoral Neck Fractures:A Biomechanical Study

作　　者：王世坤[1] 王志义[2] 刘振宇[2] 

机构地区：[1]北京市房山区良乡医院骨科,北京102401 [2]北京友谊医院骨科,北京100050

出　　处：《实用骨科杂志》2011年第11期998-1001,共4页Journal of Practical Orthopaedics

摘　　要：目的通过生物力学实验探讨空心钉固定股骨颈骨折时,3枚螺钉的构型对固定强度和稳定性的影响。方法选取25～70岁尸体股骨8对,左右股骨随机分成两组。倾角50°截骨,3枚空心钉分别呈正三角和倒三角构型固定股骨颈骨折。生物力学实验机对股骨-螺钉复合体进行线性递增的加载,同时测量股骨头的位移和沿截骨面的剪切位移。结果倒三角形构型的空心固定组较正三角形组具有更高的极限负荷和抗剪切能力,差异有统计学意义(P<0.05)。结论对于无后部皮质粉碎的股骨颈骨折,采用倒三角构型的空心钉固定,较正三角构型固定在体外的生物力学上具有更高的固定强度和稳定性。upright triangular configuration,provide significantly improved fixation strength for fixation of femoral neck fractures with three cannulated lag screws.Methods Eight pairs of femurs were selected.A osteotomy was made.One femur of each pair was randomly selected for stabilization using cannulated lag screws in either an inverse triangular configuration or an upright triangular configuration.An Universal Material Testing Machine was used to apply vertical loads directly onto the femoral head.At each applied load,the inferior femoral head displacement reading and shearing displacement of the osteotomy were recorded.Results The inverse triangular configuration group sustained a higher（P〈0.05） average ultimate load to failure（3375 N） than did specimens in the upright triangular configuration（2725 N）.At a load of 800 N,the average shearing displacement was less for specimens stabilized in the inverse triangular configuration（39.1 μm） than for those stabilized in the upright triangular configuration（93.1 μm;P〈0.05）.Conclusion Three cannulated lag screws placed in the inverse triangular configuration provide significantly improved fixation strength compared with three screws placed in the upright triangular configuration for fixation of femoral neck fractures without posterior comminution.

关 键 词：生物力学 股骨颈骨折 内固定 

分 类 号：R683.42[医药卫生—骨科学]