前路钛板加方形区螺钉治疗髋臼双柱骨折的站立位力学分析  

Experimental biomechanical analysis of standing position in both-column acetabular fractures fixed by anterior reconstruction plate combinated with trans-plate quadrilateral screws

作　　者：蔡贤华[1,2] 吴咏德[1,2] 刘曦明[1] 张红喜[3] 

机构地区：[1]广州军区武汉总医院骨科,武汉430070 [2]南方医科大学研究生院,广州510515 [3]武汉理工大学力学测试中心,武汉430070

出　　处：《中国矫形外科杂志》2013年第6期595-601,共7页Orthopedic Journal of China

摘　　要：[目的]探讨前路特殊塑形钛板加方形区螺钉治疗髋臼双柱骨折早期站立的可能性。[方法]选取成年防腐保湿处理的全骨盆标本6具,保留韧带及髋关节囊,制作单侧髋臼高位双柱骨折模型,随机先后采用前路特殊塑形钛板加方形区螺钉(B组)及常规塑形钛板加1/3管型钛板(C组)内固定,固定标本于ZWICKZ100电子万能材料试验机上,模拟站立位以400～700N垂直加载,分别测定完整骨盆(A组)、B组及C组后柱内壁横向位移、髋臼顶纵向位移,并计算刚度。[结果]随着载荷增加,各位移值呈逐渐增加的线性关系,且A组<B组<C组;在生理负荷600N载荷下,横向与纵向位移值均为C组>B组>A组、刚度为C组>B组>A组,C组与B组、A组与C组间差异明显(P<0.05),B组与A组差异无显著意义(P>0.05)。[结论]站立位下,前路特殊塑形钛板加方形区螺钉较常规塑形钛板加1/3管型钛板内固定即刻力学性能更为可靠,稳定性与完整骨盆接近,这表明早期站立并不影响前路特殊塑形钛板加方形区螺钉内固定的稳定性。[ Objective] To explore the standing possibility in the early after both - column aeetabular fracture fixed by anterior specially - shaped reconstruction plate combinated with trans - plate quadrilateral screws on cadaver. [ Method] Six Chinese adult wetly pelvic specimens with their ligament and joint capsule of hip joint preserved with antisepsis were made into the model with high both-column acetabular fracture on one side. The fractures were fixed randomly by anterior specially-shaped titanium plate with quadrilateral screws（ group B） or conventionally-shaped reconstruction titanium plate with 1/3 tubular titanium plate （group C）. To imitate the static standing position of the patient, the specimen fixed on ZWICK-Z100 electronic universal materi- al testing machine received the vertical loading from 400 N to 700 N to measure the transverse displacement of inner wall in posterior column and the longitudinal displacement of acetabular roof in the intact pelvis（ group A）, group B and group C respectively. Their stiffnesses were calculated. [ Result] The value of the displacements was group A 〈 group B 〈 group C, which in- creased as linear correlation with the load adding. Under 600 N physiological stress, the value of displacements was group C 〉 group B 〉 group A in the transverse and vertical directions, and the value of stiffnesses was group A 〉 group B 〉 group C. There was a significant difference between group C and group B, group A to group C （P 〈 0.05 ） ,while no significant difference between group B and group A（P 〉0.05）. [ Conclusion] The standing after the immediate fixation do not affect the stability of both-column acetabular fracture fixed by anterior specially-shaped plate combinated with trans-plate quadrilateral screws as biomechanical stability of this method is superior to that of conventionally-shaped plate with 1/3 tubular plate,and close to that of the normal pelvis.

关 键 词：髋臼骨折 方形区 双柱骨折 内固定 生物力学 

分 类 号：R687.3[医药卫生—骨科学]