新型微创动力髋钢板治疗股骨转子下骨折生物力学研究  

Biomechanical study of novel minimally invasive dynamic hip plate for femoral subtrochantericfractures

作　　者：翁益民[1] 水小龙[1] 孔建中[1] 潘骏[1] 洪建军[1] 陈华[1] 郭晓山[1] 

机构地区：[1]温州医学院附属第二医院骨科,325000

出　　处：《中华创伤杂志》2013年第6期556-560,共5页Chinese Journal of Trauma

基　　金：温州市科技局基金资助项目（Y20090191）

摘　　要：目的通过对新鲜尸体标本的力学研究，比较新型微创动力髋钢板（minimal inva-sion dynamic hip plate，MIDHP）和动力髁螺钉（dynamic condylar screw，DCS）固定股骨转子下骨折的生物力学性能。方法全部标本先制作Seinsheimer分型ⅡA型股骨转子下骨折模型，按随机排列表法分组进行DCS和MIDHP内固定。根据实验要求以自凝型牙托粉包埋股骨头及股骨远端。先行扭转强度试验，再行压缩强度试验，然后进行破坏试验，记录极限载荷。对所得数据进行统计学处理。结果标本扭转强度测试表明，在扭转至3。内两组标本均基本稳定。扭转1．5。时DCS组扭矩为（3．16±0．13）N·m，MIDHP组为（3．31±0．27）N·m，两组扭矩及扭转刚度比较差异无统计学意义，两种内固定器抗旋转性能相近。标本压缩强度测试表明，800N载荷时DCS组压缩刚度为（532．27±61．02）N／ram，MIDHP组为（581．98±77．56）N／ram，压缩位移及刚度MIDHP组明显高于DCS组（P〈0．05）。破坏试验表明，DCS组极限载荷为（2994．38±244．81）N，MIDHP组为（3322．13±141．21）N，MIDHP组明显大于DCS组（P〈0．01）。结论MIDHP设计合理，抗旋转能力强，抗压缩能力强于DCS，治疗股骨转子下骨折时比DCS更具生物力学优势，可以微创操作，值得推广。Objective To perform a mechanical test of fresh cadaver specimens and compare the biomechanical properties of the novel minimal invasion dynamic hip plate （MIDHP） and the dynamic condylar screw （DCS） in treatment of subtrochanteric fractures of the femur. Methods All specimens were firstly used to simulate models of Seinsheimer type ⅡA subtrochanteric fractures of the femur, which were later divided into DCS group and MIDHP group. Based on experimental requirements, the femoral head and distal femur were embedded using serf-freezing type dental base acrylic resin powder. Torsion strength test was given in the first place, succeeded by compression strength test. Finally, destructive test was made to record the limit load. All experimental data were analyzed statistically. Results Torsion strength test showed that specimens of both groups were basically stable as the reverse was within 3°. Torque for specimens in DCS and MIDHP groups was （3.16 ±0. 13） N · m and （3.31 ＋0.27） N · m respectively as the reverse was 1.5°. Both torque and torsion stiffness had no statistical significance between the two groups, and the anti-rotation features of the two internal fixations were similar. Compression strength test showed that compression stiffness of specimens in DCS group was （532.27±61.02） N/mm and （581.98 ±77.56） N/ram in MIDHP group at a load of 800 N, with evidently higher compression displacement and stiffness in MIDHP group （ P 〈 0.05 ）. Destructive test showed the maximum load of specimens in DCS and MIDHP groups was （ 2 994.38 ±244.81 ） N and （ 3 322.13 ± 141.21 ） N respectively, far higher in MIDHP group （ P 〈 0. 01 ）. Conclusions MIDHP is characterized by reasonable design, strong anti-rotation property and anti-compression property over DCS. In comparison with DCS, MIDHP has biomechanical advantage in treatment of femoral subtroehanteric fractures, for it can be performed minimally invasive and is worthy of further application.

关 键 词：股骨骨折 内固定器 生物力学 

分 类 号：R687.3[医药卫生—骨科学]