股骨髁上骨折四种内固定的生物力学评估  

A COMPARATIVE BIOMECHANICAL STUDY OF FOUR INTERNAL FIXATION METHODS FOR DISTAL FEMORAL FRACTURES

作　　者：郑琦[1] 毕大卫[1] 王以进[2] 顾军[1] 刘耀升[1] 谢水法[1] 魏威[1] 

机构地区：[1]杭州市红十字会医院,浙江杭州310001 [2]上海大学生物力学研究所,上海201800

出　　处：《医用生物力学》2002年第2期75-79,共5页Journal of Medical Biomechanics

摘　　要：目的　对股骨髁上骨折 4种内固定方法进行生物力学测试评估 ,为临床治疗提供较全面、客观的依据。方法　取 1 6具新鲜尸体股骨标本 ,造成股骨髁上骨折模型 (AO分类的C1型 ) ,分别用股骨髁上逆行交锁髓内钉 (GSHN)、动力髁螺钉 (DCS)、L形髁钢板 (L -CCP)、Ender钉固定 ,利用实验应力分析和有限元分析方法对股骨髁上骨折和内固定系统的力学性能进行比较研究。结果　在轴向应力实验中 ,GSHN固定优于DCS、L -CCP和Ender钉内固定 ( P <0 .0 1 ) ;在扭转实验中 ,GSHN和DCS优于L -CCP和Ender钉 (P <0 .0 1 ) ,尤以DCS为最佳。结论　采用GSHN和DCS内固定生物力学强刚度最佳 ,优于其它内固定方法 ,值得临床推广应用。Objective By evaluating quantitative biomechanical comparison of four internal fixation methods for distal femoral fractures, to choose suitable clinical internal fixation method according to the experimental data. Methods The models of fracture of femoral condyle were made on 16 fresh cadaver femurs (C1 of AO classification) and fixed by supracondylar intramedullary interlocking nail, dynamic condyle screw plate, L shaped condyle plate and Ender's nail fixation respectively. To compare the four different methods by experimental stress analysis and theoretical analysis of finite element method. Results Under the same load condition, the supracondylar intramedullary interlocking nail absorbed more energy during axial loading compared with the other constructs(P<0.01). The dynamic condyle screw plate had the greatest torsional stiffness (P<0.01). There were no significant differences in torsional stiffness between GSHN and DCS. Conclusion Using supracondylar intramdullary interlocking nail and the dynamic condyle screw plate are better than the other internal fixation methods and deserve to be put into clinical application and populatization.

关 键 词：骨折内固定 生物力学 股骨髁上骨折 

分 类 号：R683.42[医药卫生—骨科学] R318.01[医药卫生—外科学]