中空植骨式动力髋螺钉的设计及动物实验研究  

Design of a hollow-bone-graft dynamic hip screw： an animal study

作　　者：林达生[1] 沈佳祚[1] 李林[1] 王雷[1] 郝健明[1] 李强[1] 练克俭[1] 

机构地区：[1]解放军第一七五医院(厦门大学附属东南医院)全军骨科中心,福建省漳州市363000

出　　处：《中华创伤骨科杂志》2014年第8期705-709,共5页Chinese Journal of Orthopaedic Trauma

基　　金：南京军区科技基金（10MA073）

摘　　要：目的 设计一种中空植骨式动力髋螺钉,探讨该植骨螺钉是否能促进猪股骨颈骨折愈合. 方法 将动力髋螺钉设计成螺纹间带孔隙、中间扇叶状窗口的中空螺钉.选取16只健康实验猪（雌雄各半,平均月龄为3.5个月,平均体质量为25.1 kg）,制作双侧股骨颈骨折（经颈型）动物模型,左后肢采用中空植骨式动力髋螺钉固定（实验组）,右后肢采用普通动力髋螺钉固定（对照组）.于术后4、8、12及16周分别行双侧髋关节X线片检查及CT平扫;于术后4、8、12周各处死4只猪取材,行生物力学测试;于术后16周处死4只猪,大体观察股骨颈骨折的愈合情况. 结果 X线片及CT平扫显示：术后4周实验组骨折线已部分模糊,新骨密度均匀;对照组骨折线清晰可见.术后16周实验组骨折线处周围骨密度与正常骨组织无明显区别,外周光滑,股骨头表面未见点状致密增生;对照组骨折线处骨密度增高,少量骨吸收和骨小梁融合.术后8、12、16周实验组猪的Lane-Sandhu评分均较对照组高,差异有统计学意义（P＜0.05）.术后4、8、12周实验组猪标本的轴向刚度、三点弯曲刚度及抗扭转力均较对照组大,差异有统计学意义（P＜0.05）.术后16周大体观察显示实验组猪骨断端表面愈合良好;对照组骨折端为骨质连接. 结论 中空植骨式动力髋螺钉既能提供可靠固定,又能在骨折断端处植骨,可促进骨折早期愈合.本研究为此螺钉应用于临床治疗股骨颈骨折提供了实验依据.Objective To investigate the effect of a self-designed hollow-bone-graft dynamic hip screw on fracture healing in a pig model of femoral neck fracture.Methods We designed novel dynamic hip screws of titanium alloy which are hollow and have flabellum-like and round openings between screw threads.Sixteen healthy pigs （half males and half females,mean age of 3.5 months and mean body mass of 25.1 kg） were used to create models of bilateral femoral neck fractures.The left femurs were fixated with hollow-bone-graft dynamic hip screws as the experimental group,and the right femurs were fixated with conventional dynamic hip screws as the control group.At 4,8,12 and 16 weeks after surgery,the animals received X-ray and CT examinations and 4 animals were sacrificed each time to harvest both femurs for biomechanical test （4,8,12 weeks postoperation） or gross observation of fracture healing （16 weeks postoperation）.The axial bending and torsional stiffness were assessed in the biomechanical test.Results The X-ray and CT examinations showed：at 4 weeks,the fracture lines were partially blurred and new bone grew evenly in the experimental group but the fracture lines were still clear in the control group; at 16 weeks,the bone density around the fracture line was similar to that of normal bone tissue and no punctiform dense hyperplasia was observed on the smooth surface of the femoral head in the experimental group while increased bone density at the fracture line and limited bone resorption and bone trabecula assimilation were observed in the control group.At 8,12,16 weeks after surgery.the experimental group had significantly higher Lane-Sandhu scores than the control group P 〈 0.05）.At 4,8,12 weeks postoperation,the experimental group had significantly greater stiffness against compression,bending and torsion than the control group（P 〈 0.05）.Gross observation at 16 weeks showed fine healing of the fracture ends in the experimental group but bony connection of the fracture ends in the control group.Conc

关 键 词：股骨颈骨折 骨折愈合 骨钉 动物实验 

分 类 号：R683[医药卫生—骨科学]