股骨近端锁定钢板与Gamma 3型髓内钉固定不稳定股骨粗隆间骨折的生物力学研究  

A biomechanical comparative study on proximal femoral locking plate and Gamma 3 nail for treatment of unstable femoral intertrochanteric fracture

作　　者：江伟[1] 刘跃洪[1] 杨灵[1] 徐巍[1] 刘树平[1] 张德盛[1] 陈曦[1] 汪红[1] 

机构地区：[1]德阳市人民医院骨科,四川618000

出　　处：《中国骨与关节损伤杂志》2015年第2期136-138,共3页Chinese Journal of Bone and Joint Injury

基　　金：德阳市科技支撑计划(2012SZ043-1)

摘　　要：目的比较股骨近端锁定钢板与Gamma 3型髓内钉在固定不稳定股骨粗隆间骨折中的生物力学特性,为临床选择内固定方式提供理论依据。方法选取5对防腐股骨标本,每对标本配对随机分为A组和B组,所有股骨标本制成31-A2.2型骨折模型,A组使用Gamma 3型髓内钉固定,B组使用股骨近端锁定钢板固定,在力学测试机上进行轴向压缩、扭转、破坏试验。结果在1 200 N载荷时,A组轴向刚度为(306.52±11.32)N/mm,B组为(258.38±14.63)N/mm,A组的轴向刚度较B组高18.6%,差异有统计学意义(t=17.74,P=0.03)。A、B组在扭转角为0.5°、1.0°、1.5°、2.0°、2.5°时的扭矩值差异均无统计学意义(P>0.05)。A组扭转刚度为(1.35±0.06)N·mm/deg,B组为(1.48±0.09)N·mm/deg,2组差异无统计学意义(t=-5.00,P=0.13)。A组最大屈服载荷为(3 101.33±174.83)N,B组最大屈服载荷为(2 396.68±142.07)N,A组最大屈服载荷值较B组高29.4%,差异有统计学意义(t=48.52,P<0.001)。结论股骨近端锁定钢板在内固定治疗以31-A2.2型骨折为例的不稳定股骨粗隆间骨折时,其轴向负重力学性能不如Gamma 3型髓内钉,不宜作为首选内固定。Objective To compare the biomechanical properties between the proximal femoral locking plate and Gamma 3nail for fixing unstable femoral intertrochanteric fracture to provide a theoretical basis for selecting internal fixation in the clinical application. Methods Five pairs of antiseptic femur specimens, each pair of specimens were randomly divided into group A and group B. All specimens were made 31-A2.2 femoral intertrochanteric fracture model, group A using Gamma 3nail fixed, group B with proximal femoral locking plate fixation in mechanical testing machine to test axial compression,torsion, destruction experiment. Results Under 1 200 N load, axial stiffness of groups A and B was（306.52±11.32）N/mm and（258.38±14.63）N/mm respectively, axial stiffness of group A was 18.6% higher than group B, showing statistically significant difference（t =17.74, P =0.03）. The torque of groups A and B in the torsional Angle of 0.5°, 1.0°, 1.5°, 2.0°, 2.5° had no statistical significant difference（P 0.05）. The torsional rigidity of groups A and B was（1.35 ±0.06）N·mm/deg and（1.48±0.09）N·mm/deg respectively, showing statistically significant difference（t =-5.00,P =0.13）. The maximum yield load of groups A and B was（3 101.33±174.83）N and（2 396.68±142.07）N respectively, maximum yield load of group A was 29.4% higher than group B, showing statistically significant difference（t =48.52, P 0.001）. Conclusion The proximal femoral locking plate for the treatment of unstable femoral intertrochanteric fracture, the mechanical properties of the axial load are inferior to Gamma 3nail, unfavorable as the preferred internal fixation.

关 键 词：不稳定股骨粗隆间骨折 GAMMA 3型髓内钉 股骨近端锁定钢板 生物力学 

分 类 号：R-33[医药卫生]