骨干骨折术后钢板断裂的生物力学原因分析  

Biomechanical analysis of postoperative plate fracture of femoral shaft fracture

作　　者：李平[1] 谭雄进[2] 罗招阳[3] 

机构地区：[1]解放军第一六九医院(湖南师范大学附属湘南医院)医学工程科,湖南衡阳421002 [2]解放军第一六九医院(湖南师范大学附属湘南医院)骨科,湖南衡阳421002 [3]南华大学病理教研室,湖南衡阳421001

出　　处：《临床与病理杂志》2015年第7期1304-1308,共5页Journal of Clinical and Pathological Research

摘　　要：目的：分析股骨干骨折术后钢板断裂的生物力学原因,探讨降低术后钢板断裂率的方法。方法：选取5具完整防腐男性成尸双侧股骨,共10段股骨标本,按照左右配对纳入内侧组与外侧组,各5段。制作标本骨折模型,分别使用内后侧、前外侧钢板固定,以压缩、前屈、后屈实验观察其位移情况,探讨钢板断裂的生物力学原因。结果：外侧组100~400 N负载下压缩实验位移与内侧组比较无明显统计学差异（P〉0.05）,500 N负载下外侧组位移显著高于内侧组（P〈0.05）。外侧组20~80 N负载下前屈实验、后屈实验位移与内侧组比较无明显统计学差异（P〉0.05）,100 N负载下外侧组前屈实验、后屈实验位移显著高于内侧组（P〈0.05）。结论：于内后侧留置锁定钢板具有更佳的生物力学稳定性,对于降低术后钢板断裂具有积极意义。Objective： To analyze the biomechanical causes of postoperative femoral shaft fractures plate fracture, and investigate the method to decrease the rate of postoperative plate fracture. Methods： A total of 10 femoral specimens, which selected from 5 male adult cadavers with intact anti-corrosion bilateral femur, are evenly divided into medial group and outside group according to pairing left and right. Specimen fracture model was built and fixed by using the inner rear side and anterolateral plate respectively. Compression, anteflexion and retroflexion experiments were conducted to observe the displacement and explore the biomechanical causes of broken plate. Results： In the compression experiment of 100-400 N load, there was no significant difference between lateral group and medial group of displacement （P〉0.05）. The displacement of lateral group was significantly higher than that of medial group under 500 N load （P〈0.05）. In anteflexion and retrofhxion experiments of 20-80 N load, there were no significant difference between lateral group and medial group of displacement （P〉0.05）. The displacement of lateral group was significantly higher than that of medial group under 100 N load （P〈0.05）.Conclusion： Indwelling locking plate in the inner rear side has better biomechanical stability and positive effect on reducing postoperative plate fracture.

关 键 词：股骨干骨折 内固定 钢板断裂 生物力学 原因 

分 类 号：R687.3[医药卫生—骨科学] R318.01[医药卫生—外科学]