锁定重建板不同内固定方式治疗髋臼横形骨折的生物力学研究  

BIOMECHANICAL RESEARCH OF DIFFERENT INTERNAL FIXATIONS USING LOCKING RECONSTRUCTION PLATE FOR ACETABULAR TRANSVERSE FRACTURE

作　　者：刘弘扬[1,2] 李力更[1] 吴啸波[1] 许弘佳 张瑞杰[1] 

机构地区：[1]唐山市第二医院华北理工大学附属骨科医院创伤骨科河北唐山,063000 [2]华北理工大学研究生学院 [3]华北理工大学公共卫生学院

出　　处：《中国修复重建外科杂志》2015年第9期1084-1087,共4页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的比较单柱锁定重建板、锁定重建板联合拉力螺钉及双柱拉力螺钉治疗髋臼横形骨折的生物力学稳定性。方法将20具新鲜成人半骨盆标本随机分为5组(n=4),制备髋臼横形骨折模型。A组采用前柱锁定重建板固定,B组采用后柱锁定重建板固定,C组采用前柱锁定重建板联合后柱拉力螺钉固定,D组采用前柱拉力螺钉联合后柱锁定重建板固定,E组采用双柱拉力螺钉固定。采用生物力学试验机对各组标本加载载荷至3倍体质量,测量骨折端纵向位移,计算剪切刚度,比较各组稳定性。结果载荷为体质量3倍时,A、B组纵向位移均大于C、D、E组,剪切刚度小于C、D、E组,比较差异均有统计学意义(P<0.05)。B组纵向位移显著大于A组(P<0.05),A、B组间剪切刚度差异无统计学意义(P>0.05);C、D、E组纵向位移及剪切刚度比较,差异均无统计学意义(P>0.05)。结论对于髋臼横形骨折,锁定重建板联合拉力螺钉固定其稳定性与双柱拉力螺钉相似,优于单柱锁定重建板固定;而前柱锁定重建板稳定性优于后柱锁定重建板。Objective To compare the biomechanical stability of acetabular transverse fracture fixed with single column locking reconstruction plate, locking reconstruction plate combined with lag screw, and double columns lag screws. Methods Acetabular transverse fractures were established in 20 adult fresh semi-pelvis specimens, and divided into 5 groups randomly（n=4）. The anterior columns were fixed with locking reconstruction plates in group A; the posterior columns were fixed with locking reconstruction plates in group B; the anterior columns were fixed with locking reconstruction plates and the posterior columns with lag screws in group C; the anterior columns were fixed with lag screws and the posterior columns with locking reconstruction plates in group D; the double columns were fixed with lag screws in group E. When loading three times weight, the longitudinal displacement of fracture fragment was measured, and the shear rigidity was calculated to compare the stability among groups. Results The longitudinal displacement of groups A and B were significantly greater than that of groups C, D, and E（P0.05）, and the shear rigidity of groups A and B were significantly lower than that of groups C, D, and E（P〈 0.05）. The longitudinal displacement of group B was significantly greater than that of group A（P〈 0.05）, but no significant difference was found in the shear rigidity between groups A and B（P〉0.05）. There was no significant difference in the longitudinal displacement and shear rigidity among groups C, D, and E（P〉0.05）. Conclusion Locking reconstruction plate combined with lag screw and double columns lag screws have similar stability, they have stronger stability than the single column locking reconstruction plate. The stability of anterior column locking reconstruction plate is better than that of the posterior column locking reconstruction plate.

关 键 词：髋臼横形骨折 内固定 生物力学 

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