股骨转子间骨折：三角支架式锁定钢板的设计及生物力学评价  

Intertrochanteric fracture: design and biomechanical evaluation of triangle truss locking plate

作　　者：苗旭漫[1] 左浩[1] 姚树智[1] 

机构地区：[1]解放军第208医院骨科,吉林省长春市130062

出　　处：《中国组织工程研究》2015年第39期6373-6378,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:股骨近端锁定加压钢板在设计上还存在缺陷问题,因此课题组在股骨近端锁定加压钢板的基础上,自行设计出超短力臂三角支架式锁定钢板(专利号:201220051751.2)。目的:设计制作超短力臂三角支架式锁定钢板,分析其生物力学性能。方法:将股骨近端锁定加压钢板近端2枚螺钉在股骨颈内形成支撑,自行设计出超短力臂三角支架式锁定钢板。取成人新鲜股骨标本5对,制作AO分型A3.1型转子间骨折(逆转子间骨折)模型,选择右侧为实验组,采用三角支架式锁定钢板固定;左侧为对照组,采用股骨近端锁定加压钢板固定。检测钢板近端螺钉孔应力分布、骨断端应力分布、骨折端张开角度及最大载荷等。结果与结论:1钢板近端螺钉应力分布:实验组近端4枚螺钉应力分布较为平均,且形成三角桁架2枚螺钉应力分布接近;对照组近端4枚螺钉应力分布不平均,近端螺钉承受应力较大,大于实验组(P<0.05)。2骨断端的张开角度:实验组不同载荷下的张开角度明显小于对照组(P<0.05)。3最大载荷:实验组能够承受的最大载荷高于对照组(P<0.05),且两组破坏位置不同,实验组固定更合理。表明超短力臂三角支架式锁定钢板的各项生物力学性能优于股骨近端锁定加压钢板,固定可靠,可有效减少或避免钢板近端螺钉断裂、髋内翻等并发症。BACKGROUND： The design of proximal femoral locking compression plate existed defects. Therefore, our team designed triangle truss locking plate with hyper-short arm according to proximal femoral locking compression plate（patent No. 201220051751.2）. OBJECTIVE： To design and make triangle truss locking plate and evaluate its biomechanical properties. METHODS： Triangle truss locking plate with hyper-short arm was designed based on the support of two proximal screws of proximal femoral locking compression plate. Five pairs of fresh adult femur specimens were prepared, and the model of A3.1（AO classification） reverse intertrochanteric fracture was established. Experimental group（right side） was fixed with triangle truss locking plate. Control group（left side） was fixed with proximal femoral locking compression plate. Stress distribution of the screws of proximal end of the plate, stress distribution of the fracture ends, the opening angle of fracture, and maximum load were detected. RESULTS AND CONCLUSION：（1） Stress distribution of the four screws of the proximal femoral locking compression plate was average in the experimental group, and the stress distribution of the two screws of triangle truss locking plate was close. Stress distribution of the four screws was not average in the control group. The proximal screw bearing stress was bigger in the control group than in the experimental group（P〈0.05）.（2） Open angle under different loads were significantly smaller in the experimental group than in the control group（P〈0.05）.（3） Maximum load was higher in the experimental group than in the control group（P〈0.05）. Moreover, the position of damage was different between the two groups. The fixation in the experimental group was reasonable. These findings suggest that various biomechanic properties of the triangle truss locking plate with hyper-short arm were better than that of proximal femoral locking compression plate. Its fixation was reliable. Triangle truss locking p

关 键 词：髋骨折 生物力学 骨科植入物 骨植入物 三角支架式锁定钢板 超短力臂 股骨转子间骨折 

分 类 号：R318[医药卫生—生物医学工程]