肱骨旋入式自锁髓内钉改进设计及其生物力学特征  

Improved design and biomechanical characteristics of the rotary self-locking intramedullary nail of the humerus

作　　者：白晓兵[1] 赵勤鹏[2] 

机构地区：[1]榆林市第一医院,陕西省榆林市719000 [2]西安交通大学医学院附属红会医院,陕西省西安市710054

出　　处：《中国组织工程研究》2015年第39期6379-6384,共6页Chinese Journal of Tissue Engineering Research

基　　金：陕西省科技厅社发攻关项目(2013k14-02-13)~~

摘　　要：背景:肱骨骨折可以利用旋入式自锁髓内钉进行治疗,以往的旋入式自锁髓内钉存在一定的应用局限性,需要对其进行改进设计,以获得更好的生物力学效果。目的:对肱骨旋入式自锁髓内钉进行改进设计,并分析其生物力学特点和应用效果,为肱骨骨折的临床治疗提供一定的参考依据。方法:1对旋入式自锁髓内钉进行改进设计,并进行力学测试。2选择63例肱骨骨折患者,根据随机数字表法分为两组,对照组(n=31)和实验组(n=32)。对照组利用常规旋入式自锁髓内钉进行治疗,实验组利用改进后的旋入式自锁髓内钉进行治疗。结果与结论:改进后的髓内钉在抗轴向压缩、抗拉伸、抗扭转、抗弯曲方面的力学测试结果均显著优于改进前。置入前,两组患者的关节活动度指标得分差异均无显著性意义(P>0.05);与治疗前相比,两组患者治疗后关节活动度指标得分均明显上升(P<0.01或P<0.05),且实验组患者治疗后关节活动度指标得分均显著高于对照组(P<0.05);同时实验组治疗优良率显著高于对照组(P<0.05)。表明在对旋入式自锁髓内钉进行适当的改进设计后,可以具备更加优良的力学特点,获得更好的临床应用效果。BACKGROUND： Humeral fractures can be treated by using rotary self-locking intramedullary nail. The previous spin in self-locking intramedullary nail has some limitations in application, so it should be improved in its design so as to obtain better biomechanical effect. OBJECTIVE： To improve the design of the rotary self-locking intramedullary nail of the humerus, and to analyze its biomechanical characteristics and application effect, and to provide reference for the clinical treatment of humeral fractures. METHODS：（1） The design of the rotary self-locking intramedullary nail was improved and tested by mechanics test.（2） A total of 63 cases of humeral fractures were randomly divided into two groups： control group（31 cases） and experimental group（32 cases）. Patients in the control group received conventional rotary self-locking intramedullary nail, and patients in the experimental group received improved nail. RESULTS AND CONCLUSION： Results of mechanical test concerning anti-axial compression, tensile, torsion and bending were obviously better after improvement than before improvement. No significant difference in range of motion was detected between the two groups（P〉0.05）. Compared with that before treatment, the range of motion was significantly increased after treatment in both groups（P〈0.01 or P〈0.05）. The range of motion was significantly higher in the experimental group than in the control group（P〈0.05）. Simultaneously, the excellent and good rate was significantly higher in the experimental group than in the control group（P〈0.05）. These data suggest that the improved rotary self-locking intramedullary nail has better mechanical characteristics and can obtain better clinical effect.

关 键 词：肱骨骨折 骨钉 生物力学 骨科植入物 骨植入物 肱骨 旋入式自锁髓内钉 力学测试 不良事件 应用效果 

分 类 号：R318[医药卫生—生物医学工程]