异体皮质骨板联合不同螺钉治疗股骨干骨折生物力学研究  

Biomechanical research on treatment for femoral shaft fractures using cortical onlay strut graft combined with different screws

作　　者：李毅[1] 王永清[1] 毕红宾[2] 吴泽海[3] 赵志辉[1] 程鹏[1] 王业林[2] 

机构地区：[1]天津医科大学第四中心临床学院骨科,天津300140 [2]天津中医药大学研究生院,天津300140 [3]天津理工大学机械工程学院,天津300140

出　　处：《临床骨科杂志》2016年第1期107-110,共4页Journal of Clinical Orthopaedics

摘　　要：目的测量和探究异体皮质骨板联合可吸收螺钉加捆绑带固定治疗股骨干骨折的力学强度及机制。方法采用新鲜山羊股骨为材料,X线排除骨病后,制作接骨板及骨折模型。分别用可吸收螺钉加捆绑带(A组)、钛合金螺钉(B组)、钛合金螺钉加捆绑带(C组)、可吸收螺钉(D组)4种固定方式固定骨板。使用万能电子力学实验机进行垂直压缩实验、骨板侧及非骨板侧三点弯曲实验,记录模型极限载荷结果。结果 A组垂直压缩及三点弯曲极限载荷与C组接近(P>0.05),且高于B、D两组(P<0.05)。A组的垂直压缩、骨板侧三点弯曲和非骨板侧三点弯曲极限载荷分别为(1.51±0.33)k N、(0.80±0.31)k N、(0.82±0.11)k N;C组分别为(1.67±0.28)k N、(0.97±0.19)k N、(0.98±0.16)k N;B组(1.47±0.31)k N、(0.73±0.27)k N、(0.73±0.23)k N;D组为(1.13±0.23)k N、(0.70±0.21)k N、(0.75±0.18)k N。结论异体皮质骨板联合可吸收螺钉及捆绑带可满足山羊股骨骨折术后即刻固定强度;在骨折模型中可吸收螺钉可承受与钛合金螺钉接近的极限载荷;增加捆绑带可以提高整个骨折固定强度。Objective To measure and explore the strength and mechanism for the treatment of femoral fractures using absorbable screws combined with cortical onlay strut graft and bundling belts. Methods Fracture models and the bone plates were made of fresh goat femurs after exclusion of bone disease with X-ray,which were equally divided into Groups A,B,C and D. In Group A,the fracture model which was covered by two cortical bone plates was fixed with 4 absorbable screws and 2 bundling belts; In Group B,the model was fixed with 4 titanium alloy screws; In Group C,the model was fixed with 4 titanium screws and 2 bundling belts; In Group D,the model was fixed with 4absorbable screws. The biomechanical tests for the vertical compression and two-sides three-point bending were performed on a universal mechanical testing machine. The parameters studied were the maximum loads during the tests.Results Group A showed similar maximum loads to Group C（ P〈0. 05） and maximum loads was higher than Group B and Group D（ P〈0. 05）. The maximum loads of the vertical compression and the two-sides three-point bending in Group A were（ 1. 51 ± 0. 33） k N,（ 0. 80 ± 0. 31） k N,（ 0. 82 ± 0. 11） k N; In Group C,they were（ 1. 67 ± 0. 28） k N,（ 0. 97 ± 0. 19） k N,（ 0. 98 ± 0. 16） k N; In Group B and D,they were（ 1. 47 ± 0. 31） k N,（ 0. 73 ± 0. 27） k N,（ 0. 73 ± 0. 23） k N,and（ 1. 13 ± 0. 23） k N,（ 0. 70 ± 0. 21） k N,（ 0. 75 ± 0. 18） k N,respectively. Conclusions Cortical onlay struts graft combined with absorbable screws and bundling belts can meet the instant strength after the goat＇s femur surgery. Absorbable screws share approximate maximum loads with titanium alloy screws and bundling belts can increase the strength of the fracture model.

关 键 词：股骨骨折 异体骨 皮质骨板 可吸收螺钉 生物力学 

分 类 号：R318.01[医药卫生—生物医学工程] R683.41[医药卫生—基础医学]