髋臼横行骨折四种内固定方式的生物力学研究  

Biomechanical study on four internal fixation methods of acetabular transverse fractures

作　　者：高烁[1] 王雷[1] 吴啸波[1] 何全杰 刘弘扬[1] 徐凤松 

机构地区：[1]华北理工大学附属骨科医院唐山市第二医院河北省创伤骨科中心,河北唐山063000

出　　处：《中国临床研究》2016年第4期444-447,共4页Chinese Journal of Clinical Research

基　　金：河北省卫生厅医学科学研究重点课题计划(20130665)

摘　　要：目的探讨四种内固定方法治疗髋臼横行骨折的稳定性,以确定髋臼横行骨折前柱内固定的理想位置。方法采用防腐处理的成年男性半骨盆标本制作髋臼横行骨折模型16具,随机分成四组,A组采用前柱重建接骨板,B组采用前柱锁定接骨板,C组采用骨盆缘下重建接骨板,D组采用骨盆缘下锁定接骨板。通过对四种骨折内固定模型进行连续分级垂直加载,测量各组骨折的水平位移、纵向位移和800N下的剪切刚度,比较各组内固定方式的稳定性。结果水平位移、纵向位移都随载荷的增加呈线性变化,在600～1 200 N时,经两两比较,水平位移、纵向位移在A与C、D组,B与C、D组,C与D组之间均存在统计学差异（P均〈0.05）,在A与B组之间均无统计学差异（P均〉0.05）,其中C、D组低于A、B组,D组低于C组。在载荷800 N中,A与B组剪切刚度无统计学差异（P〉0.05）,其余剪切刚度组间的两两比较均存在统计学差异（P均〈0.05）。结论骨盆缘下接骨板内固定优于前柱接骨板内固定,并且骨盆缘下锁定接骨板稳定性高于骨盆缘下重建接骨板,而前柱锁定接骨板与前柱重建接骨板并无明显差异。Objective To investigate the stability of four internal fixation methods for the treatment of acetabular transverse fractures in order to assign the ideal position of anterior column internal fixation. Methods The hemi-pelves specimens were established with 16 adult male corpses of antiseptic treatment and randomly divided into four groups,then the acetabular transverse fractures internal fixation models were respectively designed： group A（ anterior column reconstruction plate）,group B（ anterior column locking plate）,group C（ pelvic margin reconstruction plate） and group D（ pelvic margin locking plate）. By vertical loading of continuous increased grading on four types of fracture internal fixation models,the horizontal displacement,longitudinal displacement and shear stiffness of 800 N were measured,and the stabilities of four internal fixation methods were compared. Results Horizontal displacement and longitudinal displacement presented linear changes with the increase of the loads in four groups. Under the loads of 600 N to 1 200 N,there were significant differences in horizontal displacement and longitudinal displacement between group A with group C and D,between group B with group C and D,as well as between group C with group D by pairwise comparisons（ all P 〈 0. 05）,but there was no significant difference in them between group A and B（ all P 〉 0. 05）. Under the load of 800 N,there was no significant difference in shear stiffness between group A and B（ P 〉 0. 05）,while there were significant differences among the other groups by pairwise comparisons（ all P 〈 0. 05）. Conclusions The effect of the pelvic margin plate internal fixation is superior to the anterior column plate internal fixation,and the stability of pelvic margin locking plate is higher than that of pelvic margin reconstruction plate,while there was no significant differece in the stabilities between anterior column locking plate and anterior column reconstruction plate.

关 键 词：髋臼 横行骨折 内固定 前柱重建接骨板 前柱锁定接骨板 骨盆缘下重建接骨板 骨盆缘下锁定接骨板 生物力学 

分 类 号：R318.08[医药卫生—生物医学工程]