AO张力带技术用于髌骨不同部位骨折内固定的生物力学研究  

Biomechanical study of AO tension band for patellar fractures at different levels

作　　者：金敬华 潘志军[2] 薛德挺[2] 

机构地区：[1]临海市第二人民医院骨科,317016 [2]浙江大学医学院附属第二医院骨科

出　　处：《浙江医学》2016年第12期965-968,共4页Zhejiang Medical Journal

摘　　要：目的：通过生物力学实验来研究AO张力带技术用于髌骨不同部位骨折内固定的力学稳定性，从而为髌骨骨折的治疗提供理论依据。方法取8具新鲜成人尸体膝关节，于髌骨中点、髌骨上下1/3及1/4用线锯将髌骨做成横行骨折模型，按AO张力带技术采用克氏针加钢丝固定建成实验力学模型，对股四头肌进行加载测试，加载负荷以骨折端分离1mm为实验终点，记录加载的力、髌骨骨折端分离的位移，并进行统计学分析。结果根据髌骨骨折端分离位移1mm为失效的约定，在1/2部位AO张力带能达到最大的张力为（452.2±15.1）N；在上1/3部位AO张力带能达到最大的张力为（361.2±12.3）N；在下1/3部位AO张力带能达到最大的张力为（351.0±5.6）N；在上1/4部位AO张力带能达到最大的张力为（226.7±5.8）N；在下1/4部位AO张力带能达到最大的张力为（215.3±13.1）N。结论按照正常人单膝关节生理负荷为350～400N计算，在髌骨1/2及1/3横行骨折AO张力带技术均能达到人体的生理载荷，在1/4部位则不能达到人体的生理载荷。Objective To evaluate the stability of AO tension band for the fixation of patel ar fractures at different levels. Methods Transverse patel ar fractures models at middle, upper and lower 1/3, upper and lower 1/4 levels were created with fretsaw in 8 cadaver joints. AO tension bands were used to fix the fractured patel ar bone for biomechanical study. A force to quadriceps femoris was loaded until the fractures sites were displaced to 1mm. Results When fracture sites displaced to 1mm, the largest loading in the middle level, upper 1/3, lower 1/3, upper 1/4 and lower 1/4 transverse fractures was （452.2 ±15.1）N, （361.2±12.3）N, （351.0±5.6）N, （226.7±5.8）N and （215.3±13.1）N, respectively. Conclusion As a normal single knee physiolog-ical loading 350N- 400N, AO tension bands can provide sufficient stability for middle, upper 1/3 or lower 1/3 transverse patellar fractures, but the stability may be insufficient for upper or lower 1/4 transverse patel ar fractures.

关 键 词：髌骨骨折 治疗 AO张力带技术 生物力学 

分 类 号：R687.3[医药卫生—骨科学]