新型股骨近端内侧支撑钢板治疗股骨反转子间骨折的生物力学研究  

Biomechanical assessment of newly-designed proximal femoral medial buttress plate for treatment of reverse oblique femoral intertrochanteric fracture

作　　者：张睿[1] 罗鹏[1] 胡炜[1] 柯陈荣[1] 王鉴顺[1] 郭晓山[1] 

机构地区：[1]温州医科大学附属第二医院创伤骨科,浙江温州325027

出　　处：《中国修复重建外科杂志》2017年第2期165-170,共6页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：国家自然科学基金资助项目(81472146)~~

摘　　要：目的通过与股骨近端锁定加压钢板(proximal femoral locking compression plate,PFLCP)、股骨近端防旋髓内钉(proximal femoral nail antirotation,PFNA)比较,探讨采用新型股骨近端内侧支撑钢板(proximal femoral medial buttress plate,PFMBP)固定股骨反转子间骨折在生物力学方面的优势。方法取18具第4代Synbone人工股骨标准试验骨(左侧)制备AO 31-A3.1型股骨反转子间骨折模型后,根据内固定不同随机分为3组(n=6),分别为PFLCP组、PFNA组、PFMBP组。各标本骨折固定后包埋固定,分别行轴向压缩试验、扭转试验及最大轴向压缩破坏试验,计算对应轴向压缩刚度、扭转刚度,记录最大轴向载荷及标本破坏情况。结果轴向压缩刚度PFLCP组为(109.42±30.14)N/mm,PFNA组为(119.13±29.14)N/mm,PFMBP组为(162.05±22.05)N/mm,组间比较差异有统计学意义(P<0.05)。同一组中不同扭转角度对应扭矩比较,以及同一扭转角度各组扭矩比较,差异均有统计学意义(P<0.05)。扭转刚度PFLCP组为(1.45±0.44)N·mm/deg,PFNA组为(1.10±0.13)N·mm/deg,PFMBP组为(1.36±0.32)N·mm/deg;PFLCP组、PFMBP组与PFNA组比较,差异均有统计学意义(P<0.05);PFLCP组及PFMBP组比较差异无统计学意义(P>0.05)。最大轴向载荷PFLCP组为(1 408.88±0.17)N,PFNA组为(1 696.56±0.52)N,PFMBP组为(2 154.65±0.10)N,3组间比较差异均有统计学意义(P<0.05)。结论PFBMP在轴向压缩刚度和扭转刚度方面优于PFLCP及PFNA,提示维持内侧稳定性对于治疗股骨反转子间骨折具有重要意义。Objective To evaluate the biomechanical properties of proximal femoral medial buttress plate （PFMBP） for fixing the reverse oblique intertrochanteric fractures by comparing with proximal femoral locking compression plate （PFLCP） and proximal femoral nail antirotation （PFNA）. Methods Eighteen synthetic femoral bone models （Synbone） were divided into 3 groups （group PFLCP, group PFNA, and group PFMBP）, 6 models in each group; an AO 3 l-A3.1 reverse oblique femoral intertrochanteric fracture was made based on the same criterion. After being fixed and embeded, the axial load testing, torsion testing, and axial load-to-failure testing were performed on each model. The axial displacement of different loads, torque of different torsion angles, and failure load of each model were recorded, and the stiffness of axial load and torsion were calculated. Results The axial stiffness in groups PFLCP, PFNA, and PFMBP were （109.42_＋30.14）, （119.13±29.14）, and （162.05±22.05） N/mm respectively, showing significant differences between groups （P〈0.05）. There were significant differences in torque between different torsion angles in the same group, as well as in the torque between groups at the same torsional angle （P〈0.05）. The torsion stiffness in groups PFLCP, PFNA, and PFMBP were （1.45±0.44）, （1.10±0.13）, and （1.36±0.32） N-mm/deg respectively; there were significant differences when compared groups PFLCP and PFMBP with group PFNA （P〈0.05）, but no significant difference was found between group PFLCP and group PFMBP （P〉0.05）. The failure loads of groups PFLCP, PFNA, and PFMBP were （1 408.88±0.17）, （1 696.56±0.52）, and （2 154.65±0.10） N respectively, showing significant differences between groups （P〈0.05）. Conclusion The newly-designed PFMBP is better than PFNA and PFLCP in axial load stiffness and torsion stiffness for fixing reverse oblique intertrochanteric fracture by biomechanical test, indicating that reconstruction of medial stabili

关 键 词：股骨反转子间骨折 股骨近端内侧支撑钢板 内固定 生物力学 

分 类 号：R687.3[医药卫生—骨科学] R318.01[医药卫生—外科学]