不同骨折端加压技术的加压行为和效果  

The pressurized behavior and effect of different fracture end pressure techniques

作　　者：王逸扬[1] 杨雷[2] 周飞亚[2] 汤骏[2] 冯永增[2] 吴剑彬[2] WANG Yiyang;YANG Lei;ZHOU Feiya;TANG Jun;FENG Yongzeng;WU Jianbin(Department of Neonatology,the Second Affiliated Hospital of Wenzhou Medical University,Wenzhou 325027,China;Department of Orthopaedics,the Second Affiliated Hospital of Wenzhou Medical University,Wenzhou 325027,China)

机构地区：[1]温州医科大学附属第二医院新生儿科,浙江温州325027 [2]温州医科大学附属第二医院骨科,浙江温州325027

出　　处：《中国现代医生》2018年第22期23-26,31,共5页China Modern Doctor

基　　金：浙江省温州市科学技术局公益性科技计划项目(Y20160389);浙江省自然科学基金项目(LY16H250002)

摘　　要：目的通过测量不同内固定技术在骨生物力学研究替代材料断端获得的压力,比较不同内固定技术在治疗骨折时的加压效果。方法在骨生物力学研究替代材料上制作不同骨折断端类型,测量两种常用骨折断端内固定加压技术获得的压力作为对照组,测量4种不同内固定加压技术获得的压力作为实验组,将实验组和对照组获得的断端间加压力进行比较。结果对照组1和实验组2、对照组1和实验组3、对照组2和实验组2加压效果比较,差异有统计学意义(P<0.05)。其他实验组和对照组加压效果比较,差异无统计学意义(P>0.05)。结论复位钳加压后置入1枚位置螺钉获得的加压效果,比拉力螺钉技术获得的加压效果差,在骨折手术中要尽量避免使用此种方法;在缺少标准加压器械的情况下,复位钳加压后置入两枚位置螺钉,或许可以成为替代拉力螺钉技术的加压方法;偏心螺钉技术在横行断面和短斜形断面获得的加压效果相当;拉力螺钉技术与偏心螺钉技术在斜形45°断面获得的加压效果相当。Objective To compare the pressure effect of different internal fixation techniques on the treatment of fracture,through measuring the pressure gained by different internal fixation techniques in bone biomchanics in replacement of material ends.Methods Different fracture end types were made with the substitute material of bone biomechanics.The pressure obtained by two kinds of commonly used fractures internal fixation pressure technology was used as control group.The pressure obtained by four different internal fixation and compression techniques was measured as experiment group.The pressure intermittently applied between the experimental group and the control group was compared.Results The effect of pressure between the control group 1 and the experimental group 2,the control group 1 and the experimental group 3,and between the control group 2 and the experimental group 2,the differece was statistically significant（P〈0.05）.There was no significant difference of the effect of pressure between the other experimental groups and the control group（P〉0.05）.Conclusion The compression effect obtained by inserting one position screw after compression of the forceps is worse than that achieved by the lag screw technique.This method should be avoided in the fracture surgery.In the absence of standard compression instruments,the placement of two position screws after compression of the forceps may be a method of pressurization instead of the lag screw technique.The eccentric screw technology is equivalent to the pressurization effect obtained in the transverse section and the short oblique section.The compression effect obtained by the lag screw technique and the eccentric screw at the oblique 45° section is equivalent.

关 键 词：骨折 横断骨折 斜形骨折 内固定 钢板 拉力螺钉 加压 压力 

分 类 号：R683.1[医药卫生—骨科学]