新型内固定器固定肱骨大结节骨折的生物力学研究  

Biomechanical Study of New Internal Fixation Device for the Greater Tuberosity Fracture of Humerus

作　　者：薛兆龙 孟艳丽 王勤业 罗亚平 Xue Zhaolong;Meng Yanli;Wang Qinye(Department of Orthopedics,Nanxiang Hospital of Jiading,Shanghai 201802,China)

机构地区：[1]上海市嘉定区南翔医院骨科,上海201802

出　　处：《实用骨科杂志》2018年第3期234-238,共5页Journal of Practical Orthopaedics

基　　金：上海市嘉定区卫计委科研项目(2014-KY-05)

摘　　要：目的通过研制新型内固定器固定肱骨大结节骨折生物力学测试,论证该内固定物的力学稳定性和下一步临床试验的可行性,比较空心钉、张力带、新型内固定器三种固定方式治疗肱骨大结节骨折的生物力学稳定性。方法18具保留肩袖肌的新鲜冰冻成人肱骨尸体标本,建立大结节骨折模型后,随机编号分为3组,分别采用空心螺钉、张力带、新型内固定器固定大结节骨折块,在测试前,每个模型均给予3次加、卸载预处理,每次加载速度为10mm/min,在0~80N之间,每次30s时间间隔,以消除标本模型的肌肉黏弹性及松弛效应,提高数据的可重复性及稳定性。最后将加载值调零,设定在保护载荷(900N)下对每个标本匀速加载(10 mm/min),标本的位移大小及相应载荷情况通过实验机的计算机软件自动记录,选取骨折线位移在2mm、5mm的大结节加载负荷作为比较数据。结果三组标本(空心螺钉组、张力带组、新型内固定器组)在大结节移位2 mm时载负荷大小分别为(201.18±7.14)N、(238.83±31.04)N、(240.74±5.19)N,三组组间比较,张力带组较空心螺钉组差异具有统计学意义(P<0.01),新型内固定器组较空心螺钉组差异具有统计学意义(P<0.01),新型内固定器组较张力带组差异无统计学意义(P>0.05)。三组标本(空心螺钉组、张力带组、新型内固定器组)在大结节移位5 mm时载负荷大小分别为(410.48±32.79)N、(530.48±31.04)N、(728.36±10.43)N,三组组间比较,张力带组较空心螺钉组差异具有统计学意义(P<0.01),新型内固定器组较空心螺钉组差异具有统计学意义(P<0.01),新型内固定器组较张力带组差异具有统计学意义(P<0.01)。结论肱骨大结节新型内固定器相对空心螺钉或张力带表现出明显生物力学优势,新型内固定器理论上为肱骨大结节骨折提供稳定固定效果,为下一步临床试验提供依据。Objective Biomechanical tests were performed on a new type of internal fixator for great tuberosity fractures of the humerus to test the mechanical stability of the internal fixation and the feasibility of the clinical trial and compare the biomechanical stability of cannulated screws,tension band and new type of internal fixation for the treatment of large tuberosity fractures of the humerus.Methods 18 fresh frozen adult cadaveric humeral specimens with rotator cuff muscle and a greater tuberosity fracture model were established.The samples were randomly divided into 3 groups.Hollow screws,tension band and new type of internal fixator were used to fix the great tubercle fracture.Before the test,each model were given 3 times of loading and unloading pretreatment.The loading rate was 10mm/min,and the pressure was between 0 and 80 N.There were 30 seconds between loads to eliminate the muscle relaxation effect and viscoelastic specimen model.The load value was set to zero in the end.Under protective load(900N),each specimen was subjected to constant loading(10 mm/min).The displacement size and the corresponding load condition of the specimen were recorded automatically by computer software of the experimental machine.The greater tuberosity load when fracture had displacement of 2mm and 5mm was chosen to compare.Results The loading of the three groups of specimens(cannulated screws,tension band and new type of internal fixator group)were[(201.18±7.14)N,(238.83±31.04)N and(240.74±5.19)N]respectively,when the greater tuberosity had displacement of 2mm.Compared with the cannulated screw group,the tension band group was statistically significant(P<0.01).Compared with the cannulated screw group,the new internal fixator group had statistical difference(P<0.01),and there was no significant difference between the new internal fixator group and the tension band group(P>0.05).The compressive stress of three groups of specimens(cannulated screw tension band group,model group,new internal fixation group)were[(410.48±32.79)N,

关 键 词：肱骨大结节 骨折 新型内固定器 生物力学 

分 类 号：R683.41[医药卫生—骨科学]