桥接系统混棒与双棒结构治疗股骨及胫骨骨折的生物力学特点  

Biomechanical characteristics of bridge-link type combined internal fixation system with mixed-rod versus double-rod in the treatment of femoral and tibial fractures

作　　者：汪亮 黄朝朝 于娇娜 顾卫东[1] 王忍[1] 钱志艺[1] Wang Liang;Huang Zhaozhao;Yu Jiaona;Gu Weidong;Wang Ren;Qian Zhiyi(Department of Orthopedics,the Seventh People's Hospital of Changzhou,Changzhou 213011,Jiangsu Province,China;Newton Laboratory,Tianjin Weiman Biomaterials Co.,Ltd.,Tianjin 301600,China)

机构地区：[1]常州市第七人民医院骨科,江苏省常州市213011 [2]天津市威曼生物材料有限公司牛顿实验室,天津市301600

出　　处：《中国组织工程研究》2020年第6期888-892,共5页Chinese Journal of Tissue Engineering Research

基　　金：国家卫计委科技发展中心项目《桥接系统治疗四肢及骨盆骨折的临床研究》(W2015QJ045)，项目负责人：顾卫东~~

摘　　要：背景:桥接系统双棒结构为偏心固定,术后可能导致纵向上固定减弱及横向上抗扭转降低。目的:比较桥接组合式内固定系统混棒与双棒结构治疗股骨及胫骨骨折的生物力学特性。方法:以40根短聚甲醛材料配对模拟人体长骨骨干模型20个,其中10个以桥接组合式内固定系统混棒结构固定(混棒结构组),另10个以桥接组合式内固定系统双棒结构固定(双棒结构组),对2组分别进行轴向压缩实验和径向扭转实验(每种实验各选择每组5个模型),观察2组的轴向压缩力与位移情况,以及横向扭转力与角度变化,记录各组曲线出现折点或趋于水平状态时的载荷即最大载荷,并计算屈服载荷。结果与结论:①当轴向压缩屈服载荷≤2 000 N、产生相同位移时,混棒结构组所需轴向压缩屈服载荷大于双棒结构组;当轴向压缩屈服载荷>2000N、产生相同位移时,双棒结构组所需轴向压缩屈服载荷大于混棒结构组,并且双棒结构组最大轴向压缩屈服载荷大于混棒结构组[(2420.60±5.67),(2721.40±5.80)N,t=-82.885,P=0];②当径向扭转屈服载荷≤50 N·m、产生相同角度时,混棒结构组所需的扭矩小于双棒结构组;当径向扭转屈服载荷>50 N·m、产生相同角度时,混棒结构组所需扭矩大于双棒结构组,并且混棒结构组最大径向扭转屈服载荷大于双棒结构组[(101.85±2.97),(85.41±2.82)N·m,t=8.985,P=0];③结果说明,桥接系统混棒与双棒结构纵向上均可坚强固定骨折,但混棒结构固定骨折更稳定、牢靠,更容易促使骨折愈合;混棒结构横向上固定骨折后,骨折端容易产生微动,符合弹性固定,并且最大抗扭转力及抗疲劳性能优于双棒结构,可防止因横向不稳定造成的桥接系统断裂。BACKGROUND: The double-rod of bridge-link type combined internal fixation system belongs to eccentric fixation, which may lead to the weakening of longitudinal fixation and the decrease of transverse anti-torsion after operation. OBJECTIVE: To compare the biomechanical characteristics of bridge-link type combined internal fixation system with mixed-rod and double-rod in the treatment of femoral and tibial fractures. METHODS: Twenty human long bone diaphysis models were made by 40 short polyformaldehyde materials. Of these, 10 were fixed by mixed-rod, and the rest with bridge-link type combined internal fixation system. Axial compression tests and radial torsion tests were carried out (five models were selected from each group). The changes of axial compression forces and displacements and transverse torque and angle were observed. The maximum load was recorded when the curve had a break point or in a horizontal state, and then the yield load was calculated. RESULTS AND CONCLUSION: (1) When the axial compression load was ≤ 2 000 N, and with same displacement, the axial compression yield load in the mixed-rod group was larger than that in the bridge-link type combined internal fixation system group. When the axial compression load was > 2 000 N, and with the same displacement, the axial compression yield load in the bridge-link type combined internal fixation system group was larger than that in the mixed-rod group. The maximum axial compression yield load in the bridge-link type combined internal fixation system group was larger than that in the mixed-rod group [(2 420.60±5.67), (2 721.40±5.80) N, t=-82.885, P=0]. (2) When the radial torsional yield load was ≤ 50 N m, and with the same angle, the torque in the mixed-rod group was less than that in the bridge-link type combined internal fixation system group. When the radial torsional yield load was > 50 N m, and with the same angle, the torsion in the mixed-rod group was greater than that in the bridge-link type combined internal fixation system group. The m

关 键 词：桥接组合式内固定系统 双棒结构 混棒结构 生物力学 股骨与胫骨骨折 屈服载荷 轴向压缩 

分 类 号：R459.9[医药卫生—治疗学] R318.01[医药卫生—临床医学]