三种内固定治疗Mason Ⅱ型桡骨小头骨折生物力学稳定性的比较  

Biomechanical stability comparison of three internal fixation for Mason Ⅱ radial head fractures

作　　者：杨路德 刘明轩 胡善友 吴晓波 解品亮 王以进[2] YANG Lude;LIU Mingxuan;HU Shanyou;WU Xiaobo;XIE Pinliang;WANG Yijin(Department of Orthopaedics,Jiading District Central Hospital Affiliated to Shanghai Medical College of Health,Shanghai 201800;Institute of Biomechanics,Shanghai University)

机构地区：[1]上海健康医学院附属嘉定区中心医院骨科,上海201800 [2]上海大学生物力学研究所

出　　处：《南通大学学报（医学版）》2019年第4期252-255,共4页Journal of Nantong University(Medical sciences)

基　　金：上海市卫生与健康委员会立项课题基金资助项目(2007048);上海市嘉定区科委立项课题基金资助项目(JDKW-2016-W08);上海市嘉定区卫生系统第三批重点学科建设计划项目(ZD01)

摘　　要：目的:探讨3种内固定方式治疗MasonⅡ型桡骨小头骨折的生物力学稳定性特征,寻找最合适的内固定方法,为临床治疗提供基础实验依据。方法:运用3D打印技术制作20具桡骨小头标本,建立MasonⅡ型桡骨小头骨折模型,随机分为4组,每组5具,A组采用克氏针固定,B组运用Bold螺钉固定,C组应用微型钢板固定,N组为正常对照组,测量桡骨小头骨折内固定后的轴向压缩稳定性指标:合成位移和应变,并利用日本富士压敏片技术测量3种接触力学性能指标:接触面积(S)、接触压力(P)、接触应力(σ0),运用统计学分析比较各组内固定方式的差异。结果:(1)轴向压缩合成位移和应变:A组[(1.69±0.14) mm、(59.00±6.00)με]、B组[(1.47±0.12) mm、(50.00±5.00)με]、C组[(1.35±0.11) mm、(47.00±4.00)με]分别比N组[(1.32±0.10) mm、(46.00±4.00)με]大22.0%、10.0%和2.0%;(2)S、P、σ0:A组[(0.38±0.03) cm^2、(27.10±1.02) N、(71.32±5.71) N/cm^2]、B组[(0.43±0.03) cm^2、(30.10±2.78) N、(70.00±5.25) N/cm2]、C组[(0.46±0.04) cm^2、(31.70±2.72) N、(68.90±5.28) N/cm2],分别与N组[(0.48±0.04) cm^2、(33.00±3.16) N、(68.75±4.60) N/cm^2]比较相差A组(21.0%、18.0%、3.6%)、B组(10.0%、9.0%、1.8%)、C组(4.0%、4.0%、0.2%),说明微型钢板组力学稳定性能最佳,Bold钉组其次,克氏针固定组最差。结论:MasonⅡ型桡骨小头骨折采用微型钢板固定具有优越的力学稳定性能,比Bold螺钉及克氏针两组固定效果更好,是一种比较理想的术式,但Bold螺钉固定也是一种较好的内固定方式,对临床具有指导意义。Objective : To explore the biomechanical characteristics of three internal fixation methods for the treatment of Mason type Ⅱ fracture of the radial head, and to find the best internal fixation method to provide the basic theoretical basis for clinical application. Methods : 20 radial specimens were made by 3 D printing technology and a Mason Ⅱ radial head fracture model was established. It was divided into four groups. Each group was 5 cases. Group A was fixed with Kirschner wire, group B was fixed with Bold screws, group C was fixed with mini plate, N group was normal control group. Measurement of axial compression stability index after internal fixation of radial head fractures: synthetic displacement and strain. Three kinds of contact mechanical properties were measured by Fuji pressure sensitive film technology: contact area(S), contact pressure(P) and contact stress(σ0). Statistical analysis was used to compare the differences of internal fixation methods in each group. Results :(1)The axial displacement and strain of group A[(1.69±0.14) mm,(59.00±6.00) με], group B[(1.47±0.12) mm,(50.00±5.00) με] and group C[(1.35±0.11) mm,(47.00±4.00) με], the three group were 22.0%, 10.0% and 2.0% larger than those of group N[(1.32±0.10) mm,(46.00±4.00) με], respectively.(2)The S, P, σ0 of group A[(0.38±0.03) cm^2,(27.10±1.02) N,(71.32±5.71) N/cm^2], group B[(0.43±0.03) cm^2,(30.10±2.78) N,(70.00±5.25) N/cm^2], group C[(0.46±0.04) cm^2,(31.70±2.72) N,(68.90±5.28) N/cm^2], were different from those of group N[(0.48±0.04) cm^2,(33.00±3.16) N,(68.75±4.60) N/cm^2], group A(21.0%, 18.0%, 3.6%), group B(10.0%, 9.0%, 1.8%), group C(4.0%, 4.0%, 0.2%). The results showed that the mechanical stability of the mini plate group was the best, followed by the Bold nail group, and the Kirschner wire fixation group was the worst. Conclusion : Mason type Ⅱ fracture of the radial head with mini plate fixation has superior mechanical stability, which is better than the other two groups. It is an ideal sur

关 键 词：桡骨小头骨折 内固定 生物力学稳定性 

分 类 号：R683.41[医药卫生—骨科学]