髋臼后柱骨折3种不同钢板固定后站立及坐立位下的生物力学比较  

Biomechanical comparison of three different plate fixation methods for acetabular posterior column fractures in standing and sitting positions

作　　者：许玉林 沈师 卓乃强 杨惠麟 杨超 李洋 赵恒 赵露 Xu Yulin;Shen Shi;Zhuo Naiqiang;Yang Huilin;Yang Chao;Li Yang;Zhao Heng;Zhao Lu(Department of Bone and Joint Surgery,Affiliated Hospital of Southwest Medical University,Luzhou 646000,Sichuan Province,China;Southwest Medical University,Luzhou 646000,Sichuan Province,China)

机构地区：[1]西南医科大学附属医院骨与关节外科,四川省泸州市646000 [2]西南医科大学,四川省泸州市646000

出　　处：《中国组织工程研究》2021年第6期826-830,共5页Chinese Journal of Tissue Engineering Research

基　　金：西南医科大学青年基金资助(2018-ZRQN-030),项目负责人:许玉林。

摘　　要：背景:有研究显示,不同内固定方式固定髋臼后柱骨折的生物力学存在差异。目的:模拟髋臼后柱骨折,评估3种固定方式固定髋臼后柱骨折后的稳定性。方法:取36个尸体半骨盆标本,建立髋臼后柱骨折模型,随机分3组固定:A组以髂坐短钢板固定,B组以传统后柱钢板固定,C组以髂坐长钢板固定,每组12个模型。模拟人体站立及坐立位时垂直方向加载力学载荷,采用图像位移法评估骨折断端的位移及生物力学稳定性。结果与结论:①站立位时,3组模型骨折断端相对位移与载荷大小呈正相关,相同载荷下3组间相对位移比较差异无显著性意义(P>0.05);加载1800 N载荷时,各组模型相对位移均未超过3 mm;②坐立位时,3组模型骨折断端相对位移与载荷大小呈正相关,相同载荷下3组间相对位移比较差异有显著性意义(P<0.05);相同载荷下,B组相对位移大于A、C组;A组100-500 N载荷下的相对位移大于C组,600 N载荷下的相对位移小于C组;③结果表明,髂坐钢板固定髋臼后柱骨折时能提供与传统后柱钢板同样的生物力学稳定性,固定结构刚度高,可满足术后康复需求。BACKGROUND:Studies have shown that there are differences in the biomechanics of different internal fixation methods to fix the acetabular posterior column fracture.OBJECTIVE:To simulate the acetabular posterior column fracture and evaluate the stability of the acetabular posterior column with three fixation methods.METHODS:Thirty-six cadaveric hemipelvic specimens were collected to establish models of acetabular posterior column fracture.The models were randomly divided into three groups,and were fixed by three different fixation methods:(short iliosciatic plate in group A,traditional posterior plate in group B,and long iliosciatic plate in group C;n=12 per group).Mechanical loads were applied vertically in standing and sitting positions.The fracture ends displacement and biomechanical stability were evaluated by using image displacement method.RESULTS AND CONCLUSION:(1)In the standing position,the relative displacement of the fracture ends of the three groups was positively correlated with the load;there was no statistically significant difference in the displacement of the fracture ends under the same load in the three groups(P>0.05).When loaded with a load of 1800 N,the relative displacement of each group of models did not exceed 3 mm.(2)In the sitting position,the relative displacement of the fracture end was positively correlated with the size of the load;the relative displacement of the three groups under the same load was significantly different(P<0.05).Under the same load,the relative displacement of group B was greater than that of groups A and C;the relative displacement of group A under 100-500 N load was greater than that of group C,and the relative displacement under 600 N load was smaller than that of group C.(3)The results suggested that the iliosciatic plate fixation of the acetabular posterior column fracture can provide the same biomechanical stability as the traditional posterior column steel plate,and the rigidity of the fixed structure is high,which can meet the postoperative rehabilitation n

关 键 词：骨 骨折 内固定 髋臼后柱 钢板 生物力学 髋臼骨折 稳定性 

分 类 号：R459.9[医药卫生—治疗学] R683.3[医药卫生—临床医学]