交叉倒三角方式置入加压螺纹钉应用于股骨颈骨折内固定的力学研究  

Mechanical study of the application of compression screw nail in the cross-inverted triangular pattern for internal fixation of femoral neck fracture

作　　者：王云龙 吴文杰 邹发 何怡 高钰 盛华均[1] WANG Yun-long;WU Wen-jie;ZOU Fa;HE Yi;GAO Yu;SHENG Hua-jun(Department of Anatomy,Chongqing Medical University,Chongqing 400331,China)

机构地区：[1]重庆医科大学解剖教研室,重庆400331

出　　处：《局解手术学杂志》2020年第12期959-962,共4页Journal of Regional Anatomy and Operative Surgery

基　　金：重庆医科大学基础医学院英耀计划项目(jcyy201814);2019年度创新实验(SRIEP201939)。

摘　　要：目的设计一种交叉倒三角方式置入加压螺纹钉治疗股骨颈骨折,并比较股骨以交叉倒三角和倒三角方式置入加压螺纹钉的生物力学。方法选取6具成年人体标本,其中男女各3具。通过随机数字表法将3具男性标本分为A1、B1、C1组,3具女性标本分为A2、B2、C2组。A1、A2组制作成头下型股骨颈骨折模型,B1、B2组制作成经颈型股骨颈骨折模型,C1、C2组制作成基底型股骨颈骨折模型。将每组的右支股骨按照交叉倒三角方式置入加压螺纹钉,左支股骨按照倒三角方式置入加压螺纹钉。应用电子万能试验机进行静态加压测试,根据实验中绘制的压力-位移曲线读取股骨颈的最大载荷及股骨头轴向位移3.00 mm时的载荷。结果A1、A2、B1、B2及C2组左支股骨的股骨颈最大载荷及股骨头轴向位移3.00 mm时的载荷均大于右支股骨;而C1组左支股骨的股骨颈最大载荷及股骨头轴向位移3.00 mm时的载荷小于右支股骨。比较A1、A2组,B1、B2组,C1、C2组右支股骨头轴向位移3.00 mm时的载荷及最大载荷,差异均无统计学意义(P>0.05)。经K-S检验,股骨颈的最大载荷及股骨头轴向位移3.00 mm时的载荷呈正态分布(P=0.20),2组载荷数据再进行LSD-t检验,差异无统计学意义(P=0.235)。结论交叉倒三角方式置入加压螺螺纹钉应用于男性和女性效果相似,在固定头下型和经颈型股骨颈骨折时稳定性较好;但在固定基底型股骨颈骨折时,稳定性劣于倒三角置钉方式。Objective To design a cross-inverted triangular pattern to insert compression screw nail for treatment of femoral neck fracture,and to compare the biomechanics of inserting compression screw nail in cross-inverted triangular pattern and inverted triangular pattern.Methods A total of 6 adult human specimens were selected,of which 3 males and 3 females were respectively divided into A1,B1,C1 groups and A2,B2,C2 groups by random number table method.A1 and A2 groups were made into subhead femoral neck fracture models,B1 and B2 groups were made into trans-neck femoral neck fracture models,and C1 and C2 groups were made into basal femoral neck fracture models.The right femur of each group inserted compression screw nail in the crossed-inverted triangular pattern,and the left femur of each group inserted compression screw nail in the inverted triangular pattern.The static compression test was performed by an electronic universal testing machine.The maximum load of the femoral neck and the load of 3.00 mm axial displacement of femoral head were read according to the pressure-displacement curve drawn in the experiment.Results The maximum load of the femoral neck and the load of 3.00 mm axial displacement of femoral head of the left femur were greater than those of the right femur in A1、A2、B1、B2 and C2 groups,while the maximum load of the femoral neck and the load of 3.00 mm axial displacement of femoral head of the left femur was smaller than those of the right femur in C1 group.There was no statistically significant difference in maximum load of the femoral neck and the load of 3.00 mm axial displacement of femoral head between A1 and A2 groups,B1 and B2 groups,C1 and C2 groups(P>0.05).After K-S test,the maximum load of the femoral neck and the load of 3.00 mm axial displacement of femoral head were normally distributed(P=0.20),and LSD-t test was conducted for the two load data,the difference was not statistically significant(P=0.235).Conclusion The effect of compression screw nail in the cross-inverted triangular

关 键 词：交叉倒三角方式 骨折固定术 股骨颈骨折 生物力学 

分 类 号：R683.4[医药卫生—骨科学]