新型弹性固定治疗胫骨髁间嵴骨折的实验研究  

Biomechanical Study of a New Elastic Fixation for Tibial Eminence Fracture

作　　者：王江涛[1,2] 步建立 常晗 滕立佳 钱宇航 周勇[1] 车建伟 罗涛[1] 孙成 刘玉杰[2] Wang Jiangtao;Bu Jianli;Chang Han(Second Department of Orthopaedics,Chinese PLA 980 Hospital,Shijiazhuang 050000,China;Department of Orthopaedics,Chinese PLA General Hospital,Beijing 100853,China;Department of Orthopaedics,Chinese PLA 92196 Troops,Qingdao 266000,China)

机构地区：[1]中国人民解放军第980医院骨二科,河北石家庄050000 [2]中国人民解放军总医院骨科,北京100853 [3]中国人民解放军92196部队,山东青岛266000 [4]中国人民解放军第984医院骨科,北京100094

出　　处：《实用骨科杂志》2021年第1期40-43,共4页Journal of Practical Orthopaedics

基　　金：河北省重点科技研究基金项目(20170958)。

摘　　要：目的探讨新型缝线网状套扎弹性固定胫骨髁间嵴骨折的生物力学性能。方法取新鲜猪膝关节标本16个,制备Ⅲ型胫骨髁间嵴骨折模型,随机分为两组,每组各8个,分别采用缝线网状套扎固定(A组)和缝合锚钉固定(B组)。通过疲劳试验及拔出试验,分析比较两组最大失败载荷、失效载荷、拔出刚度及循环位移。结果失败模式:A组位移超限8个;B组锚钉拔出4个,缝线断裂2个,缝线切割骨块2个。生物力学结果显示,最大失败载荷及失效载荷:A组(517.798 N,247.841 N)>B组(247.469 N,123.254 N),两组比较差异有统计学意义(P=0.001);循环位移:A组(2.316 mm)<B组(5.423 mm),两组比较差异有统计学意义(P=0.001);拔出刚度:A组(40.062 N/mm)>B组(35.699 N/mm),两组比较差异无统计学意义(P=0.386)。结论缝线网状套扎固定法生物力学性能优于缝合锚钉固定法,能够满足术后早期功能锻炼的要求。Objective To study the biomechanical stability of Reticular Loop Ligature Fixation.Methods 16 fresh porcine knee joints were involved in this experiment.After the fracture model was made in uniform size,all samples were randomly divided into two groups:reticular loop ligature group(A)and suture anchor group(B),eight cases in each group.Biomechanical tests were made on universal electromagnetic.Each specimen firstly underwent fatigue test,then pull-out test until failure.The maximum failure load,yield load,stiffness and displacement were analyzed.Results Failure Mode:All of the 8 cases of A group went beyond the displacement limit,B group suture anchor pull-out 4 cases,suture rupture 2 cases,thread cutting 2 case.Biomechanical test:The maximum failure load and yield load:A(517.798 N,247.841 N)>B(247.469 N,123.254 N).These differences were statistically significant(P=0.001).The displacements:A(2.316 mm)<B(5.423 mm).These differences were statistically significant(P=0.001).The stiffness:A(40.062 N/mm)>B(35.699 N/mm),the differences of stiffness between the three groups had no statistically significance(P=0.386).Conclusion Compared with suture anchor,Reticular Loop Ligature Fixation has better biomechanical performance and can meet the requirement of early post-operative exercise.

关 键 词：胫骨髁间嵴骨折 高强度缝线 弹性固定 生物力学 猪 

分 类 号：R683.42[医药卫生—骨科学]