股骨前弓角在股骨粗隆间骨折髓内钉内固定生物力学临床实践研究  

The biomechanical analysis of anterior femoral arch angle in the intramedullary nail fixation of intertrochanteric fracture

作　　者：韩晓斌 王建光 田明 李玉民 HAN Xiaobin;WANG Jianguang;TIAN Ming;LI Yumin(China Civil Aviation Medical Center(CAAC),Beijing 100123)

机构地区：[1]民航总医院骨科,北京100123

出　　处：《北京生物医学工程》2021年第1期79-84,共6页Beijing Biomedical Engineering

摘　　要：目的通过对股骨前弓角在股骨粗隆间骨折(intertrochanteric fracture,IF)髓内钉内固定的生物力学分析,探讨股骨前弓角在股骨粗隆间骨折临床治疗中的意义。方法对股骨粗隆间骨折进行生物力学分析,然后对2013年1月至2019年1月民航总医院骨科收治的股骨粗隆间骨折手术患者266例进行回顾性研究。患者分为70岁以上年龄组和70岁以下年龄组,均行髓内钉内固定手术治疗,对股骨前弓角、股骨大粗隆顶点至股骨前弓角顶点的距离(顶尖距)及术后恢复Harris评分进行统计学分析。结果股骨前弓角及Harris评分两组比较有统计学意义(P<0.05),顶尖距两组比较无统计学意义(P>0.05)。70岁以上年龄组女性股骨前弓角(7.71°±1.94°)大于男性股骨前弓角(6.41°±2.05°)(P<0.05),而男性顶尖距(184.65 cm±19.31 cm)大于女性顶尖距(176.50 cm±17.83 cm)(P<0.05),术后恢复Harris评分未见明显差别(P>0.05)。结论股骨前弓角在股骨粗隆间骨折髓内钉内固定生物力学固定中具有重要意义,临床治疗中股骨前弓角和顶尖距可作为重要参考以取得最佳的临床效果。Objective To study the main factors influencing the curative effect of intertrochanteric fracture(IF)through the biomechanical analysis of the fixation of the anterior arch angle of femur with intramedullary nail.Methods The biomechanical analysis of intertrochanteric fracture was carried out.From January 2013 to January 2019,266 patients with intertrochanteric fracture in orthopaedic ward of civil aviation general hospital were studied retrospectively.All patients were treated with intramedullary nail fixation,divided into the age group over 70 years old and the age group under 70 years old.In the age group over 70 years old,the anterior arch Angle of femur was greater than that of male femur,while the distance between the apex of femur greater trochanter and the apex of femoral anterior arch angle of male femur was greater than that between the apex of femur greater trochanter and the apex of femur anterior arch angle of female femur.No significant difference was found in postoperative recovery Harris score.Results There was significant difference in anterior femoral arch angle and Harris score between the two groups(P<0.05),but there was no significant difference in apical distance between the two groups(P>0.05).Conclusions The angle of anterior arch of femur is of great significance in the biomechanical fixation of intramedullary nail for intertrochanteric fracture of femur.It can be used as an important reference to select the appropriate intramedullary nail in the clinical treatment to obtain the best clinical effect.

关 键 词：股骨前弓角 股骨粗隆间骨折 髓内钉内固定 生物力学分析 

分 类 号：R318.01[医药卫生—生物医学工程] R683.42[医药卫生—基础医学]