斯氏针置入股骨头不同方式的生物力学分析  

Biomechanical analysis of different ways of inserting Steinmann Pins into the femoral head

作　　者：许新忠[1] 吴钟汉 余水生[1] 赵耀[1] 徐春归[1] 张鑫 郑嵋戈 荆珏华[1] Xu Xinzhong;Wu Zhonghan;Yu Shuisheng;Zhao Yao;Xu Chungui;Zhang Xin;Zheng Meige;Jing Juehua(Department of Orthopedics,Second Hospital of Anhui Medical University,Hefei 230000,Anhui Province,China)

机构地区：[1]安徽医科大学第二附属医院骨科,安徽省合肥市230000

出　　处：《中国组织工程研究》2022年第9期1313-1317,共5页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金青年项目(81801220),项目负责人:郑嵋戈。

摘　　要：背景:对于不同年龄段的人群,股骨颈骨折有其不同的骨折线走向特点,有着不同的治疗策略。如何在手术治疗中提高复位质量、避免股骨头坏死及内固定失效,成为骨科学者面对的共同挑战。通过对股骨头颈部模型进行力学测试,期望获得相关数据,为提高复位稳定性及复位质量指明方向。目的:通过静态拉伸实验和疲劳实验得出斯氏针不同方式置入股骨头的力学特点。方法:选取天津正天医疗器械有限公司生产型号为ZLW02SJA的斯氏针,规格φ3.5*300 mm,样品材质为317不锈钢,按照2个步骤进行研究。步骤一:静态拉伸实验,使用1枚或者2枚斯氏针,按照前方或者侧方打入股骨头的方式组合,共计8种方案,每一方案将斯氏针打入Sawbone股骨头相应深度,以20 mm/min的速度对斯氏针进行拔出力测试,记录拔出力值。步骤二:疲劳拉伸实验,汇总前8次实验拔出力的平均值,取2个最大拔出力的75%值分别进行疲劳拉伸测试。结果与结论:①经过静态抗拔出力测试,得出抗拔出力最佳的2种方案为方案五和方案七,其中方案五的打入方式为自前而后,皮质骨厚度为4.3 mm,松质骨厚度为25.7 mm,斯氏针数量为2枚,置入深度为股骨头2/3;方案七的打入方式为侧方大转子,皮质骨厚度为3.0 mm,松质骨厚度为26.3 mm,斯氏针数量为2枚,置入深度为股骨头2/3;②然后选用这2种方案的最大拔出力的75%分别进行至少300次疲劳循环,2种方案均能完成疲劳测试,斯氏针最稳定的打入方式为方案五,其具有较大的拔出力,在斯氏针打入股骨头复位过程中可以与股骨头相对稳定的产生牵引;③结果显示:抗拔出力实验和疲劳实验均提示打入2枚斯氏针强于1枚斯氏针,而打入2枚斯氏针的情况下自前而后方向进针优于侧方大转子进针。BACKGROUND:For people of different ages,femoral neck fractures have different fracture line characteristics and different treatment strategies.It has become a common challenge for orthopedic scholars that how to improve the quality of reduction and avoid osteonecrosis of the femoral head and failure of internal fixation in surgical treatment.Through mechanical tests of models of the femoral head and neck,we expect to obtain the relevant data and point out the direction for the improvement of reduction stability and reduction quality.OBJECTIVE:To obtain the mechanical characteristics of different ways of inserting Steinmann Pins into the femoral head through the static anti-pull-out test and the fatigue test.METHODS:The Steinmann Pins with model ZLW02SJA produced by Tianjin Zhengtian Medical Equipment Co.,Ltd.,with a specification ofφ3.5*300 mm,and a sample material of 317 stainless steel,were selected for the study according to two steps.Step 1:Static tensile test was the test that inserted one or two Steinmann Pins into the Sawbone with corresponding depth in the femoral head.The direction could be from front to back or from greater trochanter of femur into the femoral head,and the total kind of solution combinations was eight.The Steinmann Pins were injected into the specified depth.The pullout force of the Steinmann Pins was tested with the speed of 20 mm/min,and the pullout force was recorded.Step 2:Fatigue tensile test.The average pullout force of the first eight tests was summarized;75%of the two maximum pullout forces were taken for fatigue tensile test.RESULTS AND CONCLUSION:(1)Through static tensile tests,it is concluded that the two schemes with the best pullout force were scheme 5 and scheme 7.In scheme 5 whose direction was from front to back into the femoral head:the thickness of cortical bone was 4.3 mm.The thickness of cancellous bone was 25.7 mm.The number of Steinmann Pins was 2.Insertion depth was 2/3 of femoral head.In scheme 7 whose direction was from greater trochanter of femur into the femo

关 键 词：斯氏针 股骨头 力学 股骨颈骨折 静态拉伸 疲劳拉伸 股骨模型 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学]