新型儿童股骨颈系统固定带游离骨块的儿童股骨颈骨折的生物力学性能研究  

A new pediatric femoral neck system for pediatric femoral neck fractures with a free fracture fragment:a biomechanical analysis

作　　者：陈晋宸 黄殿华 卢育南 陈添来 宁毓伟 陈顺有[1] Chen Jinchen;Huang Dianhua;Lu Yunan;Chen Tianlai;Ning Yuwei;Chen Shunyou(Department of Pediatric Orthopaedics,The Second Hospital of Fuzhou,Clinical Research Center of Emergency and Rehabilitation in Orthopedics&Traumatology in Fujian Province,Fuzhou 350007,China)

机构地区：[1]福州市第二医院小儿骨科,福建省创伤骨科急救与康复临床医学研究中心,福州350007

出　　处：《中华创伤骨科杂志》2023年第12期1074-1078,共5页Chinese Journal of Orthopaedic Trauma

基　　金：福建省创伤骨科急救与康复临床医学研究中心经费资助(2020Y2014);福建省临床重点专科经费资助(20220104);福州市科技计划项目(2020-WS-98)。

摘　　要：目的探讨新型儿童股骨颈系统(NP-FNS)固定带游离骨块的儿童股骨颈骨折的生物力学性能。方法将10个Sawbones模型骨随机分成A、B两组(n=5),全部制作成Pauwels角为70°的DelbetⅡ型股骨颈骨折模型,在骨折近端底部移除一个游离骨块,模拟带游离骨块的股骨颈骨折。A组模型采用传统倒三角形空心钉固定,B组模型采用NP-FNS固定。将两组模型放置在电子液压力学实验测试机上,每个标本依次进行静态轴向压缩试验、抗扭转试验和循环载荷试验。记录并比较两组标本的轴向压缩刚度、扭转刚度和最大位移差值。结果B组模型的轴向压缩刚度[(321.718±5.770)N/mm]和扭转刚度[(1.448±0.079)N·m/°]显著强于A组模型[(266.722±4.788)N/mm、(1.282±0.023)N·m/°],差异均有统计学意义(P<0.05)。B组模型的循环载荷试验最大位移差值为(0.063±0.038)mm,显著小于A组模型[(0.117±0.056)mm],差异也有统计学意义(P<0.05)。结论与传统倒三角形空心钉固定相比,NP-FNS固定带游离骨块的儿童股骨颈骨折具有更好的生物力学稳定性。Objective To investigate the biomechanical properties of a new pediatric femoral neck system in the fixation of pediatric femoral neck fractures with a free fracture fragment.Methods Ten Sawbones model bones were randomly divided into 2 even groups(n=5),all of which were made into Delbet TypeⅡfemoral neck fractures with a Pauwels angle of 70°.A free bone block was removed from the bottom at the proximal end of the fracture to simulate a femoral neck fracture with a free fragment.Group A were fixed with traditional inverted triangle cannulated screws,and group B with a new pediatric femoral neck system.After the 2 groups of specimens were placed on a biomechanical testing machine,each specimen was subjected to a static axial compression test,an anti-torsion test and a cyclic load test in turn.The biomechanical results were compared between groups A and B in aspects of axial compression stiffness,torsional stiffness and maximum displacement difference.Results The axial compression stiffness[(321.718±5.770)N/mm]and torsional rigidity[(1.448±0.079)N·m/°]in group B were significantly higher than those in group A[(266.722±4.788)N/mm and(1.282±0.023)N·m/°](P<0.05).The maximum displacement difference in the cyclic load test in group B[(0.063±0.038)mm]was also significantly smaller than that in group A[(0.117±0.056)mm](P<0.05).Conclusion In fixation of pediatric femoral neck fractures with a free fracture fragment,the new pediatric femoral neck system can lead to better biomechanical stability than the traditional inverted triangle cannulated screws.

关 键 词：股骨颈骨折 骨折固定术 内 内固定器 生物力学 游离骨块 

分 类 号：R726.8[医药卫生—儿科]