髋臼横形骨折稳定性的生物力学评估  

Biomechanical evaluation of hip joint stability after simulated transverse acetabular fracture

作　　者：陆爱清[1] 孙俊英[1] 董天华[1] 唐天驷[1] 

机构地区：[1]苏州大学附属第一医院骨科

出　　处：《江苏医药》2003年第8期581-584,F002,共5页Jiangsu Medical Journal

摘　　要：目的研究不同平面髋臼横形骨折对髋关节稳定性的影响,以正确界定髋臼负重区。方法选24个尸体髋关节,按内侧顶弧角30°、40°、50°和60°截骨,分为4组,每组6髋,建立髋臼横形骨折模型。对骨折模型加载轴向载荷,测定反映髋关节稳定性的纵向、水平位移和轴向刚度。结果 加载800N时,30°、40°、50°和60°组髋臼的纵向位移分别为7.83mm、6.20mm、5.50mm和5.00mm,水平位移分别为0.036mm、0.029mm、0.024mm和0.022mm,轴向刚度分别为102.17N/mm、129.03N/mm、145.46N/mm和160.02N/mm。按照稳定性评判标准,30°和40°组分别有6髋和1髋完全不稳定,且40°组有3髋部分不稳定,50°组1髋部分不稳定,60°组无不稳定。结论后顶弧角大小与髋关节的稳定性密切相关,在内顶弧角>40°、后顶弧角≥45°且两者之和>90°时,能维持髋关节的稳定性。Objective To define the limits of the weight-bearing region of the acetabulum and study the effects on the stability of the joint of the different levels of tranverse acetabular fractures. Methods Twenty-four cadaveric hip joints were divided into four groups 60,50,40, and 30 degrees of medial roof-arc angle, each group consisting of six joints. The models were established by osteotomy. Their biomechanical stability was evaluated on longitudinal displacement, horizontal displacement and axial stiffness measurements, all being carried out under 800 Newton vertical compression load. Results The longitudinal displacements were 7. 83mm, 6. 20mm, 5. 50mm and 5. 00mm in 30°, 40°, 50° and 60?groups respectively. And their horizontal displacements were 0. 036mm, 0. 029mm, 0. 024mm and 0.022mm, respectively. But their values of axial stiffness were 102. 17N/mm, 129.03N/mm, 145. 46N/mm and 160. 02N/mm, respectively. According to the criteria of stability, there are six and one completely unstable joints in 30?and 40?groups respectively,while three and one partial unstable joints in 40° and 50° groups, respectively. But there is not any unstable joint in 60° group. Conclusion In transverse acetabular fractures, the stability of the hip joint is closely related to the posterior roof-arc angle and was maintained on condition that a medial roof-arc angle is greater than 40 degrees, a posterior roof-arc angle is or greater than 45 degrees and a medial plus posterior roof-arc angle is greater than 90 degrees.

关 键 词：髋臼横形骨折 稳定性 生物力学 评估 

分 类 号：R683.3[医药卫生—骨科学]