CAJ | 학술논문

背景:交锁髓内钉是治疗股骨骨折的常用内固定器械,术中是否常规提拉加压,以及术后是否及时动力化,对骨折愈合起着至关重要的作用,如何通过干扰各种因素来提高骨折愈合率是人们研究的重点.目的:观察股骨静力交锁髓内钉生物力学性能及对骨折愈合的影响.方法:采用甲醛浸泡的成人尸体股骨标本8对,制成中段横形骨折模型后分别用静力型交锁髓内钉(髓内钉组)、TiNi环抱式接骨板(环抱器组)、有限接触动力加压接骨板(加压钢板组)固定,测试抗轴向压缩、抗三点弯曲和抗扭转力学性能,计算应力遮挡率.结果与结论:髓内钉组与加压钢板组相比,抗轴向压缩性能和抗三点弯曲性能相当(P>0.05),但抗扭转性能较弱(P<0.05);与环抱器组相比,抗轴向压缩性能和抗三点弯曲性能较强(P<0 05),而抗扭转性能差异无显著性意义(P>0.05);髓内钉组的应力遮挡率与加压钢板组差异无显著性意义(P>0.05),明显高于环抱器组(P<0.01).提示交锁髓内钉的生物力学稳定性可靠,但应力遮挡率较高,临床应用时需及时对其动力化,促进骨折愈合.
배경:교쇄수내정시치료고골골절적상용내고정기계,술중시부상규제랍가압,이급술후시부급시동력화,대골절유합기착지관중요적작용,여하통과간우각충인소래제고골절유합솔시인문연구적중점.목적:관찰고골정력교쇄수내정생물역학성능급대골절유합적영향.방법:채용갑철침포적성인시체고골표본8대,제성중단횡형골절모형후분별용정력형교쇄수내정(수내정조)、TiNi배포식접골판(배포기조)、유한접촉동력가압접골판(가압강판조)고정,측시항축향압축、항삼점만곡화항뉴전역학성능,계산응력차당솔.결과여결론:수내정조여가압강판조상비,항축향압축성능화항삼점만곡성능상당(P>0.05),단항뉴전성능교약(P<0.05);여배포기조상비,항축향압축성능화항삼점만곡성능교강(P<0 05),이항뉴전성능차이무현저성의의(P>0.05);수내정조적응력차당솔여가압강판조차이무현저성의의(P>0.05),명현고우배포기조(P<0.01).제시교쇄수내정적생물역학은정성가고,단응력차당솔교고,림상응용시수급시대기동력화,촉진골절유합.
BACKGROUND: Interlocking intramedullary nails(SliN)is frequently used to treat femoral fracture.Routine pulling and compression and postoperative motorization are important for fracture healing.To improve fracture healing rate has been focused using various factors.OBJECTIVE: To explore the biomechanical performance of static SliN in fixation of femoral fracture,and the effect on fracture healing.METHODS: A total of 8 pairs of femurs from adult cadavers immersed in formalin were used to prepare models of midpiece transverse fracture.The fracture was respectively fixed using static SliN,TiNi shape-memory sawtooth-arm embracing internal fixator(TiNi SMA),and dynamic compression plate(DCP).The anti-compression,anti-bending,and anti-torsion rigidity were measured,and the stress shielding rate was calculated.RESULTS AND CONCLUSION: SliN was similar to DCP group in anti-compression rigidity and anti-bending rigidity(P > 0.05),but the anti-torsion was lower than DCP group(P<0.05).Compared with TiNi SMA group,SliN displayed greater anti-compression rigidity and anti-bending rigidity(P<0.05),but similar anti-torsion(P > 0.05).SliN was similar to DCP group in stress shielding rate(P>0.05),but significantly greater than TiNi SMA group(P<0.01).The biomechanics of SliN was stable,but the stress shielding rate was high.Changing static interlocking into dynamic interlocking in time is necessary in clinic to promote fracture healing.