CAJ | 학술논문

目的根据锁骨的解剖学特点,研制一种交锁髓内钉固定锁骨中段骨折,并探讨其优缺点. 方法通过对60根成人锁骨及5具成人新鲜尸体标本的测量、实验,测量锁骨长度、外侧段与中段夹角、中段与内侧段夹角、锁骨最窄处直径、锁骨最窄处髓腔内径等数据.设计出交锁髓内钉,其两端结构相同,均可与瞄准器相连接,采用逆行穿钉及两端锁定的方法固定锁骨中段骨折. 结果锁骨全长为(14.82±1.15)cm,外侧段与中段夹角、中段与内侧段夹角均为30°左右,锁骨最窄处直径为(1.00±0.16)cm,锁骨最窄处髓腔内径为(0.50±0.18)cm.由锁骨中段骨折端逆行穿导针并扩髓,根据锁骨的形状适度折弯髓内钉,由近端或远端插入髓腔,分别用瞄准器锁定远、近端,固定稳定可靠. 结论采用自制交锁髓内钉固定锁骨中段骨折手术创伤小,直视下复位满意而且固定可靠.但相关生物力学数据还有待于进一步研究.
목적 근거쇄골적해부학특점,연제일충교쇄수내정고정쇄골중단골절,병탐토기우결점. 방법 통과대60근성인쇄골급5구성인신선시체표본적측량、실험,측량쇄골장도、외측단여중단협각、중단여내측단협각、쇄골최착처직경、쇄골최착처수강내경등수거.설계출교쇄수내정,기량단결구상동,균가여묘준기상련접,채용역행천정급량단쇄정적방법고정쇄골중단골절. 결과 쇄골전장위(14.82±1.15)cm,외측단여중단협각、중단여내측단협각균위30°좌우,쇄골최착처직경위(1.00±0.16)cm,쇄골최착처수강내경위(0.50±0.18)cm.유쇄골중단골절단역행천도침병확수,근거쇄골적형상괄도절만수내정,유근단혹원단삽입수강,분별용묘준기쇄정원、근단,고정은정가고. 결론 채용자제교쇄수내정고정쇄골중단골절수술창상소,직시하복위만의이차고정가고.단상관생물역학수거환유대우진일보연구.
Objective To design an intramedullary nail that had the same ends and could be connected to hairline pointer and employ it to fixate mid-shaft clavicular fractures. Methods Sixty adult clavicles and five fresh adult cadaveric clavicles were employed to measure full length, angle between lateral and middle segments, angle between middle and medial segments as well as the narrowest outer and inner diameters of the clavicle. The interlocked intramedullary nail with the same structure of two ends was designed and used to fixate mid-shaft clavicular fractures. The nail was inserted in retrograde manner and locking screws could be inserted at beth ends. Results The full length, angle between lateral and middle segments, angle between middle and media] segments as well as the narrowest outer and inner diameters of the clavicle were (14.82 ± 1.15) cm, 30°, 30°, (1.00±0.16) cm and (0.50± 0. 18) cm respectively. After conversely placing guide pin from the fracture end, expanding medullary cavity and adjusting the nail, the designed nail was inserted into the medullary cavity from the distal or proximal ends of the clavicle, which was locked by interlocked screws. Conclusions Self-made nail takes advantages of less surgical invasion, visible fracture reduction and stable fracture fixation for treatment of mid-shaft clavicular fractures. While the biomechanieal properties of the nail need further investigation.