CAJ | 학술논문

目的评价一种可注射磷酸钙骨水泥(Calcium Phosphate Cement,CPC)强化股骨近端对老年骨质疏松性股骨粗隆间骨折内固定的生物力学影响.方法选用5对骨质疏松性股骨近端标本制作粗隆间骨折模型,以DHS固定,分为对照组与CPC强化组进行生物力学检测.结果 CPC强化组在500 N应力下的轴向刚度为(691.93±18.90)N/mm,水平剪切刚度为(5 553.84±27.47)N/mm,内外侧平均强度分别为(5.15±0.35)MPa,(4.13±0.24)MPa,扭转刚度为0.41,极限载荷(3580±286)N;对照组在500 N应力下的轴向刚度为(453.45±9.75)N/mm,水平剪切刚度为(3848.87±22.63)N/mm,内外侧平均强度分别为(3.12±0.37)MPa,(1.80±0.21)MPa,扭转刚度为0.35,极限载荷(2512±189)N.CPC强化组的各项力学性能均高于于对照组,差异有显著性意义(P＜0.05).结论以CPC对骨质疏松性股骨头内及内后侧缺损处强化可以有效提高骨质疏松性股骨粗隆间骨折内固定稳定性,降低术后并发症的风险.
목적 평개일충가주사린산개골수니(Calcium Phosphate Cement,CPC)강화고골근단대노년골질소송성고골조륭간골절내고정적생물역학영향.방법 선용5대골질소송성고골근단표본제작조륭간골절모형,이DHS고정,분위대조조여CPC강화조진행생물역학검측.결과 CPC강화조재500 N응력하적축향강도위(691.93±18.90)N/mm,수평전절강도위(5 553.84±27.47)N/mm,내외측평균강도분별위(5.15±0.35)MPa,(4.13±0.24)MPa,뉴전강도위0.41,겁한재하(3580±286)N;대조조재500 N응력하적축향강도위(453.45±9.75)N/mm,수평전절강도위(3848.87±22.63)N/mm,내외측평균강도분별위(3.12±0.37)MPa,(1.80±0.21)MPa,뉴전강도위0.35,겁한재하(2512±189)N.CPC강화조적각항역학성능균고우우대조조,차이유현저성의의(P＜0.05).결론 이CPC대골질소송성고골두내급내후측결손처강화가이유효제고골질소송성고골조륭간골절내고정은정성,강저술후병발증적풍험.
Objective To evaluate the biomechanical effects of using a new injectable calcium phosphate cement to consolidate the fixation of osteoporotic intertrochanteric fracture.Method Five matchod pairs of human cadaver femora were used to produce the model of intertrochanteric fracture.All fractures were fixed with dynamic hip screws(DHS),and divided into two groups.In the CPC consolidation group of each pair,CPC was used to grout the hip screw and to fill the posteromedial defect.All femora were subjected to biomechanical test.Results Under the loading of 500 N,in the CPC consolidation group,the mean axial stiffness is(691.93±18.90)N/mm and the horizontal shear stiffness is(5553.84±27.47)N/mm.The mean lateral and medial strength is(5.15±0.35)MPa and(4.13±0.24)MPa.The torsion stiffness was 0.41 and the ultimate loading is(3580±286)N.In the control group,the mean axiak stiffness is(453.45±19.75)N/mm,the horizontal shear stiffness is(3848.87±22.63)N/mm,the mean lateral and medial strength is(3.12±0.37)MPa and(1.80±0.21)MPa,and,the torsion stiffness is 0.35 and the ultimate loading is(2512±189)N.Consolidation fixation with CPC increased each of the biomechanical efficiency(P＜0.05).Conclusions CPC consolidation of osteoprotic femoral head and the medial defect of intertrochanteric fracture can significantly improve the overall stability and decrease the rate of postoperative complication.