中国骨与关节外科
中國骨與關節外科
중국골여관절외과
CHINESE BONE AND JOINT SURGERY
2013年
6期
526-529
,共4页
洪建仁%李力更%吴啸波%梁卫东%李飞
洪建仁%李力更%吳嘯波%樑衛東%李飛
홍건인%리력경%오소파%량위동%리비
髋臼%骨折%内固定%生物力学
髖臼%骨摺%內固定%生物力學
관구%골절%내고정%생물역학
Acetabulum%Fracture%Internal fixation%Biomechanics
背景：髋臼横形骨折治疗较为困难，常采用内固定的治疗方法。近年来有学者尝试采用锁定重建接骨板，但对其的研究报道较少。<br> 目的：比较4种不同锁定重建接骨板后方入路内固定方式治疗髋臼横行骨折的生物力学稳定性。<br> 方法：采用成人防腐标本10具，制成髋臼横行骨折模型20个，随机分为4组，每组5个标本。A组：重建接骨板两端各固定3枚螺钉。B组：重建接骨板两端各固定3枚螺钉及距骨折线最近的两侧螺孔各1枚螺钉。C组：锁定重建接骨板两端各3枚单皮质螺钉。D组：锁定重建接骨板两端各3枚单皮质螺钉及距骨折线最近的两侧螺孔各1枚单皮质螺钉。行轴向的加载实验，记录内固定失效时最大负载和轴向刚度。<br> 结果：A、B、C、D组所能承受的最大负载分别为（180.60±11.781）N、（240.80±7.981）N、（243.80±11.755）N和（438.00±23.227）N；轴向刚度分别为（95.21±6.32）N/mm、（123.47±23.95）N/mm、（126.39±18.52）N/mm和(227.35±13.74）N/mm。除B、C两组数据比较无统计学差异（P>0.05），其余各组的最大负载和轴向刚度差异均有统计学意义（P<0.05）。<br> 结论：髋臼横形骨折采用接骨板后方入路内固定时，锁定重建接骨板固定的稳定性优于重建接骨板，而且距骨折线最近的两侧螺孔给予螺钉固定能增强内固定的稳定性。
揹景：髖臼橫形骨摺治療較為睏難，常採用內固定的治療方法。近年來有學者嘗試採用鎖定重建接骨闆，但對其的研究報道較少。<br> 目的：比較4種不同鎖定重建接骨闆後方入路內固定方式治療髖臼橫行骨摺的生物力學穩定性。<br> 方法：採用成人防腐標本10具，製成髖臼橫行骨摺模型20箇，隨機分為4組，每組5箇標本。A組：重建接骨闆兩耑各固定3枚螺釘。B組：重建接骨闆兩耑各固定3枚螺釘及距骨摺線最近的兩側螺孔各1枚螺釘。C組：鎖定重建接骨闆兩耑各3枚單皮質螺釘。D組：鎖定重建接骨闆兩耑各3枚單皮質螺釘及距骨摺線最近的兩側螺孔各1枚單皮質螺釘。行軸嚮的加載實驗，記錄內固定失效時最大負載和軸嚮剛度。<br> 結果：A、B、C、D組所能承受的最大負載分彆為（180.60±11.781）N、（240.80±7.981）N、（243.80±11.755）N和（438.00±23.227）N；軸嚮剛度分彆為（95.21±6.32）N/mm、（123.47±23.95）N/mm、（126.39±18.52）N/mm和(227.35±13.74）N/mm。除B、C兩組數據比較無統計學差異（P>0.05），其餘各組的最大負載和軸嚮剛度差異均有統計學意義（P<0.05）。<br> 結論：髖臼橫形骨摺採用接骨闆後方入路內固定時，鎖定重建接骨闆固定的穩定性優于重建接骨闆，而且距骨摺線最近的兩側螺孔給予螺釘固定能增彊內固定的穩定性。
배경：관구횡형골절치료교위곤난，상채용내고정적치료방법。근년래유학자상시채용쇄정중건접골판，단대기적연구보도교소。<br> 목적：비교4충불동쇄정중건접골판후방입로내고정방식치료관구횡행골절적생물역학은정성。<br> 방법：채용성인방부표본10구，제성관구횡행골절모형20개，수궤분위4조，매조5개표본。A조：중건접골판량단각고정3매라정。B조：중건접골판량단각고정3매라정급거골절선최근적량측라공각1매라정。C조：쇄정중건접골판량단각3매단피질라정。D조：쇄정중건접골판량단각3매단피질라정급거골절선최근적량측라공각1매단피질라정。행축향적가재실험，기록내고정실효시최대부재화축향강도。<br> 결과：A、B、C、D조소능승수적최대부재분별위（180.60±11.781）N、（240.80±7.981）N、（243.80±11.755）N화（438.00±23.227）N；축향강도분별위（95.21±6.32）N/mm、（123.47±23.95）N/mm、（126.39±18.52）N/mm화(227.35±13.74）N/mm。제B、C량조수거비교무통계학차이（P>0.05），기여각조적최대부재화축향강도차이균유통계학의의（P<0.05）。<br> 결론：관구횡형골절채용접골판후방입로내고정시，쇄정중건접골판고정적은정성우우중건접골판，이차거골절선최근적량측라공급여라정고정능증강내고정적은정성。
Background:It is very difficult to treat transverse acetabular fracture and locking reconstruction plates have been used for in-ternal fixation. But there are few literatures on it. <br> Objective: To compare the biomechanical stability of four different internal fixation with plates and screws for transverse acetabular fractures. <br> Methods:Ten adult corpses were used to prepare for 20 models of transverse acetabular fractures. Then the fracture models were randomly divided into four groups (n=5): three screws were fixed at each end of reconstruction plates in group A, three screws were fixed at each end of reconstruction plates and one screw was fixed in the screw holes nearest to the frac-ture line on both sides in group B, three single cortical screws were fixed at each end of locking reconstruction plates in group C, and three single cortical screws were fixed at each end of locking reconstruction plates and one single cortical screw was fixed in the screw holes nearest to the fracture line on both sides in group D. Axial loading experiment was per-formed, and the maximum load and axial stiffness were recorded when internal fixation was failed. <br> Results:The maximum load was (180.60 ± 11.781)N, (240.80 ± 7.981)N, (243.80 ± 11.755)N and (438.00 ± 23.227) Nin the four groups in turn;axial stiffness was (95.21 ± 6.32) N/mm, (123.47 ± 23.95) N/mm, (126.39 ± 18.52)N/mm and (227.35 ± 13.74) N/mm. There was no statistical difference in maximum load and axial stiffness between group B and C (P>0.05), while the maximum load and axial stiffness in the rest groups was statistically different (P<0.05). <br> Conclusions:The biomechanical stability of locking reconstruction plate is better than reconstruction plates for transverse acetabular fracture. The screws fixed in the screw holes nearest to the fracture line the on both sides can enhance fixation stability.
