CAJ | 학술논문

目的：评估带锁髓内钉（interlocking intramedullary nail，IIN）与锁定加压接骨板（locking compression plate， LCP）固定胫骨近端骨折的生物力学稳定性，为临床治疗方案的选择提供指导。方法按胫骨近端不同位置模拟骨折将其分成 A、B、C 三组，使用两种不同内固定物分别对骨折模型进行固定并用有限元法分析胫骨骨折模型及内固定物在500N 轴向压缩载荷下的位移和等效应力及分布情况。结果3组模型中使用 IIN 固定的胫骨骨折模型及胫骨的最大轴向位移均比使用 LCP 的小；IIN 及其固定的胫骨最大等效应力值均比 LCP 及固定的胫骨的小。且 IIN 应力分布较均匀，LCP 应力集中在骨板与锁定连接处。结论 IIN 抗压缩能力强且固定坚强可靠，应力分布较均匀，抗疲劳性好，其固定胫骨近端骨折稳定性优于 LCP。
목적：평고대쇄수내정（interlocking intramedullary nail，IIN）여쇄정가압접골판（locking compression plate， LCP）고정경골근단골절적생물역학은정성，위림상치료방안적선택제공지도。방법안경골근단불동위치모의골절장기분성 A、B、C 삼조，사용량충불동내고정물분별대골절모형진행고정병용유한원법분석경골골절모형급내고정물재500N 축향압축재하하적위이화등효응력급분포정황。결과3조모형중사용 IIN 고정적경골골절모형급경골적최대축향위이균비사용 LCP 적소；IIN 급기고정적경골최대등효응력치균비 LCP 급고정적경골적소。차 IIN 응력분포교균균，LCP 응력집중재골판여쇄정련접처。결론 IIN 항압축능력강차고정견강가고，응력분포교균균，항피로성호，기고정경골근단골절은정성우우 LCP。
Objective To evaluate the biomechanical stability of proximal tibial fractures fixation using Interlocking Intr-amedullary Nail(IIN)and Locking Compression Plate(LCP),and to provide guidance for the choices of clinical treatment schemes. Methods Simulate fracture types were divided into three groups respectively A,B and C according to the different locations of the proximal tibia. Fracture models were fixed respectively using two different internal fixators. Displacement,equiv-alent stress and stress distribution were analyzed under axial compression load of 500N of tibial fracture models and internal fixators. Results The maximum axial displacement of tibial fracture models fixed by IIN and tibia was smaller than that of tib-ial fracture models fixed by LCP. The stress distribution on IIN was relative uniform,and stress concentrates in the connection between bone plate and locking screws of LCP. Conclusion IIN's anti-compression capability is strong,fixation is stable and reliable,stress distribution is relative uniform,and fatigue resistance is high. The stability of proximal tibial fractures fixation with IIN is superior to LCP.