中华创伤杂志
中華創傷雜誌
중화창상잡지
Chinese Journal of Traumatology
2012年
12期
1078-1082
,共5页
股骨骨折%内固定器%外科手术%生物力学
股骨骨摺%內固定器%外科手術%生物力學
고골골절%내고정기%외과수술%생물역학
Femoral fractures%Internal fixators%Surgical procedures,operative%Biomechanics
目的 对单纯股骨近端锁定板(locking proximal femoral plate,LPFP)、LPFP联合磷酸钙骨水泥(calcium phosphate cement,CPC)、防旋股骨近端髓内钉(proximal femoral nail antirotation,PFNA)固定不稳定性股骨转子间骨折进行生物力学研究. 方法 18具标本共36根股骨纳入试验,标本证实无病理缺陷、骨折、畸形或肿瘤,分为A、B、C三组,每组各12根股骨,依据Evans分型中的ⅢA型股骨转子间骨折造模,A组采用LPFP联合CPC固定,B组采用单纯LPFP固定,C组采用PFNA固定.将股骨标本固定在特殊的夹具内进行力学对比测试. 结果 轴向压缩试验结果显示,在生理载荷作用下,三种内固定股骨上的载荷-位移关系基本上呈线性变化；股骨转子间骨折三种内固定扭矩-扭角测量结果表明,随着扭角的逐渐增大,扭矩也逐渐增大,直至内固定物失效. 结论 LPFP联合CPC或PFNA治疗不稳定性转子间骨折均能够达到坚强固定.
目的 對單純股骨近耑鎖定闆(locking proximal femoral plate,LPFP)、LPFP聯閤燐痠鈣骨水泥(calcium phosphate cement,CPC)、防鏇股骨近耑髓內釘(proximal femoral nail antirotation,PFNA)固定不穩定性股骨轉子間骨摺進行生物力學研究. 方法 18具標本共36根股骨納入試驗,標本證實無病理缺陷、骨摺、畸形或腫瘤,分為A、B、C三組,每組各12根股骨,依據Evans分型中的ⅢA型股骨轉子間骨摺造模,A組採用LPFP聯閤CPC固定,B組採用單純LPFP固定,C組採用PFNA固定.將股骨標本固定在特殊的夾具內進行力學對比測試. 結果 軸嚮壓縮試驗結果顯示,在生理載荷作用下,三種內固定股骨上的載荷-位移關繫基本上呈線性變化；股骨轉子間骨摺三種內固定扭矩-扭角測量結果錶明,隨著扭角的逐漸增大,扭矩也逐漸增大,直至內固定物失效. 結論 LPFP聯閤CPC或PFNA治療不穩定性轉子間骨摺均能夠達到堅彊固定.
목적 대단순고골근단쇄정판(locking proximal femoral plate,LPFP)、LPFP연합린산개골수니(calcium phosphate cement,CPC)、방선고골근단수내정(proximal femoral nail antirotation,PFNA)고정불은정성고골전자간골절진행생물역학연구. 방법 18구표본공36근고골납입시험,표본증실무병리결함、골절、기형혹종류,분위A、B、C삼조,매조각12근고골,의거Evans분형중적ⅢA형고골전자간골절조모,A조채용LPFP연합CPC고정,B조채용단순LPFP고정,C조채용PFNA고정.장고골표본고정재특수적협구내진행역학대비측시. 결과 축향압축시험결과현시,재생리재하작용하,삼충내고정고골상적재하-위이관계기본상정선성변화；고골전자간골절삼충내고정뉴구-뉴각측량결과표명,수착뉴각적축점증대,뉴구야축점증대,직지내고정물실효. 결론 LPFP연합CPC혹PFNA치료불은정성전자간골절균능구체도견강고정.
Objective To study the biomechanics of simple locking proximal femoral plate (LPFP),LPFP combined with calcium phosphate cement (CPC) and proximal femoral nail antirotation (PFNA) in treatment of unstable intertrochanteric fractures.Methods Thirty-six femurs from 18 specimens with no pathological defects,fractures,malformations or neoplasms were enrolled in the study and were divided into three groups (Groups A,B and C),with 12 femurs per group.Intertrochanteric fractures were duplicated in accordance with Evans classification of type Ⅲ A.The fractures in Group A were treated by LPFP combined with CPC fixation,that in Group B treated with only LPFP fixation,while that in Group C fixed with PFNA.A comparative mechanical test of femoral specimens was performed in a special clamp.Results Axial compression test showed linear change of the load-displacement of three surgical fixations for intertrochanteric fractures under biological load.The measurement of torque-torsion angle of three fixations for intertrochateric fractures showed that the torque was enlarged with increase of torsion angle till the failure of internal fixation.Conclusion LPFP combined with CPC or PFNA can attain solid fixation of unstable intertrochanteric fractures.
