中华创伤骨科杂志
中華創傷骨科雜誌
중화창상골과잡지
CHINESE JOURNAL OF ORTHOPAEDIC TRAUMA
2013年
6期
517-520
,共4页
李尚政%苏伟%赵劲民%谢能峰
李尚政%囌偉%趙勁民%謝能峰
리상정%소위%조경민%사능봉
骨盆%骨钉%外固定器%生物力学
骨盆%骨釘%外固定器%生物力學
골분%골정%외고정기%생물역학
Pelvis%Bone nails%External fixators%Biomechanics
目的 通过对钉-棒系统和骨盆髂骨翼外固定支架固定骨盆水平旋转不稳定损伤模型的生物力学进行测试,对比两者固定骨盆的力学稳定性,为临床治疗提供理论依据. 方法 取经福尔马林处理的正常成人骨盆标本7具,保留从L5至股骨近端中上20 cm的骨盆标本,保留完整的耻骨联合、双侧髋关节、双侧骶髂关节、双侧骶结节韧带、双侧骶棘韧带、双侧骶髂前韧带、双侧骶髂后韧带.将骨盆置于AGX生物力学试验机上,模拟人体正常双足站立中立位,由L5垂直向下加压至500 N,依次测量下述4种情况下的耻骨联合位移:①完整骨盆；②骨盆水平旋转不稳定Tile B1型损伤模型；③钉-棒系统固定骨盆Tile B1型损伤模型；④骨盆髂骨翼外固定支架固定骨盆Tile B1型损伤模型.结果 在500 N的压力下,4组耻骨联合位移由小到大依次为完整骨盆[(0.121 ±0.025) mm]、钉-棒系统固定模型[(0.656±0.103) mm]、髂骨翼外固定支架固定模型[(1.512±0.101) mm]、Tile B1型损伤模型[(4.512±0.391) mm],4组间两两比较差异均有统计学意义(P＜0.05).结论钉-棒系统固定骨盆水平旋转不稳定损伤模型的生物力学稳定性明显优于骨盆髂骨翼外固定支架,能有效恢复骨盆环的力学稳定性.
目的 通過對釘-棒繫統和骨盆髂骨翼外固定支架固定骨盆水平鏇轉不穩定損傷模型的生物力學進行測試,對比兩者固定骨盆的力學穩定性,為臨床治療提供理論依據. 方法 取經福爾馬林處理的正常成人骨盆標本7具,保留從L5至股骨近耑中上20 cm的骨盆標本,保留完整的恥骨聯閤、雙側髖關節、雙側骶髂關節、雙側骶結節韌帶、雙側骶棘韌帶、雙側骶髂前韌帶、雙側骶髂後韌帶.將骨盆置于AGX生物力學試驗機上,模擬人體正常雙足站立中立位,由L5垂直嚮下加壓至500 N,依次測量下述4種情況下的恥骨聯閤位移:①完整骨盆；②骨盆水平鏇轉不穩定Tile B1型損傷模型；③釘-棒繫統固定骨盆Tile B1型損傷模型；④骨盆髂骨翼外固定支架固定骨盆Tile B1型損傷模型.結果 在500 N的壓力下,4組恥骨聯閤位移由小到大依次為完整骨盆[(0.121 ±0.025) mm]、釘-棒繫統固定模型[(0.656±0.103) mm]、髂骨翼外固定支架固定模型[(1.512±0.101) mm]、Tile B1型損傷模型[(4.512±0.391) mm],4組間兩兩比較差異均有統計學意義(P＜0.05).結論釘-棒繫統固定骨盆水平鏇轉不穩定損傷模型的生物力學穩定性明顯優于骨盆髂骨翼外固定支架,能有效恢複骨盆環的力學穩定性.
목적 통과대정-봉계통화골분가골익외고정지가고정골분수평선전불은정손상모형적생물역학진행측시,대비량자고정골분적역학은정성,위림상치료제공이론의거. 방법 취경복이마림처리적정상성인골분표본7구,보류종L5지고골근단중상20 cm적골분표본,보류완정적치골연합、쌍측관관절、쌍측저가관절、쌍측저결절인대、쌍측저극인대、쌍측저가전인대、쌍측저가후인대.장골분치우AGX생물역학시험궤상,모의인체정상쌍족참립중립위,유L5수직향하가압지500 N,의차측량하술4충정황하적치골연합위이:①완정골분；②골분수평선전불은정Tile B1형손상모형；③정-봉계통고정골분Tile B1형손상모형；④골분가골익외고정지가고정골분Tile B1형손상모형.결과 재500 N적압력하,4조치골연합위이유소도대의차위완정골분[(0.121 ±0.025) mm]、정-봉계통고정모형[(0.656±0.103) mm]、가골익외고정지가고정모형[(1.512±0.101) mm]、Tile B1형손상모형[(4.512±0.391) mm],4조간량량비교차이균유통계학의의(P＜0.05).결론정-봉계통고정골분수평선전불은정손상모형적생물역학은정성명현우우골분가골익외고정지가,능유효회복골분배적역학은정성.
Objective To compare the biomechanical performances of pedicle screw-rod system versus pelvic ala ilium external fixator in cadaveric models of rotatory unstable pelvic injury.Methods Seven cadaveric specimens of normal adult pelvis were used for the test,retaining intact spines from the fifth lumbar vertebra to the proximal 20 centimeters of both femurs,intact pubic symphysis,bilateral hip joints,bilateral sacroiliac joints,bilateral sacrotuberous ligaments,bilateral sacrospinous ligaments,bilateral anterior sacroiliac ligaments and bilateral posterior sacroiliac ligaments.The pelvic specimens were put in an AGX biomechanical testing machine at a standing neutral posture and subjected to a vertical load of up to 500 N downward from the L5 body.The displacements of the symphysis pubis were recorded sequentially in the following 4 conditions:1.intact pelvis; 2.pelvic Tile B1 injury in simulation of rotatory unstable injury of the pelvis in which the symphysis pubis was cut off and accompanied with ruptures of ipsilateral sacrospinous and sacrotuberous ligaments; 3.pelvic Tile B1 injury fixated with the pedicle screw-rod system; 4.pelvic Tile B1 injury fixated with the pelvic ala ilium external fixator.Results Under the vertical load of 500 N,displacements of the symphysis pubis increased significantly from condition 1 (0.121 ± 0.025 mm),to condition 3 (0.656 ±0.103 mm),to condition 4 (1.512 ±0.101 mm) and last to condition 2 (4.512 ±0.391 mm).The difference between any two conditions was significant (P ＜ 0.05).Conclusion Fixation by the pedicle screw-rod system is significantly better than that by the pelvic ala ilium external fixator for rotatory unstable pelvic injury,because the former can more effectively restore the biomechanical stability of the pelvic ring.
