CAJ | 학술논문

目的比较钢板与钉棒系统内固定支架(简称钉棒系统)固定骨盆Tile B1型损伤模型的生物力学稳定性,以期为临床治疗提供理论依据. 方法取防腐正常成人骨盆标本7具,男2具,女5具;死亡年龄平均为42.1岁.保留从L5至股骨近端中上20 cm的骨盆标本,并保留完整的耻骨联合、双侧髋关节、双侧骶髂关节及韧带等结构.将骨盆标本置于AGS-X生物力学实验机上,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模拟完整骨盆(完整骨盆组);②耻骨联合切开,伴单侧骶棘韧带、骶结节韧带、骶髂前韧带切断,模拟骨盆水平旋转不稳定Tile B1型损伤(TileB1型损伤模型组);③钢板固定骨盆Tile B1型损伤模型(钢板固定组);④钉棒系统固定骨盆Tile B1型损伤模型(钉棒系统固定组).结果在500 N的压力下,完整骨盆组、Tile B1型损伤模型组、钢板固定组及钉棒系统固定组的耻骨联合位移平均分别为(0.121±0.025)、(4.512±0.391)、(0.358±0.051)、(0.656±0.103)mm,4组之间比较差异有统计学意义(F =725.707,P=0.000),其中完整骨盆组＜钢板固定组＜钉棒系统固定组＜Tile B1型损伤模型组,4组之间两两比较差异均有统计学意义(P＜0.05). 结论钢板与钉棒系统固定骨盆Tile B1型损伤模型均能有效恢复骨盆环的力学稳定性,钢板的生物力学稳定性优于钉棒系统.
목적 비교강판여정봉계통내고정지가(간칭정봉계통)고정골분Tile B1형손상모형적생물역학은정성,이기위림상치료제공이론의거. 방법 취방부정상성인골분표본7구,남2구,녀5구;사망년령평균위42.1세.보류종L5지고골근단중상20 cm적골분표본,병보류완정적치골연합、쌍측관관절、쌍측저가관절급인대등결구.장골분표본치우AGS-X생물역학실험궤상,모의인체정상쌍족참립중립위,유L5수직향하가압지500 N,의차측량하술4충정황하적치골연합위이:①모의완정골분(완정골분조);②치골연합절개,반단측저극인대、저결절인대、저가전인대절단,모의골분수평선전불은정Tile B1형손상(TileB1형손상모형조);③강판고정골분Tile B1형손상모형(강판고정조);④정봉계통고정골분Tile B1형손상모형(정봉계통고정조).결과 재500 N적압력하,완정골분조、Tile B1형손상모형조、강판고정조급정봉계통고정조적치골연합위이평균분별위(0.121±0.025)、(4.512±0.391)、(0.358±0.051)、(0.656±0.103)mm,4조지간비교차이유통계학의의(F =725.707,P=0.000),기중완정골분조＜강판고정조＜정봉계통고정조＜Tile B1형손상모형조,4조지간량량비교차이균유통계학의의(P＜0.05). 결론 강판여정봉계통고정골분Tile B1형손상모형균능유효회복골분배적역학은정성,강판적생물역학은정성우우정봉계통.
Objective To compare the biomechanical properties of reconstruction plate and pedicle screw-rod system in fixation of the models of Tile B1 pelvic injury.Methods We used 7 cadaveric specimens of normal adult pelvis from 2 males and 5 females with an average death age of 42.1 years.The cadaveric pelvis preserved an intact spine from the fifth lumbar vertebra to 20 centimeters above the proximal ends of both femurs,intact pubic symphysis,bilateral hip joints,bilateral sacroiliac joints,and major pelvic ligaments.After the pelvic specimens were put in an AGS-X biomechanical testing machine at a simulated standing neutral posture,they were subjected to a vertical load of up to 500 N downward from the L5 vertebral body.The displacements of the symphysis pubis were recorded sequentially in the following 4 conditions:1.intact pelvis (the intact group); 2.models of Tile B1 pelvic injury simulating rotatory unstable injury of the pelvis in which the symphysis pubis was cut apart in combination with ruptures of ipsilateral sacrospinous and sacrotuberous ligaments (the injury group); 3.Tile B1 pelvic injury fixated with a reconstruction plate (the plate group).4.Tile B1 pelvic injury fixated with the pedicle screw-rod system (the screw-rod group).Results Under the vertical load of 500 N,the displacements of the symphysis pubis in the intact,injury,plate and screw-rod groups were respectively 0.121 ±0.025 mm,4.512 ±0.391 mm,0.358 ±0.051 mm,and 0.656 ±0.103 mm.There were significant differences between the 4 groups (F =725.707,P =0.000).The displacement increased from the intact group,the plate group,the screw-rod group to the injury group.The differences between any 2 groups were significant (P ＜ 0.05).Conclusions In fixation of the models of Tile B1 pelvic injury,the reconstruction plate and the pedicle screw-rod system can both effectively restore the biomechanical stability of the injured pelvis.However,internal fixation with the reconstruction plate may yield better biomechanical stability than that with the pedicle screw-rod system.