CAJ | 학술논문

背景:随着交锁髓内钉的广泛使用,使骨折延迟愈合、交锁钉断裂等问题逐渐显露出来,在此情况下,一种锁孔和锁钉杆过渡配合交锁髓内钉应运而生.目的:观察新设计的锁孔和锁钉杆直径过渡配合交锁髓内钉和传统交锁髓内钉固定骨折稳定性的比较.方法:应用8具两侧股骨骨折标本,分别采用8根锁孔和锁钉杆直径过渡配合交锁髓内钉和传统交锁髓内钉固定骨折断端.实验组应用定制髓内钉远端瞄准微调装置配套安装器械锁钉,使用定制的直径4.3 mm锁钉交锁固定;对照组应用常规的配套安装器械,常规的直径4.0 mm锁钉交锁固定,给予两组股骨固定标本,分别记录测量两组股骨骨折断端左右、前后、旋转移位情况,来进行骨折固定稳定性比较.结果与结论:锁钉杆过渡配合髓内钉固定股骨中下段骨折,在10 N受力的情况下,股骨骨折断端平均有左右移位1.22 mm、前后移位1.2 mm、旋转移位0.33 mm;传统交锁髓内钉锁孔在10 N受力的情况下,股骨骨折断端平均有左右移位3.26 mm、前后移位3.37 mm、旋转移位2.15 mm,锁钉杆过渡配合髓内钉固定股骨骨折,骨折断端左右、前后、旋转移位明显小于传统交锁髓内钉,有显著性差异.说明锁孔和锁钉杆直径过渡配合交锁髓内钉置入内固定可明显提高骨折断端的稳定性.
배경:수착교쇄수내정적엄범사용,사골절연지유합、교쇄정단렬등문제축점현로출래,재차정황하,일충쇄공화쇄정간과도배합교쇄수내정응운이생.목적:관찰신설계적쇄공화쇄정간직경과도배합교쇄수내정화전통교쇄수내정고정골절은정성적비교.방법:응용8구량측고골골절표본,분별채용8근쇄공화쇄정간직경과도배합교쇄수내정화전통교쇄수내정고정골절단단.실험조응용정제수내정원단묘준미조장치배투안장기계쇄정,사용정제적직경4.3 mm쇄정교쇄고정;대조조응용상규적배투안장기계,상규적직경4.0 mm쇄정교쇄고정,급여량조고골고정표본,분별기록측량량조고골골절단단좌우、전후、선전이위정황,래진행골절고정은정성비교.결과여결론:쇄정간과도배합수내정고정고골중하단골절,재10 N수력적정황하,고골골절단단평균유좌우이위1.22 mm、전후이위1.2 mm、선전이위0.33 mm;전통교쇄수내정쇄공재10 N수력적정황하,고골골절단단평균유좌우이위3.26 mm、전후이위3.37 mm、선전이위2.15 mm,쇄정간과도배합수내정고정고골골절,골절단단좌우、전후、선전이위명현소우전통교쇄수내정,유현저성차이.설명쇄공화쇄정간직경과도배합교쇄수내정치입내고정가명현제고골절단단적은정성.
@@@@BACKGROUND: With the wide application of interlocking intramedul ary nail, the issues of delayed fracture healing and interlocking nail fracture are gradual y revealed, thus the keyhole and lockpin shank transition combined with interlocking intramedul ary nail come into being. OBJECTIVE: To observe the stability of keyhole and lockpin shank diameter transition combined with interlocking intramedul ary nail and traditional interlocking intramedul ary nail fixation. METHODS: Eight bilateral femoral fracture specimens were used and the fracture sites were fixed with eight keyholes and lockpin shanks diameter transition combined with interlocking intramedul ary nail and traditional interlocking intramedul ary nail fixation. In the experimental group, the customized intramedul ary nail distal aiming fine-tuning device was used to instal the matching equipment nail, and then interlocking fixed by customized interlocking nail with the diameter of 4.3 mm; in the control group, conventional matching instal ation equipment was used, and then interlocking fixed by interlocking nail with the conventional diameter of 4.0 mm. The specimens in two groups were fixed with the methods above respectively, and then the displacement from left to right, from forward to backward and the rotation displacement of the femoral fracture sites in two groups were recorded and measured, in order to compare the stability of the fracture fixation. RESULTS AND CONCLUSION: For the treatment of middle femur fracture with keyholes and lockpin shanks transition combined with interlocking intramedul ary nail fixation, when loaded with 10 N force, the femoral fracture sites had 1.22 mm displacement from left to right, 1.22 mm from forward to backward and 0.33 mm rotation displacement; when the traditional interlocking intramedul ary nail keyhole loaded with 10 N force, the femoral fracture sites had 3.26 mm displacement from left to right, 3.37 mm from forward to backward and 2.15 mm rotation displacement. The displacement from left to right, from forward to backward and the rotation displacement of the fracture sites after fixed with lockpin shanks transition combined with interlocking intramedul ary nail were smal er than those after fixed with lockpin shanks transition combined with traditional interlocking intramedul ary nail, and the differences were significant. The results indicate that keyhole and lockpin shank transition combined with interlocking intramedul ary nail fixation can improve the stability of fracture site.