CAJ | 학술논문

目的：分析动力髋部螺钉(DHS)与股骨近端髓内钉(PFN)固定用于不稳定股骨转子间骨折治疗的生物力学差异。方法选取16根新鲜冷冻成人尸体股骨标本，制备成不稳定股骨转子间骨折模型。随机分为采用PFN固定的观察组(n=8)和采用DHS固定的对照组(n=8)，比较两组骨折间压缩位移及压缩刚度、内固定失效时的最大载荷、抗扭转刚度等差异。结果观察组模型采用PFN固定后的轴向压缩位移小于对照组，压缩刚度值大于对照组，差异有统计学意义(P<0.05)；观察组内固定失效时的平均载荷为(4.28±0.39) kN，对照组内固定失效时的平均载荷为(3.76±0.41) kN，差异有统计学意义(P<0.05)；随着扭矩增大，两组骨折模型的股骨头颈部的扭角增加，但是观察组模型的抗扭转性能明显优于对照组，差异有统计学意义(P<0.05)。结论股骨近端髓内钉用于不稳定性股骨转子间骨折的内固定，其具有良好的生物力学性能，在抗压及抗逆转方面均具有优势。
목적：분석동력관부라정(DHS)여고골근단수내정(PFN)고정용우불은정고골전자간골절치료적생물역학차이。방법선취16근신선냉동성인시체고골표본，제비성불은정고골전자간골절모형。수궤분위채용PFN고정적관찰조(n=8)화채용DHS고정적대조조(n=8)，비교량조골절간압축위이급압축강도、내고정실효시적최대재하、항뉴전강도등차이。결과관찰조모형채용PFN고정후적축향압축위이소우대조조，압축강도치대우대조조，차이유통계학의의(P<0.05)；관찰조내고정실효시적평균재하위(4.28±0.39) kN，대조조내고정실효시적평균재하위(3.76±0.41) kN，차이유통계학의의(P<0.05)；수착뉴구증대，량조골절모형적고골두경부적뉴각증가，단시관찰조모형적항뉴전성능명현우우대조조，차이유통계학의의(P<0.05)。결론고골근단수내정용우불은정성고골전자간골절적내고정，기구유량호적생물역학성능，재항압급항역전방면균구유우세。
Objective To compare biomechanical indexes of dynamic hip screw (DHS) and proximal femo-ral nail (PFN) in the treatment of unstable intertrochanteric fracture. Methods Sixteen femur specimens of root fresh frozen adult corpses were collected, and then prepared into unstable intertrochanteric fracture models, which were ran-domly divided into observation group (n=8, treated by PFN) and control group (n=8, treated by DHS). Compression displacement and compression stiffness, maximum load in case of internal fixation failure, torsional stiffness of the fractures were compared. Results The axial compression displacement in the observation group was significantly less than that in the control group, while compression stiffness value in the observation group was significantly greater (P<0.05). The average load in case of internal fixation failure was (4.28±0.39) kN in the observation group and (3.76± 0.41) kN in the control group, with statistically significant difference between the two groups (P<0.05). With torque in-creases, femoral neck torsion angle increased in both groups, but the torsion performance in the observation group was significantly better than that of control group (P<0.05). Conclusion PFN for unstable intertrochanteric fracture has good biomechanical properties, which is advantageous in both compressive strength and anti-reversal.