新型股骨近端内侧支撑钢板治疗股骨反转子间骨折的生物力学研究

发布时间：2018-05-18 08:32

本文选题：股骨反转子间骨折 + 股骨近端内侧支撑钢板　；参考：《中国修复重建外科杂志》2017年02期

【摘要】：目的通过与股骨近端锁定加压钢板(proximal femoral locking compression plate,PFLCP)、股骨近端防旋髓内钉(proximal femoral nail antirotation,PFNA)比较,探讨采用新型股骨近端内侧支撑钢板(proximal femoral medial buttress plate,PFMBP)固定股骨反转子间骨折在生物力学方面的优势。方法取18具第4代Synbone人工股骨标准试验骨(左侧)制备AO 31-A3.1型股骨反转子间骨折模型后,根据内固定不同随机分为3组(n=6),分别为PFLCP组、PFNA组、PFMBP组。各标本骨折固定后包埋固定,分别行轴向压缩试验、扭转试验及最大轴向压缩破坏试验,计算对应轴向压缩刚度、扭转刚度,记录最大轴向载荷及标本破坏情况。结果轴向压缩刚度PFLCP组为(109.42±30.14)N/mm,PFNA组为(119.13±29.14)N/mm,PFMBP组为(162.05±22.05)N/mm,组间比较差异有统计学意义(P0.05)。同一组中不同扭转角度对应扭矩比较,以及同一扭转角度各组扭矩比较,差异均有统计学意义(P0.05)。扭转刚度PFLCP组为(1.45±0.44)N·mm/deg,PFNA组为(1.10±0.13)N·mm/deg,PFMBP组为(1.36±0.32)N·mm/deg;PFLCP组、PFMBP组与PFNA组比较,差异均有统计学意义(P0.05);PFLCP组及PFMBP组比较差异无统计学意义(P0.05)。最大轴向载荷PFLCP组为(1 408.88±0.17)N,PFNA组为(1 696.56±0.52)N,PFMBP组为(2 154.65±0.10)N,3组间比较差异均有统计学意义(P0.05)。结论PFBMP在轴向压缩刚度和扭转刚度方面优于PFLCP及PFNA,提示维持内侧稳定性对于治疗股骨反转子间骨折具有重要意义。
[Abstract]:Objective to compare the results of proximal femoral locking compression plate with proximal femoral locking compression plate and proximal femoral nail antirotation of proximal femoral intramedullary nail. To investigate the biomechanical advantages of proximal femoral medial buttress plate (PFMBP) in the fixation of intertrochanteric fracture of femur. Methods A model of AO 31-A3.1 type intertrochanteric fracture of femur was established in 18 fourth generation Synbone artificial femur standard test bone (left side). According to different internal fixation, it was randomly divided into 3 groups: PFLCP group and PFLCP group. After fixation, axial compression test, torsion test and maximum axial compression failure test were performed to calculate the corresponding axial compression stiffness and torsional stiffness, and to record the maximum axial load and specimen failure. Results the axial compression stiffness in PFLCP group was 109.42 卤30.14 N- / mm, 119.13 卤29.14 卤29.14 N- / nmm-PFMBP and 162.05 卤22.05 N- / mm, respectively. The difference between the two groups was statistically significant (P 0.05). There were significant differences in torque between different torsion angles in the same group and torque at the same torsion angle (P 0.05). The torsional stiffness of PFLCP group was 1.45 卤0.44 Nmm / PFNA group, which was 1.10 卤0.13 N / mm / PFNA group. There was no significant difference between P0.05PFLCP group and PFMBP group (P 0.05). The maximum axial load in PFLCP group was 1 408.88 卤0.17 nna, 1 696.56 卤0. 52 卤0. 52 and 2 154.65 卤0. 10 nna, respectively. There were significant differences among three groups (P 0. 05, P 0. 05). Conclusion PFBMP is superior to PFLCP and PFLCP in axial compression stiffness and torsional stiffness, which suggests that maintaining medial stability is of great significance in the treatment of intertrochanteric fracture of femur.
【作者单位】：温州医科大学附属第二医院创伤骨科;
【基金】：国家自然科学基金资助项目(81472146)~~
【分类号】：R687.3;R318.01

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