髋臼方形区骨折不同内固定方式的生物力学研究

发布时间：2018-02-03 11:31

  本文关键词： 髋臼方形区骨折 内固定 重建接骨板 拉力螺钉 生物力学　出处：《华北理工大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的比较髋臼方形区骨折四种内固定方式的生物力学差异。方法取16具成人男性半骨盆标本,制作髋臼方形区骨折模型,根据内固定方式不同随机分成4组(n=4),分别行骨盆缘下重建接骨板内固定(A组)、骨盆缘下锁定重建接骨板内固定(B组)、前柱重建接骨板结合方形区螺钉内固定(C组)、前柱重建接骨板加后柱拉力螺钉内固定(D组),将柳叶状压敏片贴于股骨头上,通过垂直加载依次测量生理体重600N下完整髋臼I组(未制作骨折线)和A、B、C、D四组的臼顶接触特性,及连续分级负载下A、B、C、D四组的水平位移、纵向位移,并计算轴向刚度。结果生理体重600N载荷下四组内固定的髋臼负重区接触特性未能恢复至正常,负重面积、平均应力、峰值应力差异均有统计学意义(P0.05)。同一载荷下,A、B、C、D组水平、纵向位移均逐渐减小,其中加载至1800N时A组纵向位移大于3.00mm,达到失效标准;而轴向刚度则逐渐增大。加载至200N时各组水平、纵向位移及轴向刚度比较,差异均无统计学意义(P0.05);600~1800N时,除C组与D组间水平位移差异无统计学意义(P0.05)外,其余各组水平、纵向位移及轴向刚度比较,差异均有统计学意义(P0.05)。结论对髋臼方形区骨折予以四种不同内固定,采用前柱重建接骨板加后柱拉力螺钉内固定髋臼方形骨折时的稳定性及臼顶接触特性最佳,其次为前柱重建接骨板结合方形区螺钉内固定,均优于骨盆缘下锁定重建接骨板和重建接骨板内固定。
[Abstract]:Objective to compare the biomechanical differences among the four internal fixation methods for the fracture of the acetabular square region. Methods Sixteen adult male hemipelvis specimens were taken to make the fracture model of the acetabular square area. According to the different internal fixation methods, they were randomly divided into 4 groups: group A (group A) and group B (group B). Anterior column reconstruction plate combined with square area screw internal fixation group C, anterior column reconstruction plate and posterior column lag screw internal fixation group D, willow leaf pressure sensitive film on the femoral head. The acetabular top contact characteristics of the intact acetabular group I (without fracture line) and the acetabular top contact characteristics under continuous graded loading were measured by vertical loading. Results under the load of 600N, the contact characteristics of the acetabular load-bearing area of the four groups could not return to normal, the load area and the average stress. The difference of peak stress was statistically significant (P 0.05). Under the same load, the longitudinal displacement decreased gradually. When loaded to 1800N, the longitudinal displacement of group A is greater than 3.00mm, which reaches the failure standard. However, the axial stiffness increased gradually, and there was no significant difference in longitudinal displacement and axial stiffness between each group at 200N level (P 0.05). At 600 ~ 1800N, there was no significant difference in horizontal displacement between group C and group D (P0.05), and the horizontal displacement and axial stiffness of other groups were compared. The differences were statistically significant (P 0.05). Conclusion there are four different internal fixation methods for the fracture of the acetabular square area. The stability and the contact characteristics of acetabular top were the best when the anterior column reconstruction plate was used to fix the acetabular square fracture, and the second was the anterior column reconstruction plate combined with the square area screw internal fixation. All of them were superior to the locking reconstruction plate and the internal fixation of the reconstruction plate under the pelvic margin.
【学位授予单位】：华北理工大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R683
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本文编号：1487266