股骨颈骨折2枚空心螺钉内固定的力学稳定性研究

发布时间：2018-03-03 08:02

本文选题：股骨颈骨折　切入点：骨折固定术　出处：《中国骨伤》2016年11期 　论文类型：期刊论文

【摘要】：目的:分析2枚和3枚空心螺钉固定不同骨折线方向的股骨颈骨折的力学稳定性,为2枚空心螺钉临床应用及其适应证的选择提供理论依据。方法:采集15具国人股骨尸体标本,构建3种Pauwels角(30°、50°和70°)的股骨颈骨折模型,分别行3枚及2枚空心螺钉内固定,采用生物力学检测仪分别测定抗张位移、竖向位移、剪切位移、综合位移、缝隙距、扭矩和刚度值,评价2枚和3枚空心螺钉内固定的力学稳定性。结果:Pauwels角为30°和50°时,2枚空心螺钉内固定的抗张位移、竖向位移、剪切位移、综合位移、缝隙距、扭矩和刚度值与3枚空心螺钉内固定相比较,差异无统计学意义(P0.05);当Pauwels角为70°时,采用3枚空心螺钉内固定后,其力学稳定性优于2枚螺钉内固定,差异有统计学意义(P0.05),同时发现Pauwels角为70°时,即使采用3枚空心螺钉内固定,其力学稳定性明显较Pauwels角为30°和50°时差。结论:Pauwels角为30°和50°时,2枚空心螺钉内固定与3枚空心螺钉内固定的力学稳定性相同,2枚空心螺钉内固定已能较好地维持股骨颈骨折的稳定。而当Pauwels角为70°时,3枚空心螺钉内固定力学稳定性则优于2枚空心螺钉内固定,但其力学稳定性较Pauwels角为30°和50°时弱,手术时需采用角稳定系统或者加用抗滑螺钉以增强骨折内固定的稳定性。
[Abstract]:Objective: to analyze the mechanical stability of femoral neck fractures fixed with 2 and 3 hollow screws. Methods: 15 cadavers of Chinese femur were collected and 3 kinds of femoral neck fracture models with Pauwels angle 30 掳or 50 掳and 70 掳were established, and 3 and 2 hollow screws were fixed, respectively, in order to provide theoretical basis for clinical application and indication selection of 2 hollow screws. The tensile displacement, vertical displacement, shear displacement, comprehensive displacement, gap distance, torque and stiffness were measured by biomechanical detector. Results the tensile displacement, vertical displacement, shear displacement, comprehensive displacement and gap distance of the two hollow screws were measured at 30 掳and 50 掳at the angle of 30 掳and 50 掳respectively. When the Pauwels angle was 70 掳, the mechanical stability of 3 hollow screws was better than that of 2 screws. The difference was statistically significant (P 0.05). It was also found that when the Pauwels angle was 70 掳, even if 3 hollow screws were used for internal fixation, The mechanical stability was obviously lower than that of Pauwels angle (30 掳and 50 掳). Conclusion the mechanical stability of two hollow screws is the same as that of three hollow screws when the ratio is 30 掳and 50 掳. The mechanical stability of two hollow screws can be maintained well. When the Pauwels angle was 70 掳, the mechanical stability of 3 hollow screws was better than that of 2 hollow screws. However, its mechanical stability is weaker than that at Pauwels angle of 30 掳and 50 掳. Angle stabilization system or anti-skid screw should be used to enhance the stability of fracture internal fixation.
【作者单位】：嘉兴市第二医院骨科;浙江大学医学院附属第二医院骨科;
【分类号】：R687.3

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