髋臼横行后壁骨折不同内固定方式的生物力学研究

发布时间：2018-03-14 19:24

本文选题：髋臼横行后壁骨折　切入点：内固定　出处：《成都医学院学报》2016年06期 　论文类型：期刊论文

【摘要】：目的探讨不同内固定方式在髋臼横行后壁骨折内固定中的生物力学稳定性,为临床应用不同内固定方式治疗髋臼横行后壁骨折提供可靠的生物力学依据。方法 20具成人防腐尸体标本共40具半髋臼标本随机数字表法分为4组,每组5具完整骨盆。A组:后柱重建钢板联合后壁螺钉固定;B组:后柱重建钢板联合前柱拉力螺钉及后壁螺钉固定;C组:前柱重建钢板联合后柱重建钢板及后壁拉力螺钉固定;D组:后柱锁定重建钢板。应用生物力学实验机分别对各组加载至骨折端固定失败(移位2mm)并记录各组的最大载荷,比较4组的生物力学稳定性。结果髋臼横行后壁骨折4种不同的内固定方式所能承载的最大载荷分别为:A组(823.89±106.27)N;B组(1 041.38±125.66)N;C组(1 210.19±116.27)N;D组(1 037.89±108.67)N,各组两两比较:A组所承载的最大载荷小于B、C、D组,差异有统计学意义(F=15.98;P=0.027);C组所承载的最大载荷大于B、D组,差异有统计学意义(P=0.015);B、D组差异无统计学意义(P=0.571)。结论内固定治疗髋臼横行后壁骨折时,应用前后柱双钢板、后柱锁定重建钢板及后柱重建钢板联合前柱拉力螺钉固定的生物力学稳定性均优于后柱单重建钢板,其中前后柱双钢板固定的稳定性更强;后柱锁定重建钢板与后柱重建钢板联合前柱拉力螺钉所承载的最大载荷相似。
[Abstract]:Objective to investigate the biomechanical stability of internal fixation of acetabular posterior wall fractures with different internal fixation methods. To provide reliable biomechanical basis for clinical treatment of acetabular posterior wall fractures with different internal fixation methods 20 adult embalmed cadavers 40 semi-acetabular specimens were randomly divided into 4 groups. Each group had 5 intact pelvis. Group A: posterior column reconstruction plate combined with posterior wall screw fixation group B: posterior column reconstruction plate combined with anterior column lag screw and posterior wall screw fixation group C: anterior column reconstruction plate combined with posterior column reconstruction plate and posterior wall pull. Force screw fixation group D: posterior column locking reconstruction plate. The failure of fixation to the fracture end (displacement 2 mm) was recorded by biomechanical test machine, and the maximum load of each group was recorded. Results the maximum load of the four different internal fixation methods for acetabular posterior wall fracture was 823.89 卤106.27ng in group A and 10041.38 卤125.66 in group B respectively. The maximum load of each group was 1 210.19 卤116.27ND (10037.89 卤108.67N), and that of group A was the most. The large load is smaller than that of BCU D group, The difference was statistically significant. The maximum load of group C was larger than that of group B D, and there was no significant difference in group D (P 0. 015). Conclusion when internal fixation is used to treat fracture of posterior wall of acetabular, double steel plate with anterior and posterior columns is used in treatment of fracture of acetabular posterior wall. The biomechanical stability of the posterior column locking reconstruction plate and the posterior column reconstruction plate combined with the anterior column lag screw fixation was better than that of the posterior column single reconstruction plate, and the stability of the posterior column double plate fixation was stronger. The maximum load of the lock-in-post reconstruction plate and the rear-column reconstruction plate combined with the front column lag screw is similar.
【作者单位】：河北省创伤骨科中心唐山市第二医院;华北理工大学;河北医科大学第三医院;
【基金】：唐山市科技局科研项目(No:12140210A-5)
【分类号】：R687;R318.01

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