不同台阶状移位对髋臼骨折的生物力学影响

发布时间：2018-04-30 05:10

  本文选题：髋臼 + 关节面　； 参考：《中国生物医学工程学报》2017年03期

【摘要】：探讨髋臼骨折块不同旋转方向的台阶状移位对髋臼应力分布及大小等的影响,以期为临床治疗髋臼骨折及预后评估提供一定的理论指导。采用5具成人骨盆标本(10个髋关节),其中男性尸体标本3例,女性2例,年龄在23~66岁,平均年龄38.7岁。排除骨折、畸形、发育未完全及退行性病变。分别测量完整髋臼(I组)、解剖复位(K组)、不同台阶移位(A组:1 mm、B组:2 mm、C组:3 mm、D组:4 mm;a组:-1 mm、b组:-2 mm、c组:-3 mm、d组:-4 mm)时髋臼与股骨头之间的接触特性。所获数据经统计分析软件进行分析比较差异。结果表明,完整髋臼负重区平均应力为(3.06±0.27)MPa,骨折后负重区应力有增大趋势。K组的平均应力为(2.98±0.50)MPa,当内旋使台阶移位达到2 mm或更大,当外旋使台阶移位达到3 mm时,负重区平均应力显著性增大。负重区的峰值应力在完整髋臼为(5.05±0.38)MPa,骨折后负重区峰值应力有增大趋势。解剖复位组的平均应力为(5.58±0.72)MPa(与完整髋臼负重区峰值应力相比P0.05);当内旋使台阶移位达到1 mm或更大,外旋使台阶移位达到3 mm或更大时,负重区峰值应力与完整髋臼有显著性差异。髋臼双柱骨折产生的台阶状移位改变正常髋关节的生物力学特性,使髋关节的接触面积、平均应力以及峰值应力均发生重新分布。
[Abstract]:To explore the influence of step displacement of acetabular fracture in different rotation directions on the stress distribution and size of acetabulum in order to provide some theoretical guidance for clinical treatment of acetabular fracture and evaluation of its prognosis. Five adult pelvic specimens (10 hip joint specimens) were used, including 3 male cadaveric specimens and 2 female cadaveric specimens, with an average age of 38.7 years. Excluded fractures, deformities, incomplete development, and degenerative lesions. The contact characteristics between acetabular and femoral head were measured in group I, anatomic reduction and K group respectively. The obtained data were analyzed and compared with each other by statistical analysis software. The results showed that the average stress in the intact acetabular load area was 3.06 卤0.27 MPa, and the stress in the loading area after fracture was increasing. In group K, the mean stress was 2.98 卤0.50 mpa. When the internal rotation made the step shift to 2 mm or greater, when the external rotation caused the step displacement to reach 3 mm, the average stress of group K was 2.98 卤0.50 m. The average stress increased significantly in the load area. The peak stress in the whole acetabulum was 5.05 卤0.38 MPA, and the peak stress in the load-bearing area increased after fracture. The average stress of the anatomic reduction group was 5.58 卤0.72 mpa (compared with the peak stress of the complete acetabular load area, P0.05, when the internal rotation made the step shift to 1 mm or greater, and the external rotation to the step displacement to 3 mm or more, respectively), and the average stress of the anatomic reduction group was 5.58 卤0.72 m / m (P < 0.05). There was significant difference between the peak stress and the complete acetabulum in the load area. The step displacement caused by acetabular double column fracture changes the biomechanical characteristics of the normal hip joint and redistributes the contact area, average stress and peak stress of the hip joint.
【作者单位】： 温州医科大学附属第三医院关节外科;温州医科大学附属第三医院医学工程科;
【基金】：温州市科技局项目基金(Y20140593)
【分类号】：R318.01;R683
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本文编号：1823200