探讨不同夹针螺栓及扭矩对伊氏架穿骨针张力丢失的影响

发布时间：2018-06-13 12:34

本文选题：生物力学 + 夹针螺栓　；参考：《天津医科大学》2017年硕士论文

【摘要】：目的:20世纪50年代,前苏联医生Ilizarov发明了Ilizarov环形外固定支架。与其他类型外固定支架不同,该外固定支架维持骨段相对稳定位置的稳定性需要小直径穿骨针提供,穿骨针的张力具有决定性意义。在对穿骨针进行拉张及外固定支架承受负荷时,张力的维持就需要夹针螺栓-穿骨针界面的压力及摩擦力来完成。本实验通过研究在拧紧固定螺栓后、移除拉张器后及施加轴向压缩载荷后穿骨针张力的变化情况,比较孔洞型螺栓,沟槽型螺栓,孔洞型螺栓+垫片,沟槽型螺栓+垫片四种不同类型夹针螺栓组合,10Nm、15Nm、20Nm三种不同螺栓固定扭矩对Ilizarov外固定支架穿骨针张力丢失的影响。方法:实验选用7根质地、外形相同的直径为30mm,长度为176mm的聚乙烯塑料(Polyethylene,PE)棒代替胫骨横断形骨折近端骨干,并分为A、B、C、D、E、F、G七组。两相同质地、相同型号的180mm不锈钢环之间用3根相同的240mm长螺纹杆连接,螺纹杆分布均匀并且两环平行,两环间距为100mm。在上端环的一侧内部安装张力传感器,并保证传感器的穿骨针连接位点与环在同一水平。传感器与信号转换及传输装置相连。下端环连接底座,距离为100mm。将组装好的外固定支架套在PE棒上,PE棒近端距近端环50mm,PE棒置于两环中央并与之垂直。用电钻在两个环的平面各交叉穿入2枚相同型号2.0mm穿骨针,两针在水平面上呈垂直状态,并且针垂直于PE棒。A组采用孔洞型螺栓(I型),B组采用沟槽型螺栓(II型),C组采用孔洞型螺栓+垫片(III型),D组采用沟槽型螺栓+垫片(IV型)。四组夹针螺栓的固定扭矩通过扭力扳手给定15Nm。E组、F组、G组均使用临床上最常见使用最多的沟槽型螺栓(II型),固定扭矩分别采用10Nm、15Nm、20Nm。4枚穿骨针利用拉张器拉张1275N后固定于各环。同一环上的两枚穿骨针的拉张同时进行。在夹针螺栓固定后松开拉张器前,移除拉张器后,观察并记录穿骨针张力的变化。之后在电子万能实验机上对A-G七组力学模型提供800N的轴向压缩载荷。每个模型测试3次,每次更换穿骨针及螺栓,实验结果取平均值。将实验数据用SPSS22.0分析软件进行统计处理,采用方差分析(Analysis of Variance,ANOVA)进行组间比较。结果:1、不同夹针螺栓固定实验中,A、B、C、D四组穿骨针的张力值,在拧紧螺栓时分别为1234.7±4.3N、1236.9±10.6N、1243.5±11.1N、1247.8±7.0N;在移除拉张器时张力分别为1097.3±28.2N、1117.6±6.7N、1190.1±11.8N、1194.3±11.0N;在加载800N的轴向压缩载荷后,张力值分别为836.7±8.4N、895.3±7.2N、1001.0±8.2N、1055.2±6.7N。采用方差分析(AnalysisofVariance,ANOVA)进行数据分析,可见A、B、C、D四组的张力值在拧紧螺栓时没有统计学差异(p0.05),四种螺栓的作用没有明显区别;在移除拉张器时,AB两组的张力值没有统计学差异(p0.05),CD两组的张力值也没有统计学差异(p0.05),但AB两组与CD两组之间有统计学差异(p0.05),AB两组的张力值低于CD两组。在加载800N的轴向压缩负载后,四组的张力值两两比较均有统计学差异(p0.05),D组的张力值高于C组高于B组高于A组。2、螺栓固定扭矩实验中,E、F、G三组的张力,在拧紧螺栓时分别为1251.8±5.6N、1234.8±3.2N、1211.5±27.7N;在移除拉张器时张力值分别为1008.0±6.6N、1120.9±9.0N、1128.4±8.6N;加载800N的轴向压缩载荷后,张力值分别为812.7±7.7N、931.3±5.9N、942.0±35.0N。采用方差分析(AnalysisofVariance,ANOVA)进行数据分析。E、F、G三组的张力值,在拧紧螺栓时,组间比较没有统计学差异(p0.05),三种扭矩的作用没有明显区别;在移除拉张器时,FG组之间没有统计学差异(p0.05),E组张力值要低于FG组;在800N轴向压缩载荷后,F G组之间没有统计学差异(p0.05),E组的张力值要低于E G组。结论:本实验对应用孔洞型螺栓、沟槽型螺栓、孔洞型螺栓+垫片、沟槽型螺栓+垫片四种不同类型夹针螺栓,及10Nm、15Nm、20Nm三种不同固定扭矩的外固定支架穿骨针在拧紧螺栓时、移除拉张器时,以及施加800N轴向压缩载荷后的张力变化进行了记录和分析。初步得出结论如下:在对外固定支架施加轴向压缩载荷之前,针的张力就已经发生一定程度的丢失,四种螺栓类型及三种螺栓固定扭矩的力学表现没有明显差别。当移除拉张器后,张力会进一步丢失,拥有垫片夹针螺栓组合的实验组,其张力丢失量要少于未应用垫片的实验组。应用高扭矩实验组的张力丢失量要少于低扭矩的实验组。在对外固定支架施加800N轴向压缩载荷后,张力的丢失量最显著,四种夹针螺栓类型的作用有显著区别。沟槽型螺栓与垫片组合维持张力的能力最好,其次是孔洞型螺栓与垫片组合及单纯沟槽型螺栓,单纯孔洞型螺栓维持张力的能力最差。高扭矩的实验组的张力丢失量少于低扭矩组。
[Abstract]:Objective: in 1950s, the former Soviet doctor Ilizarov invented the Ilizarov ring external fixator. Unlike other type of external fixator, the stability of the external fixator to maintain the relatively stable position of the bone segment requires a small diameter puncture. The tension of the needles is decisive. The tension and external fixation of the needles are made. When the load is loaded, the tension is maintained by the pressure and friction of the needle bolt interface. This experiment is to compare the changes of the tension of the bone needle after the tightening of the fixed bolt and the axial compression load, and compare the hole type bolts, groove bolts, hole type bolts + gasket, groove stud type studs. The effect of three different bolts of 10Nm, 15Nm, 20Nm on the tension loss of the Ilizarov external fixator through the bolt combination of four different types of bolts and bolts. Method: the experiment selected 7 textures, the same diameter was 30mm, the length of the polyethylene plastic (Polyethylene, PE) was substituted for the proximal tibia fracture of the tibial transverse fracture. It is divided into seven groups of A, B, C, D, E, F, G. The same type of 180mm stainless steel rings are connected with 3 same 240mm long threaded rods, the threaded rods are evenly distributed and the two rings are parallel, and the two ring spacing is 100mm. in the side of the upper end ring, and the attachment site of the needle is at the same level as the ring. The sensor is connected with the signal conversion and transmission device. The lower end ring connects with the base, the distance is 100mm., the assembled external fixer is set on the PE rod, the near end of the PE rod is from the near end ring 50mm, the PE bar is placed in the center of the two ring and perpendicular to it. With the electric drill, 2 phases of the same type 2.0mm wear needle and the two needle are hanging on the horizontal plane at the plane of the plane of the two rings. Straight state, and the needle perpendicular to the PE bar.A group adopts hole type bolt (I type), B group adopts groove bolt (II type), C group adopts hole type bolt + gasket (III type), D group adopts groove bolt + gasket (IV type). The fixed torque of four groups of needle bolts is given by torque wrench for given 15Nm.E group, F group, G group are the most commonly used clinical use Groove bolt (II type), fixed torque using 10Nm, 15Nm, 20Nm.4 needle to pull the needle to pull 1275N after pulling the 1275N fixed to each ring. The tension of the needle on the same ring is carried out simultaneously. Before the bolt is fixed, the tension device is removed, and the tension changes of the needle are recorded and recorded. Then the electronic omnipotence is used. The axial compression load of the A-G seven groups of mechanical models was provided on the test machine. Each model was tested 3 times, each time was replaced by the needle and bolt, the experimental results were averaged. The experimental data were statistically processed by SPSS22.0 analysis software, and the variance analysis (Analysis of Variance, ANOVA) was used for comparison between groups. Results: 1, different pin bolts were fixed. In the experiment, the tension values of the four groups of A, B, C and D were 1234.7 + 4.3N, 1236.9 + 10.6N, 1243.5 + 11.1N, 1247.8 + 7.0N, respectively, and the tension was 1097.3 + 28.2N, 1117.6 + 6.7N, 1190.1 + 11.8N and 1194.3 + 11.0N when the tension removes were removed, and the tension values were 836.7 +, 895.3, 10, 10, 10, respectively, respectively, after loading the axial compression load. 1 + 8.2N and 1055.2 + 6.7N. were analyzed by variance analysis (AnalysisofVariance, ANOVA). The tension values of A, B, C, D four groups were not statistically different when tightening the bolts (P0.05), and there was no significant difference between the four kinds of bolts. The tension values of the AB two groups were not statistically different (P0.05) and the tension values of the two groups of CD two were also in the removal of the tension device. There was no statistical difference (P0.05), but there was a statistical difference between the AB two groups and the CD two groups (P0.05). The tension value of the AB two groups was lower than that of the CD two group. The tension values of the four groups were statistically different after loading the axial compression load of 800N, and the tension value of the D group was higher than that in the C group. The tension of the three groups was 1251.8 + 5.6N, 1234.8 + 3.2N and 1211.5 + 27.7N when the bolts were tightened, and the tension values were 1008 + 6.6N, 1120.9 + 9.0N and 1128.4 + 8.6N respectively when removing the tension device. After loading the axial compression load of 800N, the tension values were 812.7 + 7.7N, 931.3 + 5.9N and 942 + 35.0N. using variance analysis (AnalysisofVariance, ANOVA). Data analysis of.E, F, G three groups of tension values, when tightening the bolt, there is no statistical difference between groups (P0.05), there is no significant difference between the three kinds of torque; in the removal of tension, there is no statistical difference between the FG groups (P0.05), the tension value of the E group is lower than that of the FG group; there is no statistical difference between the F G groups after the axial compression of 800N (P0.05). The tension value of the E group is lower than that of the E G group. Conclusion: in this experiment, four different types of pin bolts with hole type bolt, groove bolt, hole type bolt + gasket, groove bolt + gasket, and three different fixed torque external fixers of 10Nm, 15Nm, and 20Nm are used to remove the tension holder and apply the axial pressure of 800N when the bolt is tightened. The tension changes after the loading are recorded and analyzed. Preliminary conclusions are drawn as follows: the tension of the needle has been lost to a certain extent before the axial compression load is applied to the external fixator. The mechanical performance of the four bolt types and the fixed torque of the three bolts is not clearly different. When the tension is removed, the tension will go further. The loss, the experimental group with the combination of the gasket and the bolt combination, has less tension loss than the experimental group of the non applied gasket. The tension loss of the high torque experimental group is less than the low torque experimental group. After the 800N axial compression load is applied to the external fixator, the loss of tension is the most significant. The effect of the four types of pin bolts is obvious. Difference. Groove bolt and gasket combined to maintain the best ability to maintain tension, followed by hole type bolts and gasket combination and pure groove bolt, simple hole type bolt to maintain the worst ability to maintain tension. High torque test group of tension loss is less than the low torque group.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3

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