肱骨近端解剖型塑质夹板的生物力学研究及临床应用价值探讨

发布时间：2018-06-24 09:26

本文选题：肱骨近端骨折 + 固定带拉力　；参考：《甘肃中医药大学》2016年硕士论文

【摘要】：目的基于肱骨近端的解剖结构及其骨折的类型,并结合“动静结合、筋骨并重”的治疗原则,设计研制出肱骨近端解剖型塑质夹板;对新型夹板进行相关的生物力学研究,为其进一步的优化和改良提供科学的理论依据,使肱骨近端解剖型塑质夹板更加符合人体肩部的力学特性,且佩戴舒适,方便固定与调节;探讨其临床应用的价值,以明确其创新性和临床使用的有效性。方法1.研制新型夹板根据肱骨近端的解剖结构和其骨折的类型,选择合适的材料,在石膏模型的基础上,制作出肱骨近端解剖型塑质夹板。2.生物力学实验2.1根据材料的力学特性,对肱骨近端解剖型塑质夹板所使用的固定带和传统夹板扎带进行拉伸实验研究,比较何种固定带更适于固定夹板。2.2在正常功能锻炼的条件下,测定肱骨近端解剖型塑质夹板固定带束缚力随时间衰减的情况,检测新型夹板是否能为骨折固定提供持续、有效的束缚力。2.3测量志愿者在佩戴肱骨近端解剖型塑质夹板前、佩戴后12小时、佩戴后24小时、佩戴后36小时、佩戴后48小时,各时间点的该侧手指的血氧饱和度,并观察肱骨近端解剖型塑质夹板对被固定肢体局部的压迫情况和对该肢体远端血运的影响情况,验证新型夹板是否安全、可靠及佩戴舒适。3.对研制的肱骨近端解剖型塑质夹板进行了生物力学研究后,根据肱骨近端骨折临床上老年人多发的特点及微动对骨折愈合的促进作用,进一步探讨新型夹板在临床应用的价值。结果根据设计,成功的研制出了肱骨近端解剖型塑质夹板,并申请到了国家实用新型专利。生物力学实验结果如下:1.在拉力小于100N(10.20Kg)的情况下,新型夹板的固定带比传统扎带具有更高的杨氏模量。2.大、中、小三组新型夹板不同位置处固定带,在固定后8个时间点,测得的束缚力均在已设定的标准700~900g之间,而且各组的固定带未发生明显的松弛。3.大、中、小三组于佩戴前、佩戴后12小时、佩戴后24小时、佩戴后36小时、佩戴后48小时,测得的血氧饱和度,均在正常范围以内。结论1.新型夹板的固定带比传统夹板扎带具有更强的抵抗拉伸变形能力,更适合作为肱骨近端解剖型塑质夹板的固定带。2.肱骨近端解剖型塑质夹板符合正常人体肩部与肱骨近端部的生物力学特性,能够持久、有效的维持骨折固定的稳定性,而且佩戴舒适、操作简便、安全可靠,满足最初的设计要求和预期目标。3.应用数字图像相关法研究新型夹板的束缚力,准确、有效,值得在生物力学实验测定中推广应用。
[Abstract]:Objective based on the anatomical structure of proximal humerus and the type of fracture, combined with the therapeutic principle of "combination of movement and movement, and equal weight of muscles and bones", a plastic splint of proximal humerus was designed and developed, and a biomechanical study on the new type of splint was carried out. To provide a scientific theoretical basis for its further optimization and improvement, to make the anatomical plastic splint of proximal humerus more in line with the mechanical characteristics of the human shoulder, and to wear comfortably, to facilitate fixation and adjustment, and to explore the value of its clinical application. To clarify the effectiveness of its innovative and clinical use. Method 1. According to the anatomical structure of proximal humerus and the type of fracture, a new type of splint was developed. Based on the gypsum model, the plastic splint of proximal humerus was made. Biomechanical experiment 2.1 according to the mechanical properties of the material, the tensile experiments were carried out on the fixation band and the traditional splint band used in the anatomic plastic splint at the proximal end of the humerus. Compare which fixation band is more suitable for fixing splint .2.2 under normal functional exercise, determine the attenuation of the binding force of the proximal humerus anatomical plastic splint over time, and determine whether the new splint can provide continuity for fracture fixation. The effective binding force. 2.3 measured the oxygen saturation of the finger at each time point, 12 hours after wearing, 24 hours after wearing, 36 hours after wearing, 48 hours after wearing, before wearing anatomic plastic splint of proximal humerus. The influence of the proximal humeral anatomical plastic splint on the local compression of the fixed limb and on the distal blood supply of the limb was observed to verify whether the new splint was safe, reliable and comfortable to wear. Based on the biomechanical study on the anatomical plastic splint of proximal humerus, the value of new splint in clinical application was further discussed according to the characteristics of multiple fractures in the clinic and the promoting effect of fretting on fracture healing. Results according to the design, the anatomical plastic splint of proximal humerus was successfully developed, and applied for the patent of national utility model. The biomechanical results are as follows: 1: 1. When the tensile force is less than 100N (10.20kg), the fixed band of the new splint has higher Young's modulus. Large, medium and small three groups of new splints were fixed at different positions. At 8 time points after fixation, the binding force measured was between 700 ~ 900g of the set standard, and there was no obvious relaxation of .3in the fixation bands of each group. Before wear, 12 hours after wearing, 24 hours after wearing, 36 hours after wearing, 48 hours after wearing, the oxygen saturation is within normal range. Conclusion 1. Compared with the traditional splint band, the new type of splint has stronger resistance to tensile deformation and is more suitable for the fixation of anatomic plastic splint of proximal humerus. The anatomical plastic splint of proximal humerus accords with the biomechanical characteristics of the shoulder and proximal humerus of normal human body. It can maintain the stability of fracture fixation for a long time and effectively, and it is comfortable to wear, easy to operate, safe and reliable. Meet initial design requirements and expected goals. 3. The application of digital image correlation method to the study of the binding force of the new splint is accurate and effective. It is worth popularizing and applying in biomechanical experiment.
【学位授予单位】：甘肃中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R274

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