锁骨骨折克氏针内固定的不稳因素

The research on classifying toenails and cure of paronychia

目的研究锁骨骨折克氏针内固定存在的不稳定因素。方法分析术后出现克氏针失稳的情况,从锁骨的解剖结构和骨折力学改变及克氏针缺陷等方面探索失稳的原因。结果锁骨骨折克氏针内固定不稳的因素较多,但主要是锁骨骨折力学改变及克氏针存在缺陷所致。结论锁骨呈“S”形和螺旋状,其整体形状不在同一矢状面,螺旋形的结构在骨折后容易出现旋转应力,骨折内固定因旋转应力不均出现移位;克氏针两端光滑,其轴向加压作用几乎不存在。而内固定锁骨只单用一根克氏针,缺乏双面或多面交叉,完全不能抵抗骨折产生的旋力,在多种肌力的作用下骨折易产生分离,克氏针容易出现不稳定。将克氏针尖端加工出螺纹, 使骨折产生轴向加压,是减少骨折不稳定的关键。

Objective To study the instable facts existing in the kirschner's wire of internal fixation on clavicle fracture. Methods Through analysis of various instable clinical phenomena after kirschner's wire operation, to probe into instable reasons may cause instable clinic performance in clavicle fracture internal fixation. Yet, the main fact lies in mechanics alteration of fracture and fail deshich may lies in clavicle anatomize structure, mechanics alteration of fracture and design fail model in kirschner's wire. Results There exist a bit more facts which were model in kirschner's wire. Conclusions It is easier to appear internal fixation transposition after fracture which is due to uneven revolving stress from inherent 'S' and twist shape of clavicle, which makes the whole shape of clavicle did not exist in the same vertical side. Due to kirschner's wire is lubricity in both ends, the function of pressure-adding in axis-orientated tends to be zero. It can be drawn that kirschner's wire instable performance of fracture which is easily to separate caused by various muscles power due to internal fixation of clavicle only use one piece of kirschner's wire without any cross or multi-cross support, which can't resist the revolving stress at al. The key path to reduce instable performance of fracture is to process the screw thread on the end of kirschner's wire to produce the stress-adding in axial direction.