医用硬组织黏接胶黏接胫骨中段蝶形骨折的生物力学研究

Biomechanical Study of Medical Hard Tissue Adhesive Bonding Butterfly Fracture Fragment in Middle Part of Fresh Human Tibia

在粉碎性骨折的治疗中 ,数目较多的骨折碎块的固定仍是一个临床常见的难题。医用硬组织黏接胶是治疗粉碎性骨折的又一新方法 .采用完整新鲜人胫骨、骨块缺失的新鲜人胫骨、黏接后的新鲜人胫骨在扭转、三点弯曲、压缩等状态下的应力 -应变指标变化 ,研究医用硬组织黏接胶黏接人胫骨蝶形骨块后的力学指标的改变。在弯曲、扭转、压缩等实验中 ,胫骨中段的蝶形骨缺损 ,显著减弱了胫骨的抗弯曲、抗扭转、抗压缩的强度。在扭转实验中 ,完整胫骨的扭距大于黏接后的胫骨 ,黏接后胫骨的扭距大于缺损的胫骨。在压缩实验中 ,胶体断裂前 ,完整胫骨的压缩曲线斜率大于黏接后的胫骨的压缩曲线斜率 (P<0 .0 1) ,黏接后胫骨压缩曲线斜率大于缺损胫骨的压缩曲线斜率 ,并有统计学显著性差异 (P<0 .0 5 )。三点弯曲实验中 ,在胶体断裂前 ,完整胫骨的曲线斜率与黏接后的胫骨无显著差异 (P>0 .0 5 ) ,黏接后胫骨与缺损的胫骨曲线斜率有显著差异 (P<0 .0 5 )。黏接后的胫骨 ,其弹性模量、刚度系数与完整的胫骨无显著差异 (P>0 .0 5 )。医用硬组织黏接胶黏接蝶形骨块后 ,能显著提高其抗弯曲、抗扭转、抗压缩应力。在临床操作中 ,可以最大程度上减少骨折碎块固定时周围的软组织剥离 。

A medical hard tissue adhesive,octyl-a-cyanoacrylate,was tested in 6 fresh human tibiae. A 90°butter-fly fracture fragment was made in the middle part of tibia by bandsaw. The compressive stress,torsional stress and angular deflection were assessed before and after osteoectomy respectively. After adhesive bonding, the compressive stress,torsional stress and angular deflection were tested again.The butterfly fracture fagment decreased the bending strength,torsion strength,yielding strength of tibia bone.In torsion test,the torque of tibia before osteoectomy is greater than bonded tibia,the bonded tibia is greater than that of the unbonded tibia.In compression test, before adhesive bonding broken,the compressive curve slope of tibia before osteoectomy is greater than that of bonded tibia,the bonded tibia is greater than that of the unbonded tibia.In angular deflection test before adhesive bonding of broken,the curve slope of tibia before osteoectomy is not different from that of bonded tibia (P>0.05), the slope the bonded tibia is greater than the slope of unbonded tibia(P<0.05). The elastic modulus, rigidity coefficient and moment of area inertia show no statistical difference between the bonded tibia and intact tibia. The used of medical hard tissue adhesive to bond the fracture fragment could improve the bending strength,torsion strength,yielding strength of tibia bone.In operation,it can reduce the soft tissue injury when the fracture fragment is being fixed, and this will benefit bone healing.