骨骺与移植骨不同固定方法的生物力学特征

Biomechanics of fixation methods for epiphysis and massive allograft

目的:探讨适合骨骺与大段移植骨固定方法的理论基础。方法:实验于2004-03/08在第四军医大学西京医院骨科研究所完成。采用新鲜猪股骨15根,随机均分为松质骨螺钉垂直固定组,松质骨螺钉交叉固定组,钢丝环扎固定组。所有标本固定后,制成股骨—环氧树脂复合体的试件。对所有标本进行压缩刚度,拉伸刚度,扭矩刚度,弯曲刚度等生物力学实验,观察不同固定方法的稳定性。结果:螺钉交叉固定组的拉伸刚度最大,钢丝环扎固定组最差。螺钉垂直固定组的扭矩刚度最大,钢丝环扎固定组最差。在前后弯曲及左右弯曲刚度实验中,螺钉垂直固定组和交叉固定组均大于钢丝环扎固定。结论:在保留骨骺的保肢术中,骨骺与大段移植骨的固定,采用螺钉垂直固定或交叉固定,能提供两者之间更好的早期稳定性。

AIM:To study the theoretical basis of the methods for fixing epiphysis and massive allograft.METHODS:The experiment was conducted in the Institute of Orthopaedics,Xijing Hospital,Fourth Military Medical University of Chinese PLA from March to August 2004.Fifteen fresh pig femurs were randomly divided into three different groups:vertical fixation group,cruciate fixation group and wire loops fixation group.All the groups were made into femur epoxy resin compound pieces.So,such biomechanical experiments as compression rigidity,tension rigidity,torsion rigidity,bending rigidity were carried out,and the steadiness of different fixation methods was observed.RESULTS:In the test of tension rigidity,the situation of the cruciate fixation group was the best,and that of the wire loops fixation group was the worst.In the test of torsion rigidity,the situation of the vertical fixation group was the best,and that of the wire loops fixation group was the worst.In the tests of anterior and posterior bending rigidity,the situation of the cruciate fixation group and the vertical fixation group was better than that of the wire loops fixation group.CONCLUSION:The project that epiphysis and massive allograft are fixed with the cruciate fixation or the vertical fixation can provide more reliable early steadiness in the limb salvage surgery for reserving epiphysis.