四种临床常见骨科固定器械的生物力学评价

Biomechanical evaluation of the four kinds of common fixing apparatuses in clinical orthopedics

目的:探讨骨科固定器械生物力学评价方法的应用,为广大临床医生提供参考,以便在临床中发挥固定器械的优点,克服固定器械的不足,取得最佳的医疗康复水平。方法:从生物力学观点出发,根据骨折固定的生物力学评价方法,对骨折固定常见的4种器械进行分析和讨论,提出生物力学评价观点。结果:生物力学观点认为,带锁髓内钉和C型滑杆式骨科固定器具有较多的生物力学优点同时也存在着某些不足。虽然内固定加压钢板和单边外固定器其生物力学优点不如上述两种固定器械多,但有着其方面如使用方便,患者乐于接受等优点。结论:骨科固定器的设计影响因素较多,研制既满足生物力学的科学要求,又满足使用方便,功能齐全的固定器械是十分困难的。注重了发挥某一方面的优点,也就不可避免地带来了另一方面的不足。所以任一种固定器械在具有突出优点的同时,也必存在不足。这就需要临床医生在临床实践中,根据生物力学原理和结构分析方法,对临床上使用的固定器械和固定方法进行经常地一些研究和评价,以便充分发挥固定器械的优点,取得最佳的医疗康复水平和效果。

AIM:To probe into the application of biomechanical valuation methods by using the fixing apparatuses in orthopedics so as to provide references for the clinicians,to play the advantages of fixing apparatuses fully and to overcome the shortage of fixing apparatuses in the achievement of best rehabilitation.METHODS:From the biomechanical point of view,four kinds of fixing apparatuses used in orthopedics were analyzed and discussed,and the biomechanical valuation standpoint was suggested based on the biomechanical valuation methods of fracture fixing.RESULTS:From the biomechanical point of view,the locked intramedullary pin and C type sliding bar fixing apparatuses have many biomechanical virtues and some defects.The internally fixed compressing steel plate and the unilateral external fixation have less biomechanical virtues than those two fixing apparatuses,but they still have such virtues as being easy to use and pleased to be accepted by patients.CONCLUSION:To devise a fixing apparatus in orthopedics that can not only satisfy biomechanical science,but also be used conveniently is difficult due to a lot of influencing factors of its design.When we pay much attention to one advantage,the other defect will be following unavoidably.So,any one fixing apparatus has both definite virtues and some defects.It is necessary for the clinicians to often investigate and evaluate the clinical fixing apparatuses and fixing methods according to the biomechanical principles and structural analysis methods in order to bring advantage of the fixing apparatuses into full play and achieve the satisfactory rehabilitation level and curative effect.