人工臼顶治疗大龄儿童先天性髋关节脱位双足站立位体位下生物力学分析

Biomechanics of Acetabular Implant for Congenital Dislocation of The Hip in Old Children

目的:研究人体正常骨盆和髋臼指数为6 0°骨盆以及人工臼顶治疗后骨盆髋臼的生物力学变化。方法:收集5～12岁的大龄儿童新鲜骨盆标本10具分别测量标本几何尺寸并进行标准化,采用应变电测法及特种压力传感器,分别对标本在正常、破坏后(髋臼指数6 0°)、人工臼顶加盖包容后,进行模拟人体在双足站立体位下和4级加载压力下(5kg、10kg、15kg、2 0kg)进行髋臼的多点测定,同时互相比较。所有标本在载荷、结构、高度等力学实验模型上均相一致,以提高测量精度。按照实验应力分析要求严格贴片操作技术,以便得到良好的应变粘结性和传递性。将制作好的标本置于实验机夹具内,调整对心,安装上测力传感器。实验机分四级加载并记录载荷、应变;进行数据处理、误差分析,统计学检验和精度分析后绘制曲线。测试结果使用SPSS软件处理并进行配对t检验。结果:人工臼顶加盖后骨盆标本与正常骨盆标本在双足站立位体位下髋臼各点的生物力学变化无显著性差异P >0 .0 5。而髋臼指数6 0°时骨盆与正常骨盆髋臼各点的力学变化有显著性差异和极显著性差异P <0 .0 5。结论:人工臼顶治疗大龄儿童先天性髋关节脱位是一种既安全可靠、又符合生物力学原理的造盖术,具有一定的临床应用价值。

Objective: To study changes of acetabular biomechanics in normals,pelvic with acetabular index of 60°and with implant after shelf-acetabuloplasty.Methods:10 pelvic specimens of old children aged from 5 to 12 years were collected.Their geometrical data were measured and standized.The acetabulum of normals,pelvic with acetabular index of 60°and with implant in erect position with and without loading at 4 levels were measured by strain electicity methods and special stress sensor,then compared them.All specimens were coincided in mechanics model including loading,structure and height for improving accuracy.Adhibition slice technique was demanded for better stickiness and conduction.Specimens were fixed with experiment jig with stress sensor.The loading of equipment at 4 levels were recorded and analyzed.Statistical analyses were performed with the SPSS statistical package and paired design.Results:There were no significant differences between pelvic with acetabular implant and normals (P>0.05),significant differences were noted between pelvic with acetabular index of 60°and onrmals (P<0.05).Conclusion:Shelf acetabuloplasty with acetabular implant is a safe and effective operation for old children with congenital dislocation of the Hip (CDH).It is valuable in clinical application.