骶髂关节骨折脱位不同内固定方式的生物力学研究

The Biomechanical Study on Three Different Kinds of Fixation for the Impaired Sacroiliac Joint

目的比较骶髂关节(SIJ)行三种不同内固定后对其生物力学稳定性的影响.方法取成年男性防腐骨盆标本12个,随机分为4组,每组三个标本.A组为正常完整的骨盆标本(N),作为对照组;B组为SIJ使用重建钢板(SP)内固定组;C组为SIJ使用骶髂螺钉(SS)内固定组;D组为SIJ使用COLORADO 2TM内固定组.用实验应力的方法测试各组的生物力学稳定性.结果(1)COLORADO 2TM应变最小.(2)负载500N,COLORADO 2TM位移最小.(3)强度测定:COLORADO 2TM与N相差为14%(P>0.05),SS和SP与N相差分别为16%、21%(P<0.05).(4)轴向刚度和弯曲刚度比较,COLORADO 2TM高于SS4%、5%,高于SP8%、10%.统计显示采用COLORADO 2TM差异无统计学意义(P>0.05),而SS和SP却呈现显著的统计学意义(P<0.05).(5)骨盆的极限力学性能测试,COLORADO 2TM的承载能力与N相差为15%(P>0.05),SS和SP与N相差分别为31%、36%(P<0.05).结果表明COLORADO 2TM比SS和SP优越.结论COLORADO2TM、SS、SP三种不同的内固定可以维持骨折脱位后的SIJ的稳定,以COLORADO 2TM固定最为坚固.

Objective To compare the stability of the three different kinds of fixation for the sacroiliac joint.Methods Twelve embalmed pelves were harvested for this study.They were divided into four groups randomly,N,SP,SS and COLORADO 2TM.Nondestructive biomechanical tests were performed in axis compression on every group.Results（1）COLORADO 2TM strain the smallest.（2）Loaded with 500 N,COLORADO 2TM displaced the smallest.（3）The strength of COLORADO 2TM decreased 14% compared with N（P0.05）.The strength of SS decreased 16%,SP decreased 21%（P0.05）.（4） The axial stiffenes and bend stiffenes of COLORADO 2TM increased 4%,5% compared with SS,increased 8%,10% compared with SP.COLORADO 2TM showed no the significant difference（P0.05）.But SS and SP showed significant（P0.05）.（5）The pelvise＇s extreme mechanical function,COLORADO 2TM decreased 15% compared with N difference（P0.05）.SS and SP decreased 31%、36%（P0.05）.Results indicate SS and SP were inferior to COLORADO 2TM.Conclusion COLORADO 2TM,SS and SP can maintain the stability of the impaired sacroiliac joint,and COLORADO 2TM is the stongest.