股骨颈切迹与股骨颈骨折的相关性研究

Notching of the femoral neck during resurfacing arthroplasty of the hip:a biomechanical study

目的通过对人股骨上段标本的实验研究,探讨人工全髋关节表面置换术后股骨颈切迹与股骨颈骨折发生的相关性。方法选用成年男性股骨上段标本,模拟股骨颈切迹,股骨头垂直受力,测量股骨颈应力集中部位的应力值及发生股骨颈骨折时的极限载荷值。结果随着切迹深度的增加,股骨颈发生骨折的极限载荷明显减少,股骨颈张力骨小梁区切迹较股骨颈压力骨小梁区切迹对极限载荷的影响大。结论 MMSA术股骨颈切迹形成后,股骨颈应力集中部位的压应力值明显增加,使股骨颈更易发生骨折,股骨颈张力骨小梁区切迹更易引起股骨颈骨折。

Objective To observe and investigate the relationship between femoral neck notches and femoral neck fractures after the total hip rcsurfacing through the experimental study of the proximal femur. Methods 30 proximal femurs of adult male were selected. The femoral neck notches were made by electric saw. The femoral head was pressed vertically, and measured the stress of the femoral neck and the maximum load when femoral neck fracture was ongoing. Results With the increase of the depth of femoral neck notches, the maximum load reduced obviously. When the notch was located in tensility trabeculae, the effect to the maximum load was larger than the group which notch was located in compression trabeculae. Conclusion The formation of femoral neck notches is an important factor which causes femoral neck fractures after total hip resurfacing, and leads to the failure of the total hip resurfacing ultimately.