股骨髁间骨折三种内固定方法生物力学实验研究与临床应用

Biomechanical Experiment and Clinical Application of Three Internal Fixation Methods for Fracture of Femoral Condyle

目的 为临床选择有效的内固定方法提供实验依据。方法 取 9具新鲜尸体股骨标本 ,制成股骨髁间骨折 (AO分类的C1型 ) ,采用L形髁钢板 +螺栓、L形髁钢板、加压钢板 +螺栓三种内固定方法 ,进行实验应力分析 ,比较不同内固定方法的优劣 ,并以有限元理论分析进一步论证它的结果。结果 L形髁钢板 +螺栓内固定优于L形髁钢板、加压钢板 +螺栓固定 ,应力和髁间位移均具有显著差异 (P <0 0 1)。临床手术 5 2例中 43例平均随访 2 5个月 ,膝关节功能优良率分别为 :L形髁钢板+螺栓 95 % ,L形髁钢板 84 6 % ,加压钢板 +螺栓 81 8%。结论 L形髁钢板 +螺栓联合固定是治疗股骨髁间骨折较好的内固定方法。

Objective To Choose suitable clinical internal fixation method according to experimental data Methods The models of fracture of femoral condyle were made on 9 fresh cadaver femurs(C 1 of AO classification) The fractures have been fixed by using L shaped condyle steel plate added bolt,L shaped condyle plate and compressed plate added bolt fixation These three different internal fixation methods have been compared t hrough experimental stress analysis Their results have been further confirmed by theoretical analysis using finite element mathod(FFM) Results It has been proved that the internal fixation using L shaped condyle steel plate added bolt is better than that using L shaped condyle plate and compressed plate added bolt There exist distinct differences in stress and displacement between two condyles(P<0 01) The average followed up time for 43 of 52 patients were 25 months,the rate of excellent and good knee joint function are 95% for L shaped condyle plate added bolt,84 6% for L shaped condyle plate,and 81 8% for compressed plate added bolt Conclusion The combined fixation of L shaped condyle stress plate added bolt is a very good internal fixation method for fracture of femoral condyle