加压空心钉不同部位治疗股骨颈骨折的生物力学研究

Biomechanical Study on the Treatment of Femoral Neck Fracture with Cannulated Compression Screw with Different Arrangement

目的通过对加压空心钉内固定不同部位的生物力学研究,得出各种相关的生物力学数据,以得出更加稳定的内固定植入方法,在生物力学方面为临床治疗提供理论依据。方法将股骨模型按人体股骨颈骨折时常见的pauwels 70°角用电锯截断,模拟常见的内收型股骨颈基底骨折,分别按正三角(向前分散排列、向前平行排列),倒三角(向前分散排列、向前平行排列)不同的固定结构做成股骨颈骨折复位固定模型,在微机控制电子万能试验机上施加一定载荷,测出模型在水平和垂直方向的位移,同时在股骨颈内外侧贴应变片,在应变力综合测试仪上测出内、外侧的应变,根据公式计算出断面张开角。结果 3枚空心加压螺钉采用上2枚,下1枚的向前分散倒三角形结构时,无论在载荷下水平位移、垂直位移、内外侧应力及断面张开角,还是在股骨颈骨折牢固固定方面,生物力学相关数据均显示最好。结论 3枚加压空心钉呈倒三角向前分散结构的内固定方式最稳定。

Objective To explore a better cannulated screw fixation arrangement in femeral neck fracture. Methods sing an electrical saw, an experimental femoral was cut with a 70 degrees pauwels angle just like when human femoral neck normally fractured. Four different types of fixed structures were used to fix the femoral neck. They were equilateral triangle types （ dispersive and parallel arrangements forward）, inverted triangle types （dispersive and parallel arrangements forward）. Results The cannulated compression screw which formed inverted triangle dispersing forward showed the best stability. Conclusion The most stable internal fixation method is the structure of three cannulated compression screws inverted triangle dispersing for-ward.