实验性髋臼横形骨折对髋关节接触特征的影响

Effects of Transverse Fractures of the Acetabulum on the Comtact Characteristics the Hip Joint

目的 了解不同平面髋臼横形骨折及内固定后髋关节接触压力、面积的变化 ,确定髋臼横形骨折手术指征 ,探讨髋臼横形骨折最可靠的内固定方式。方法 采用 2 4个髋关节标本制成 30°、40°、5 0°、6 0°内侧顶弧角髋臼横形骨折模型 ,利用压敏片技术 ,对不同内侧顶弧角截骨前后及不同内固定后髋关节标本分别进行加载 80 0N ,研究髋关节接触特征。结果 30°内侧弧顶弧角组髋关节接触面积最小 ,接触压力最大。前柱螺钉加后柱钢板 (S+P)、前柱钢板加后柱螺钉 (P +S)较前柱单钢板 (P/none)及后柱双钢板 (none/P× 2 )内固定在降低接触压力、提高接触面积方面优越。结论 30°内侧顶弧角髋臼横形截骨组需手术治疗 ,髋臼横形骨折内固定以S +P及P

Objective To explore the changes on the contact area and contact pressure of the hip joint after the different local transverse acetabular fractures and the different fixations of acetabular fractures,To define the indication of operation for transverse acetabular fractures and the optimal fixation method for transverse acetabular fractures.Methods Twenty-four cadaveric hip joints were developed for simulated transverse acetabular fracture models of 30°?40°?50°?60°degrees of medial roof-arc angle,under a 800N load,the contact charateristics of hip joint after the different level transverse osteotomies and the diffrernt fixations were studied by means of pressure sensitive film.Results The contact area was minimun and the contact pressure was maximun at 30 degrees of mdeial roof-arc angle.A posterior column plate with an anterior column screw(S+P)and an anterior column plate with a posterior column screw(P+S)were better than an anterior colmn plate and two posterior column plates on the decreaded contact strees and rised contact area.Conclusions Transverse acetabular fractures at medial roof-arc angle of 30 degrees need operation and the fixations of S+P or P+S are optimal methods for transverse acetabular fractuers.