股骨近端锁定钢板治疗股骨转子间骨折的生物力学研究

Proximal femoral locking plate for treatment of intertrochanteric fracture: a biomechanical study

目的本研究旨在明确股骨近端锁定钢板治疗股骨转子间骨折的生物力学特性,为其在临床使用提供理论依据。方法选取15根防腐(10%的甲醛溶液浸泡)股骨标本并随机分配到A、B、C三组中,A组为股骨近端锁定钢板固定31A1.1骨折组,B组为股骨近端锁定钢板固定31A2.2骨折组,C组为正常无骨折股骨组;每组各5个标本,在力学测试机上测试轴向压缩、扭转、破坏实验。结果三组的轴向刚度、屈服载荷比较,A组高于B组,差异有统计学意义;C组高于A组,同时也显著高于B组,差异有统计学意义。三组的扭转刚度比较,C组仍好于A、B组,差异具有统计学意义。结论股骨近端锁定钢板在固定股骨转子间骨折时,其生物力学性能仍不如正常股骨,在固定稳定性股骨转子间骨折时,可以达到坚强内固定和早期活动所需要的生物力学要求,但在治疗不稳定股骨转子间骨折时,不宜作为首选。

Objective This study aims to study the biomechanical properties of proximal femoral locking plate in the treatment of intertrochanteric fractures and to provide a theoretical basis for its clinical application.Methods Fifteen anticorrosive femurs were randomly divided into three groups（ group A,group B,group C,5 in each group）. Group A included type 31A1. 1 fractures treated with proximal femoral locking plate fixation,group B included type 31A2. 2 fractures with proximal femoral locking plate fixation and group C normal without fractures.Each group underwent through tests for the axial compression,torsion,and damage experiment. Results Group A was higher than group B in axial rigifity and yield load,with the statistically significant difference. Group C was higher than both group A and B and the difference was statistically significant. As for torsional rigidity,group C was better than group A and B and the difference was statistically significant. Conclusion Biomechanical properties of proximal femoral locking plate for fixing stable intertrochanteric fracture is still not as good as that of the normal femur. It could achieve strong internal fixation and early activity in stable fractures. But in the treatment of unstable intertrochanteric fractures,proximal femoral locking plate would not be appropriate as the prime choice.