髋臼骨折记忆合金三维内固定系统的设计与临床应用

Design and clinical applications of acetabular tridimensional memoryalloy-fixation system

目的介绍应用记忆合金三维内固定系统治疗髋臼骨折的新技术与新方法。方法依髋臼的解剖学特点与镍钛合金的特性,研制出髋臼骨折记忆合金三维内固定系统。它由前柱臼A、后柱臼B、弓齿C、转子D四组系列组成。至2001年10月,该系统临床治疗髋臼骨折41例。结果该内固定系统能将复杂粉碎的髋臼骨折稳定地聚合于解剖位,术中操作简便。术后随访6～28个月,其中38例术后1.6个月达骨性愈合,并于术后2.5个月,患侧髋关节功能达到健侧水平。术后并发异位骨化、关节失用1例,骨化性肌炎致功能障碍2例,感染但未遗留功能障碍1例。结论髋臼骨折记忆合金三维内固定系统的应用,为粉碎性髋臼骨折的解剖性重建,提供了一种新的有效的方法。

Objective To introduce a new technique for treatment acetabular fractures with nitinol tridimensional internal fixation system. Methods According to the characteristics of nitinol and acetabular anatomy, a new internal fixation system for acetabular fracture, acetabular tridimensional memoryalloy-fixation system (ATMFS), was designed. This system consisted of anterior column, posterior column, arch teeth and trochanter device. During operation, these devices were transformed in iced water first, after fracture reduction they were inserted into bones, finally, these devices were reverted to their original shape by warm saline. Till October 2001, 41 cases acetabular fractures were treated with this system. All these cases were followed from 6 to 28 months. Results This system could transform the complicated and comminuted fracture to its anatomic position, and was easy to use in operation. Bone healing time averaged 1.6 months in 38 cases, and the hip function recovered time averaged 2.5 months. Heterotopic ossification which led to joint functional disturbance in one case, and myositis ossificans which caused joint dysfunction in two cases. One case was complicated by infection which was cured and good function was reserved. Conclusion ATMFS provides a new and efficacious method for the anatomic reduction or reconstruction of comminuted acetabular fractures.