股骨干骨折并内侧皮质缺损重建的生物力学研究

A Biomechanical Study of Reconstruction of Femoral Shaft Fracture with Medial Cortical Defect

目的 采用同种异体骨板重建股骨干内侧皮质缺损并进行生物力学评价。方法 6具新鲜股骨标本,在内侧造成皮质缺损后,测定正常股骨组(对照组),钢板固定组(实验组1),钢板加骨板固定组(实验组2),钢板加骨板加内侧骨块复位组(实验组3)的垂直压缩,三点弯曲及抗扭转能力,比较不同内固定方法在相同载荷下的位移。结果 本实验三项指标间,对照组和实验组3间的垂直压缩、三点弯曲间无显著性差异(P>0.05),与实验组1、2间有显著性差异(P<0.05),旋转角度间均有显著性差异(P<0.05)。压力侧骨缺损单纯用钢板内固定效果最差,而用异体骨板加钢板固定强度明显优于单纯钢板固定,骨块复位加骨板、钢板固定优于单纯骨板及钢板固定。结论 应用异体骨板重建股骨干内侧皮质缺损,可较好的恢复股骨干内侧皮质的完整性,增加钢板内固定的成功率,值得在临床上推广应用。

Objective To evaluate the biomechanical intensity of the femoral shaft which own a bony defect on the medial side of the femomur and reconstructed by allograft bone plate. Methods Six femurs of corpse were taken and made fracture with a medial cortical defect. The vertical compression, bending and torsion intension intensity in normal femur (control team), steel plate fixated only (team 1), steel plate and bone plate fixated (team 2), steel plate and bone plate fixated with the reduction of the medial cortical fragment (team 3) were measured. The displacement of 4 teams with same load was compared. Results Among results, the vertical and bending displacement had no difference between control team and team 3 (P>0.05), but there were obvious difference between contrast team and team 1 , 2 (P<0.05). For the torsion angle, there was obvious difference among the four teams (P<0.05). It was worst to use the method of team 1, team 2 was better, and the team 3 was best. Conclusion When there is a cortical defect in the medical side of the femur, using a bone plate to reconstruct it can recover the integrity of the bone, increase the successful rate of the plate internal fixation, and this method is worth applying in the clinical.