Although InterTAN(IT)nails are widely employed to treat femoral intertrochanteric fractures,the mechanism behind the tautening effect of titanium-alloy IT nails is not well understood.This study aimed to reveal the me...Although InterTAN(IT)nails are widely employed to treat femoral intertrochanteric fractures,the mechanism behind the tautening effect of titanium-alloy IT nails is not well understood.This study aimed to reveal the mechanism of this effect.A torque test experiment was conducted,with the torque value recorded and transformed to obtain the tautening effect.Then,theoretical and finite element analyses were performed to further understand the mechanism.The influence of age and pitch-difference on the tautening effect was also examined in the study,the results attributed to the pitch-varying integrated interlocking lag screw.The torque and the corresponding tautening effect drastically increase as the screw is inserted deeper during the second stage,while the torque measured in the first stage is always zero.Additionally,the tautening force increases with increasing age,this relationship helps evaluate the effect at different ages.The tautening effect also increases nearly linearly with the pitch difference,which can be adjusted during the IT design stage to select or design IT in engineering practice.展开更多
目的：比较闭合复位动力髋螺钉（dynamic hip screw,DHS）与闭合复位股骨近端髓内钉Intertan治疗老年患者股骨粗隆间EvansⅠ型骨折的疗效。方法：手术治疗股骨粗隆间骨折（EvansⅠ型）老年患者70例,其中行闭合复位DHS内固定术30例（DHS...目的：比较闭合复位动力髋螺钉（dynamic hip screw,DHS）与闭合复位股骨近端髓内钉Intertan治疗老年患者股骨粗隆间EvansⅠ型骨折的疗效。方法：手术治疗股骨粗隆间骨折（EvansⅠ型）老年患者70例,其中行闭合复位DHS内固定术30例（DHS组）,行闭合复位Intertan内固定术40例（Intertan组）。结果：患者均获随访,时间6-24（12.0±3.0）个月。骨折均愈合,未出现内固定失败、股骨头坏死等并发症。手术时间：DHS组40-90（63.6±8.4）min,Intertan组40-90（55.6±9.8）min;术中出血量：DHS组100-200（145.4±22.5）mL,Intertan组100-200（92.4±25.5）mL;住院时间：DHS组6-16（11.2±2.8）d,Intertan组6-9（7.9±1.1）d;两组手术时间、术中出血量、住院时间比较,差异有统计学意义（P〈0.05）。DHS组4例患者术后手术切口液化,换药后愈合。骨折愈合时间：DHS组2.5-4.0（3.4±0.8）个月,Intertan组2.5-4.0（3.2±0.7）个月,两组差异无统计学意义（P〉0.05）。术后髋关节Harris总评分：DHS组67-84（73.5±5.1）分,Intertan组70-86（77.9±3.7）分;功能评分：DHS组23-40（30.8±3.2）分,Intertan组25-44（34.4±2.9）分;两组术后髋关节Harris总评分和功能评分比较,差异有统计学意义（P〈0.05）。疼痛评分：DHS组为20-44（34.9±4.8）分,Intertan组为20-44（35.8±5.0）分;活动范围评分：DHS组2-4（3.0±0.8）分,Intertan组2-4（3.0±1.0）分;两组疼痛评分和活动范围评分比较,差异均无统计学意义（P〉0.05）。结论：Intertan和DHS内固定都是治疗老年患者股骨粗隆间骨折的有效手段,但前者创伤较小,住院时间较短,髋关节功能恢复更好。展开更多
基金financially supported by the International Research Cooperation Seed Fund of Beijing University of Technology (No.2021A10)Medical Industry Excellence and Innovation Program Fund of Beihang University (No.KG16180401)。
文摘Although InterTAN(IT)nails are widely employed to treat femoral intertrochanteric fractures,the mechanism behind the tautening effect of titanium-alloy IT nails is not well understood.This study aimed to reveal the mechanism of this effect.A torque test experiment was conducted,with the torque value recorded and transformed to obtain the tautening effect.Then,theoretical and finite element analyses were performed to further understand the mechanism.The influence of age and pitch-difference on the tautening effect was also examined in the study,the results attributed to the pitch-varying integrated interlocking lag screw.The torque and the corresponding tautening effect drastically increase as the screw is inserted deeper during the second stage,while the torque measured in the first stage is always zero.Additionally,the tautening force increases with increasing age,this relationship helps evaluate the effect at different ages.The tautening effect also increases nearly linearly with the pitch difference,which can be adjusted during the IT design stage to select or design IT in engineering practice.
文摘目的：比较闭合复位动力髋螺钉（dynamic hip screw,DHS）与闭合复位股骨近端髓内钉Intertan治疗老年患者股骨粗隆间EvansⅠ型骨折的疗效。方法：手术治疗股骨粗隆间骨折（EvansⅠ型）老年患者70例,其中行闭合复位DHS内固定术30例（DHS组）,行闭合复位Intertan内固定术40例（Intertan组）。结果：患者均获随访,时间6-24（12.0±3.0）个月。骨折均愈合,未出现内固定失败、股骨头坏死等并发症。手术时间：DHS组40-90（63.6±8.4）min,Intertan组40-90（55.6±9.8）min;术中出血量：DHS组100-200（145.4±22.5）mL,Intertan组100-200（92.4±25.5）mL;住院时间：DHS组6-16（11.2±2.8）d,Intertan组6-9（7.9±1.1）d;两组手术时间、术中出血量、住院时间比较,差异有统计学意义（P〈0.05）。DHS组4例患者术后手术切口液化,换药后愈合。骨折愈合时间：DHS组2.5-4.0（3.4±0.8）个月,Intertan组2.5-4.0（3.2±0.7）个月,两组差异无统计学意义（P〉0.05）。术后髋关节Harris总评分：DHS组67-84（73.5±5.1）分,Intertan组70-86（77.9±3.7）分;功能评分：DHS组23-40（30.8±3.2）分,Intertan组25-44（34.4±2.9）分;两组术后髋关节Harris总评分和功能评分比较,差异有统计学意义（P〈0.05）。疼痛评分：DHS组为20-44（34.9±4.8）分,Intertan组为20-44（35.8±5.0）分;活动范围评分：DHS组2-4（3.0±0.8）分,Intertan组2-4（3.0±1.0）分;两组疼痛评分和活动范围评分比较,差异均无统计学意义（P〉0.05）。结论：Intertan和DHS内固定都是治疗老年患者股骨粗隆间骨折的有效手段,但前者创伤较小,住院时间较短,髋关节功能恢复更好。
