| 股骨外侧壁在股骨粗隆间骨折的髓内与髓外固定中的生物力学研究 |
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投稿时间：2016-09-20
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| 作者 | Author | 单位 | Address | E-Mail |
| 吴银生 |
WU Yin-sheng |
浙江中医药大学附属温州中西医结合医院骨科, 浙江 温州 325000 |
Integrated Traditional Chinese and Western Medicine Hospital of Wenzhou Affilated Hospital of Zhejiang Chinese Medicine University, Wenzhou 325000, Zhejiang, China |
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| 许兵 |
XU Bing |
浙江中医药大学附属温州中西医结合医院骨科, 浙江 温州 325000 |
Integrated Traditional Chinese and Western Medicine Hospital of Wenzhou Affilated Hospital of Zhejiang Chinese Medicine University, Wenzhou 325000, Zhejiang, China |
johonmark@163.com |
| 余作取 |
YU Zuo-qu |
浙江中医药大学附属温州中西医结合医院骨科, 浙江 温州 325000 |
Integrated Traditional Chinese and Western Medicine Hospital of Wenzhou Affilated Hospital of Zhejiang Chinese Medicine University, Wenzhou 325000, Zhejiang, China |
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| 王萧枫 |
WANG Xiao-feng |
浙江中医药大学附属温州中西医结合医院骨科, 浙江 温州 325000 |
Integrated Traditional Chinese and Western Medicine Hospital of Wenzhou Affilated Hospital of Zhejiang Chinese Medicine University, Wenzhou 325000, Zhejiang, China |
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| 戴寿旺 |
DAI Shou-wang |
浙江中医药大学附属温州中西医结合医院骨科, 浙江 温州 325000 |
Integrated Traditional Chinese and Western Medicine Hospital of Wenzhou Affilated Hospital of Zhejiang Chinese Medicine University, Wenzhou 325000, Zhejiang, China |
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| 李敏 |
LI Min |
浙江省骨伤研究所, 浙江 杭州 310053 |
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| 童培建 |
TONG Pei-jian |
浙江省骨伤研究所, 浙江 杭州 310053 |
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| 期刊信息：《中国骨伤》2017年，第30卷，第3期，第247-251页 |
| DOI：10.3969/j.issn.1003-0034.2017.03.012 |
| 基金项目:浙江省温州市科技局基金项目（编号：Y20130107） |
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中文摘要:
目的：观察股骨外侧壁的完整性对髓内与髓外固定治疗股骨粗隆间骨折的生物力学影响，指导临床选择内固定方式。
方法：采用成人尸体同侧股骨标本12具，均造成股骨粗隆间骨折AO 分型A1型骨折，随机分为外侧壁完整PFNA组、外侧壁完整PF-LCP组、外侧壁破损PFNA组、外侧壁破损PF-LCP组，每组3具，4组股骨标本采用万能材料测试机进行压缩载荷实验，观察股骨标本的最大载荷力，并用游标卡尺测量骨折断端的压缩前后的间隔位移及骨折远、近端沿粗隆间的滑动位移进行相互比较。
结果：外侧壁完整PFNA组的最大载荷力大于外侧壁完整PF-LCP组，并且外侧壁破损PFNA组的最大载荷力也大于外侧壁破损PF-LCP组，差异均具有统计学意义（P<0.05）；压缩前4组股骨标本的骨折端间隔距离相互比较差异无统计学意义（P>0.05），压缩后外侧壁完整PFNA组的骨折端间隔距离、压缩前后的骨折端位移及骨折远、近端的滑动位移与外侧壁完整PF-LCP组相互比较差异均无统计学意义（P>0.05），但外侧壁破损PFNA组的骨折端间隔距离、压缩前后的骨折端位移及骨折远、近端的滑动位移均小于外侧壁破损PF-LCP组，差异均具有统计学意义（P<0.05）.
结论：髓内固定治疗股骨粗隆间骨折具有更强的载荷力，股骨外侧壁完整时髓内与髓外固定均有较强的稳固性，但股骨外侧壁破损时髓内固定具有更强的稳固性，可见髓内固定是治疗股骨粗隆间骨折的首选方式。 |
| 【关键词】股骨粗隆间骨折 股骨外侧壁 骨折固定术，髓内 骨折固定术，内 生物力学 |
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| Biomechanical study of the lateral wall of the femur in the treatment of femoral intertrochanteric fracture with intramedullary or extramedullary fixation |
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ABSTRACT
Objective: To observe the biomechanical effects of the lateral wall of the femur in treating femoral intertrochanteric fractures with intramedullary or extramedullary fixation to guide the choice of clinical fixed methods.
Methods: Twelve adults femur specimens of intertrochanteric fractures were belong to the type A1 of the AO fracture classification and randomly divided into the lateral wall complete PFNA group,the lateral wall complete PF-LCP group,the lateral wall breakage PFNA group,lateral wall breakage PF-LCP group,every group had 3 specimens. The four groups of specimens were subjected to compressive loading experiment with Universal Material Testing Machine. The maximum loading force was observed. The distance between fracture ends,the distance of fracture dislocation and the sliding distance of the fracture fragments along the intertrochanteric were measured with Calipers.
Results: The maximum loading force of lateral wall complete PFNA group were larger than that of lateral wall complete PF-LCP group,and the maximum loading force of lateral wall breakage PFNA group were larger than that of lateral wall breakage PF-LCP group,there were significant differences(P<0.05). The distance between fracture ends of the four groups before compression were not significant differences(P>0.05). The distance between fracture ends,the distance of fracture dislocation and the sliding distance of the fracture fragments were not significant differences between lateral wall complete PFNA group and lateral wall complete PF-LCP group after compression(P>0.05). But the distance between fracture ends,the distance of fracture dislocation and the sliding distance of the fracture fragments of lateral wall breakage PFNA group were less than that of lateral wall breakage PF-LCP group(P<0.05).
Conclusion: Intramedullary fixation of intertrochanteric fractures have stronger loading force. Both intramedullary and extramedullary fixation of intertrochanteric fractures have strong stability when the lateral wall of the femur is complete,but intramedullary fixation of intertrochanteric fractures is stronger stability than extramedullary fixation when the lateral wall of the femur is broken. So the intramedullary fixation is the first choice for the treatment of intertrochanteric fracture. |
| KEY WORDS Femoral intertrochanteric fractures Femoral lateral wall Fracature fixation,intramedullary Fracture fixation,internal Biomechanics |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 吴银生,许兵,余作取,王萧枫,戴寿旺,李敏,童培建.股骨外侧壁在股骨粗隆间骨折的髓内与髓外固定中的生物力学研究[J].中国骨伤,2017,30(3):247~251 |
| 英文格式: | WU Yin-sheng,XU Bing,YU Zuo-qu,WANG Xiao-feng,DAI Shou-wang,LI Min,TONG Pei-jian.Biomechanical study of the lateral wall of the femur in the treatment of femoral intertrochanteric fracture with intramedullary or extramedullary fixation[J].zhongguo gu shang / China J Orthop Trauma ,2017,30(3):247~251 |
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