| 垂直动态冲击下骶孔骨折伴神经根损伤的生物力学研究 |
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Received:April 26, 2005
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| 作者 | Author | 单位 | Unit | E-Mail |
| 全仁夫 |
QUAN Ren-fu |
萧山中医院脊柱外科治疗中心,浙江杭州311201 |
Spinal Surgery Center,Xiaoshan Tranditional Chinese Medical Hospital,Hangzhou 311201,Zhejiang,China |
quanrenf@263.net |
| 杨迪生 |
YANG Di-sheng |
浙江大学医学院附属二院骨科 |
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| 苗旭东 |
MIAO Xu-dong |
浙江大学医学院附属二院骨科 |
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| 王以进 |
WANG Yi-jin |
上海大学生物力学工程研究所 |
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| 李伟 |
LI Wei |
萧山中医院脊柱外科治疗中心,浙江杭州311201 |
Spinal Surgery Center,Xiaoshan Tranditional Chinese Medical Hospital,Hangzhou 311201,Zhejiang,China |
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| 谢利军 |
XIE Li-jun |
萧山中医院脊柱外科治疗中心,浙江杭州311201 |
Spinal Surgery Center,Xiaoshan Tranditional Chinese Medical Hospital,Hangzhou 311201,Zhejiang,China |
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| 期刊信息：《中国骨伤》2005年18卷，第11期，第673-676页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的:探讨垂直冲击下骶孔骨折伴神经根损伤的生物力学特点。
方法:采集人体新鲜骨盆骨骼标本10具,行动态冲击试验。测量动态骨折时的一系列动力学参数,确定骨折的动力学特性;并取骶孔骨块脱钙,作石腊切片,再用Masson三色法、Mallory改良法和HE染色,并进行组织学观察。
结果:①骶孔边的应力集中明显,S1、S2孔边上缘的应变为2703με和1689με,相应的压应力分别为25 MPa和16 MPa;左右两侧边缘的最大拉应力可达40 MPa和31 MPa,比骶骨处应力高3.1倍。此时可计算得到S1、S2椎体应力集中系数分别为1.6和1.9。②骶孔发生以下四种骨折方式:Ⅰ型为单纯骶孔骨折,Ⅱ型为骶孔骨折伴骶骨翼骨折,Ⅲ型为整侧骶孔纵形骨折,Ⅳ型骶孔劈裂状骨折。当冲击能量达到25 J以上时,发生粉碎性脆性状态骨折,形成骶孔劈裂状骨折,并产生广泛的软组织损伤及神经根损伤,常累及一侧或两侧的腹侧神经根损伤。③从骶孔断面的电镜观察来看,骨折裂纹大多数在薄弱断面,高低不平,并在孔边的应力集中处交汇、集合、发散、扩散和发展,骨折面较为锐利,孔边并有一些宽度不大于120μm微裂隙存在。
结论:骶孔状骨折为高能量伤,损伤常累及神经根,与骶骨的力学结构、力的传导、冲击动力学特性以及应力、应变分布相关。 |
| [关键词]:骶骨骨折 神经根损伤 生物力学 |
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| Study of the biomechanics of the sacrum hole fracture and nerve root injury by impact of vertical and dynamic |
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Abstract:
Objective:To study the biomechanism of the sacrum hole fracture and nerve root injury by impact of vertical and dynamic.
Methods:Ten fresh pelvis specimens of human were collected to be carried out both the crash test in dynamic state.The dynamic parameters of the fracture in dynamic state were measured to be sure the dynamic characters of fracture.The fracture pieces of the sacrum wing were made decalcification,paraffin section and stained(Masons,Mallory,HE).Histomorphology were observed.
Results:①The stress was obviously concentrated in the hole edge of sacrum.The strain of the first and second hole of sacrum were (2 703) με and(1 689) με,the depress-stress were 25 MPa and 16 MPa.The most draw-stress of both edge were 40 MPa and 31 Mpa,and were 3.1 times of the sacrum.The stress concentration coefficient of first and second sacral vertebrae were 1.6 and 1.9 respectively.②The hole of sacrum fracture included four types:type Ⅰ of the hole of sacrum fracture,type Ⅱ of the hole of sacrum fracture accompanying fracture of the wing of the sacrum,type Ⅲ of homolateral erect fracture,type Ⅳ of split fracture.When the power of clash was beyond 25 J,fragility comminuted fracture appeared(typeⅣ) and accompanied with extensive injury of tissue and nerve root,the nerve included one side or two sides of ventral nerve root.③Under the electron microscope,the fracture flaw were on weak transection and looked irregular,it crossed,converged,delivered,scattered at the position of depress-stress of the hole edge,so the fracture was uneven and sharper,there existed some cranny no more than 120 μm wide at the hole edge.
Conclusion:The sacrum fracture is a kind of high-energy injury,with the injury of nerve root.It is relevant to the mechanics structure,the conduction of strength,the characteristic of dynamic crash,the stress,and the strain of the sacrum. |
| KEYWORDS:Sacrum fracture Nerve root injuries Biomechanic |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 全仁夫,杨迪生,苗旭东,王以进,李伟,谢利军.垂直动态冲击下骶孔骨折伴神经根损伤的生物力学研究[J].中国骨伤,2005,18(11):673~676 |
| 英文格式: | QUAN Ren-fu,YANG Di-sheng,MIAO Xu-dong,WANG Yi-jin,LI Wei,XIE Li-jun.Study of the biomechanics of the sacrum hole fracture and nerve root injury by impact of vertical and dynamic[J].zhongguo gu shang / China J Orthop Trauma ,2005,18(11):673~676 |
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