| 桡骨远端解剖型记忆聚合器的设计与临床应用 |
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Received:March 12, 2007
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| 作者 | Author | 单位 | Unit | E-Mail |
| 禹宝庆 |
YU Bao-qing |
第二军医大学附属长海医院骨科,上海200433 |
Department of Orthopaedics,the Affiliated Changhai Hospital of the Second Military Medical University,Shanghai 200433,China |
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| 张春才 |
ZHANG Chun-cai |
第二军医大学附属长海医院骨科,上海200433 |
Department of Orthopaedics,the Affiliated Changhai Hospital of the Second Military Medical University,Shanghai 200433,China |
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| 苏佳灿 |
SU Jia-can |
第二军医大学附属长海医院骨科,上海200433 |
Department of Orthopaedics,the Affiliated Changhai Hospital of the Second Military Medical University,Shanghai 200433,China |
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| 胡海波 |
HU Hai-bo |
第二军医大学附属长海医院骨科,上海200433 |
Department of Orthopaedics,the Affiliated Changhai Hospital of the Second Military Medical University,Shanghai 200433,China |
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| 刘辉 |
LIU Hui |
第二军医大学附属长海医院骨科,上海200433 |
Department of Orthopaedics,the Affiliated Changhai Hospital of the Second Military Medical University,Shanghai 200433,China |
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| 期刊信息：《中国骨伤》2007年20卷，第6期，第367-369页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的:寻找一种新的治疗桡骨远端骨折与骨不连的内固定方法。
方法:根据桡骨远端的解剖学特点、骨折发生机制及骨折端的应力情况,利用镍钛生物记忆材料的特殊力学行为,设计一种专门处理此类骨折、骨不连的形状记忆合金接骨器。临床上采用该接骨器治疗桡骨远端粉碎性骨折5例,桡骨远端骨折骨不连20例。桡骨远端粉碎骨折组中,男3例,女2例;年龄44~65岁,平均51.3岁。骨不连组中,男14例,女6例;年龄34~70岁,平均55.7岁;其中采用普通钢板固定7例,三棱针固定8例,克氏针加钢丝固定2例,外固定架固定1例,石膏固定2例。
结果:生物力学测试表明本接骨器具有良好的耐疲劳与重复使用性,初期产生的最大环抱持骨力12.82MPa,纵向压力13.6MPa。本组所有患者均得到随访,时间6个月~2年,平均1.3年。1例出现切口软组织的浅表感染,经局部换药2周后,切口愈合。其余患者切口均Ⅰ期愈合。腕关节伸屈活动范围120°~140°,术后6~10周骨折线消失。所有患者术后骨折无成角畸形、骨折再移位出现,无骨不连发生,取出聚合器后无再骨折。
结论:桡骨远端解剖型记忆聚合器符合桡骨远端的解剖特点,可以在骨折端产生持续纵向加压的作用,具有抗剪力、抗折弯力、抗分离、抗旋转作用,可以促进骨折愈合。 |
| [关键词]:桡骨骨折 外固定器 骨折愈合 生物力学 |
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| Design and clinical applications of Anatomical Nitinol Memory Connector for distal radius |
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Abstract:
Objective: To find a new method of internal fixation for the management of fractures and nonunion of distal radius.
Methods: According to the anatomical feature,mechanism of fracture and stress sustained on the fracture site of distal radius,a new type of Nitinol shape memory alloy connector was designed by taking the advantage of its special mechanics action.In clinical applications,25 patients were treated with the procedure,among which 5 patients were fresh fracture of distal radius and 20 patients were nonunion.Among patients with fresh fractures,3 patients were male and 2 patients were female,the mean age was 51.3 years (44 to 65 years).Among patients with nonunion,14 patients were male and 6 patients were female,the mean age was 55.7 years(34 to 70 years),7 patients were fixed with routine plate,8 with pins,2 with K-wire,1 with external fixator and 2 with plaster.
Results: The biomechanics study showed that the connector was characteristic of anti-fatigue and reuse.The initiative bone holding and longitudinal compressive forces were 12.82 MPa and 13.6 MPa respectively for maintaining axial stability.All the patients were followed-up,ranged from 6 months to 2 years (1.3 years on average).Only 1 patient had superficial infection of soft tissue which healed after 2 weeks;Other patients had primary healing without infection,angulation and displacement.Fracture lines disappeared 6 to 10 weeks later postoperatively.No refracture occurred after the connector removed.
Conclusion: The newly designed NT memory device matches optimally the anatomy of the distal radius.It not only can maintained longitudinal compressive forces continuously,but also has efficacious fixation effect with anti-shearing,anti-bending and anti-distracting forces.It can shorten the duration of bone healing and improve the healing quality of bone. |
| KEYWORDS:Radius fractures External fixators Fracture healing 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: | 禹宝庆,张春才,苏佳灿,胡海波,刘辉.桡骨远端解剖型记忆聚合器的设计与临床应用[J].中国骨伤,2007,20(6):367~369 |
| 英文格式: | YU Bao-qing,ZHANG Chun-cai,SU Jia-can,HU Hai-bo,LIU Hui.Design and clinical applications of Anatomical Nitinol Memory Connector for distal radius[J].zhongguo gu shang / China J Orthop Trauma ,2007,20(6):367~369 |
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