摘要
目的 ：在尸体上模拟髋臼后壁缺损的模型,评价不同后壁重建方法对髋臼与股骨头接触特性的影响。方法：获取6具成人尸体的骨盆股骨标本,采用随机数字表法分为A组和B组。均采用后壁截骨法建立髋臼后壁60°弧1/2缺损的模型;两侧缺损区分别选用不同的重建方法。其中,A组凿取髂前上棘后方的自体髂骨以制作解剖性自体髂骨;B组于髂后上棘前方凿取髂骨块。将髋关节置于直立位、屈曲位及后伸位,从10-250 N分级加载,使载荷直接作用于髋臼后壁上。采用压敏片检测不同状态下形变位移、载荷、头臼接触面积及接触应力。结果：在不同的髋关节状态下,A组在一定载荷下的形变位移略大于B组,但差异无统计学意义（P〉0.05）。与完整髋臼相比,后壁重建使头臼接触面积有所减少;在250 N载荷下,A组（解剖重建组）头臼接触面积与B组（普通重建组）比较的差异无统计学意义（P〉0.05）;其平均接触应力小于B组（P〈0.05）,说明A组应力集中小于B组。结论：后壁截骨法建立的尸体髋臼后壁缺损模型可有效模拟临床实际;解剖重建使后壁头臼接触面积及应力分布恢复比较理想,接近正常髋关节,避免了局部应力集中。
Objective：To construct a model of posterior acetabular defect and evaluate the effect of the reconstructive posterior wall on the contact of the acetabulum and femoral head.Methods：The entire pelvis and articulated femur were obtained from six adult body canine cadavers and were divided into group A and group B by random number table method.Adult body models of posterior acetabular defects were developed by removing the 60° arc fragment.Different measures were used to reconstruct the defect areas with iliac crest autograft.In the group A,the iliac bone was cut from the anterior superior iliac spine to produce the anatomic iliac bone;in the group B,the iliac bone was cut in front of the iliac spine.The hip joint was placed in the vertical position,the flexion position and the extension position,and the load was directly loaded on the posterior wall of the acetabulum by classification of 10 to 250 N.The pressure sensitive films were used to measure and calculate the deformation displacement,load,contact area,and the mean pressure and the distribution of the pressure between the acetabulum and femoral head.Results：Under different conditions of hip joint,the deformation displacement of group A was slightly larger than that of group B,but the difference was not statistically significant（P〈0.05）.The contact area was smaller after reconstruction of posterior wall compared with that of intact posterior wall.The contact areas were not significantly different between the group A and group B under a load of 250 N（P〈0.05）.The mean contact stress of group A was significantly less than that of group B（P〈0.05）,indicating the collection of pressure was less than that of group B.Conclusion：Adult body models of posterior acetabular defects induced by posterior wall osteotomy can effectively mimic the clinical condition;the anatomic reconstruction of the posterior wall can restore the total contact area and the distribution of the pressure within the acetabulum similar to the normal condition.
出处
《中国骨伤》
CAS
2016年第4期306-310,共5页
China Journal of Orthopaedics and Traumatology
关键词
髋臼
骨折
骨移植
生物力学
Acetabulum
Fractures
Bone transplantion
Biomechanics
