摘要
背景:内侧支撑髓内钉通过重建股骨内侧支撑的方法恢复了股骨近端的三角稳定结构,早期的有限元分析及生物力学显示其稳定性优于现在常用的股骨近端防旋髓内钉,但是在严重骨质疏松模型中的具体表现尚不明确。目的:比较内侧支撑髓内钉和股骨近端防旋髓内钉固定治疗严重骨质疏松且内侧失支撑股骨转子间骨折的生物力学差异。方法:利用严重骨质疏松人工骨构建内侧失支撑的股骨转子间骨折模型,采用内侧支撑髓内钉和股骨近端防旋髓内钉分别固定后进行轴向破坏和扭转破坏实验,记录两者在轴向和扭转载荷作用下的轴向刚度和扭转刚度等数据。结果与结论:①轴向破坏实验显示,内侧支撑髓内钉组的极限载荷、屈服载荷及轴向刚度稍大于股骨近端防旋髓内钉组,但组间比较差异均无显著性意义(P>0.05);②扭转破坏实验显示,内侧支撑髓内钉组的扭转刚度大于股骨近端防旋髓内钉组(P<0.05);③结果表明,内侧支撑髓内钉的力学稳定性尤其是抗扭转性能优于股骨近端防旋髓内钉,可能是严重骨质疏松性股骨转子间骨折治疗时不错的选择。
BACKGROUND:The medial support nail restored the triangular stable structure of the proximal femur through the reconstruction of the medial femoral support.The early finite element analysis and biomechanics showed that the stability of the nail was better than that of the commonly used proximal femoral nail antirotation,but the specific performance in the model of severe osteoporosis was unknown.OBJECTIVE:To compare the biomechanical differences between medial support nail and proximal femoral nail antirotation in the treatment of severe osteoporotic intertrochanteric fractures without medical support.METHODS:The medial unsupported intertrochanteric fracture model was made of artificial bone with severe osteoporosis.Axial and torsional failure experiments were conducted after the medial support nail and the proximal femoral nail antirotation were respectively fixed,and the axial stiffness and torsional stiffness of the two under axial and torsional loads were recorded.RESULTS AND CONCLUSION:(1)Axial failure experiment showed that the ultimate load yield load and axial stiffness of the medial support nail group were all greater than those of the proximal femoral nail antirotation group,but there was no significant difference between the two groups(P>0.05).(2)The torsional failure experiment showed that the torsional stiffness of the medial support nail group was higher than that of the proximal femoral nail antirotation group(P<0.05).(3)The findings confirmed that the mechanical stability of the medial support nail,especially torsion resistance,is better than that of the proximal femoral nail antirotation,which may be a good choice for the treatment of severe osteoporotic intertrochanteric fracture.
作者
聂少波
李建涛
孙基恩
赵喆
赵燕鹏
张里程
唐佩福
Nie Shaobo;Li Jiantao;Sun Jien;Zhao Zhe;Zhao Yanpeng;Zhang Licheng;Tang Peifu(Department of Orthopedics,Chinese PLA General Hospital,Beijing 100853,China;National Clinical Research Center for Orthopedics,Sports Medicine&Rehabilitation,Beijing 100853,China;Shandong WeiGao Orthopedic Material Limited liability Company,Weihai 264200,Shandong Province,China;Beijing Tsinghua Changgung Hospital,Beijing 102218,China)
出处
《中国组织工程研究》
CAS
北大核心
2021年第3期329-333,共5页
Chinese Journal of Tissue Engineering Research
基金
首都卫生发展科研专项项目(2016-1-5012),项目负责人:唐佩福~~。
关键词
骨
螺钉
髓内钉
股骨
转子间骨折
内侧支撑
生物力学
骨质疏松
bone
screw
intramedullary nail
femur
intertrochanteric fracture
medial support
biomechanics
osteoporosis
