人工股骨头置换治疗严重股骨转子间骨折的生物力学研究

中国临床解剖学杂志 ›› 2012, Vol. 30 ›› Issue (6): 683-686.

人工股骨头置换治疗严重股骨转子间骨折的生物力学研究

黄炳生¹，　王永胜¹，　陈顺仪²，　陈立安¹，　钟世镇³，　丁自海³

1.广州番禺区中心医院骨一科，广州 511400；　2. 广州番禺区中心医院检验科，广州 511400；　
3. 广东省创伤救治科研中心　南方医科大学解剖学教研室, 广州 510515

收稿日期:2012-06-11 出版日期:2012-11-25 发布日期:2012-12-11
作者简介:黄炳生（1961-），广州人，主任医师，主要从事关节外科、创伤方面的临床工作，Tel：（020）34859120
基金资助:
广州市科技计划项目(2010Y1-C581)

The biomechanical study of severe intertrochanic fractures treated with cemented femoral stem

HUANG Bing-sheng¹,WANG Yong-sheng¹, CHEN Shun-yi², CHEN Li-an¹, ZHONG Shi-zhen³, DING Zi-hai³

1.The No.1 orthopedic department, Panyu central hospital, Guangzhou 511400; 2. The clinical laboratory, Panyu central hospital, Guangzhou 511400; 3.Guangdong trauma research center, Department of Anatomy, Southern Medical University, Guangzhou 510515 China

Received:2012-06-11 Online:2012-11-25 Published:2012-12-11

摘要/Abstract

摘要：

目的　探讨人工股骨头置换(标准柄)治疗股骨转子间粉碎性骨折的生物力学稳定性。方法　收集18根成年股骨标本随机分成置换组、DHS组及对照组。置换组(A组)(n=6)模拟股骨转子间四部分骨折，钢丝捆扎固定大小转子及股骨矩，行标准柄股骨头置换，骨水泥固定；DHS组(B组)(n=6)模拟股骨转子间四部骨折，行DHS钢板内固定；对照组(C组)(n=6)采用完整股骨标本。Bose3510-试验机上行轴向加压和扭转测试，测量三组标本位移变化并行统计学分析。结果　轴向压力测试：垂直加载100~1000N，A组与C组两组间差异没有统计学意义(P>0.05)；B组与C组及A组与B组的组间比较差异有统计学意义（P<0.05）。扭力测试：当扭矩是8 Nm时，A组与C组及A组与B组间比较差异无统计学意义(P>0.05)，B组与C组比较差异有统计学意义(P<0.05)。结论　应用骨水泥型股骨标准柄假体进行人工股骨头转换置换治疗股骨转子间粉碎性骨折的生物力学性能是具有可行性的。

关键词: 股骨转子间骨折, 股骨头置换, 生物力学

Abstract:

Objective　To study the biomechanical stability of the comminuted intertrochanic fracture treated with cemented standard femoral stem prosthesis.　Methods　18 cadaveric femurs were selected in this study and divided into three groups randomly as FHR, DHS and control group. The FHR group(A)(n=6) was simulated as comminuted intertrochanic fractures as four parts which were treated with cemented femoral prosthesis following standard hemiarthroplasty procedure and the four parts fractures in FHR group were fixed by wires additionally. The DHS group (B) (n=6) was also simulated as comminuted intertrochanic fractures as four parts which were treated with DHS internal fixation systems. The control group (C) (n=6) was raw cadaveric femur. The specimens were tested mechanically by universal testing machine through vertical and rotational loading. The displacement of loading were recorded and analyzed. 　Results　Vertical loading tests: No significant differences of displacement were found between group A and C either in vertical loading from 100N to 1000N or in rotational loading with torque of 8Nm. There was statistically significant difference between group B and C, also group A and B in vertical loading. In rotational loading test, there was statistically significant difference between group B and C, and no significant difference between group A and B.　Conclusions　The use of cemented standard femoral stem prosthesis is biomechanically acceptable in the treatment of comminuted intertrochanic fractures.

Key words: Intertrochanic fracture, Hemiarthroplaty, Biomechanics

中图分类号:

R318.01

黄炳生, 王永胜, 陈顺仪, 陈立安, 钟世镇, 丁自海. 人工股骨头置换治疗严重股骨转子间骨折的生物力学研究[J]. 中国临床解剖学杂志, 2012, 30(6): 683-686.

HUANG Bing-Sheng, WANG Yong-Qing, CHEN Shun-Yi, CHEN Li-An, ZHONG Shi-Tian, DING Zi-Hai. The biomechanical study of severe intertrochanic fractures treated with cemented femoral stem[J]. Chinese Journal Of Clinical Anatomy, 2012, 30(6): 683-686.

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