股骨粗隆间骨折采用三维L形钢板内固定的生物力学对比性研究
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BIOMECHNICAL COMPARATIVE STUDY OF INTERTROCHANTERIC FRACTURES OF FEMUR USING THREE DIMENSION L STEEL PLATE INTERFIXATION
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    摘要:

    目的:探讨与比较作者设计的三维L形钢板(TDLP)与其他内固定物在治疗不稳定股骨粗隆间骨折中的作用。方法:采用12具新鲜尸股骨标本,将股骨粗隆造成二部分、三部分、四部分骨折,沿着股骨内外侧骨皮质粘贴6个应变片,测量股骨近端应变和不同工况下(压、弯、扭)试验结果。分别用TDLP、Gamma钉、Richards钉、SHS钉固定,系统比较其实验结果和股骨的生物力学性能。结果:采用TDLP治疗股骨粗隆间骨折其强刚度与Gamma钉相当,但无显著性差异(P>0.05),与Richards钉、SHS钉比较,在生物力学性能上占有明显优势,具有显著性差异(P<0.05)。作者自1994年始采用自行设计的TDLP治疗股骨粗隆间骨折72例,平均年龄63.5岁,平均随访32月,X线片显示骨折愈合优良,伤肢恢复正常功能,无骨折延迟愈合及髋内翻或旋转移位。结论:TDLP是目前治疗股骨粗隆间骨折较理想的内固定物。

    Abstract:

    To investigate and compare the effect of self-design three dimension L steel plate(TDLP)and other internal fixation devices on unstable intertrochanteric fracture of femur.Method The two-part,three-part and four -part trochanteric fractures of feumr have been made by using12fresh cadaver femur samples.Six strain patches have been sticked along the medical and lateral cortices of femur.Measure strain of proximal femur and com-pression,bending and twisting under different condition.Then the femur fractures have been fixed by using TDLP,Gamma nail,Richards nail and SHS nail,respectively,And their experimental results and biomechanical functions have been compared systematically.Results Using TDLP interfixation to cure intertrochanteric fracture of femur has the similar strength rigidity as compared with Gamma nai.and the standard values(P>0.05).The TDLP offered more distinct biomechanical advantage than the Richards nail and SHS nail,there exist obvious differences(P<0.05).72cases of unstable intertrochanteric fracture of femur have been treated by self-design TDLP since1994,with the average patient age63.5and average followed-up period32months.X-ray photos showed fracture headings were excellent good and satisfactory funciton of the limbs were recovered.No slow u-nion of fracture,coxa vara deformity and rotary displacement have happened.Conclusion TDLP is more ideal in-ternal fixation object in the treatment for intertrochanteric fracture of femur.

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李强一,王以进,张秋琴,韩擎天.股骨粗隆间骨折采用三维L形钢板内固定的生物力学对比性研究[J].医用生物力学,2001,16(4):239-243

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