自动加压带锁髓内钉治疗股骨干骨折的生物力学原理与临床应用
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BIOMECHANIC PRINCIPLE AND CLINICAL APPLICATION OF AUTO-COMPRESS LOCKING NAIL IN FEMORAL SHAFT FRACTURE THERAPY
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    摘要:

    目的:验证自动加压带锁髓内钉(ALN)的生物力学性能比GK钉治疗股骨干骨折的优越性,为临床提供可靠的科学依据。方法:采用9具成人新鲜尸股骨标本,对其骨折固定后,在压缩、弯曲、扭转的生物力学性能进行电测实验应力分析。结果:①ALN钉与国外GK钉在强度、刚度和稳定性方面相当(P<0.05);②在应力遮挡率方面特别小,明显比GK钉优越(P<0.01);③ALN钉具有力学分布合理、应力遮挡小、内固定稳定可靠,手术操作方便,能早期恢复伤肢功能的特点。结论:ALN钉除了具备GK钉抗弯、剪、扭、旋优良的作用外,还具备了GK钉所不具备的自动加压弹性固定的作用。解决了临床上坚强内固定(带锁髓内钉)骨折端应力传导不够或没有应力传导,弹性固定(梅花钉)不易控制骨折端弯、剪、扭、旋应力这一矛盾。是一种性能特别优良的内固定器械。

    Abstract:

    To verify the biomechanic performance of auto-compress locking nail(ALN) in femoral shaft fracture therapy, to provide reliable basis for clinical use. Methods' 9 fresh cadaveric femurs were used,the biomechanic properties of compression,bending and torsion were analysed using electric measuring apparatus after fixation of fracture. Resultst @ALN was similar to GK nail in strength, stiffness and stability(p>0.05); @The stress shielding rate of ALN was significantly smaller than that of GK nail; @ALN had reasonable mechanic distribution, low stress shielding rate and fixation stability, also was easy to operate with rapid rehabilitation. Conclusion: ALN not only have the same properties of anti-bending, anti-shearing,anti-torsion and anti-rotation as GK nails but also have auto-compress elastic fixation. In clinic, rigid fixation(interlocking intramedullary nail) has no enough stress conduction in fracture region, elastic fixation(cloverleaf type intramedullary nail)can not effective ly control bending, shearing, torsion and rotation stress in fracture region, ALN have successfully resolved the contradiction. It is one kind of new interfixation instrument with good performance.

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许纬洲,王宏鹤,王以进,赵松海,毕宏伟.自动加压带锁髓内钉治疗股骨干骨折的生物力学原理与临床应用[J].医用生物力学,2000,15(1):49-54

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