实验性股骨髓钉内固定生物力学探讨
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AN EXPERIMENTAL BIOMECHANIC STUDY OF MEDULLARY PIN INTERNAL FIXATION FOR FEMUR FRATURE
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    摘要:

    本实验采用电测技术对人体新鲜股骨标本在不同载荷下对股骨延长、骨折固定的应力、应变的影响作一探讨.结果证实,在静态载荷980N时,骨干承受抗压强度应力值为-8.04×106±1.96×106Pa,高于骨端的抗压强度,而股骨远端的抗压应力值为-8.82×106±1.274×106Pa,又高于股骨近端的抗压强度.同时表明股骨骨折后折端的稳定性依赖于可靠的内固定,在骨折端紧密接角触载荷时,应刀传导由骨与髓钉共同承担,其中62%载荷应力由髓钉承担,38%由骨承担.在股骨延长时,取大块髂骨块张力下充填骨缺损区,可有效支撑整骨的抗弯载荷及抗压强度.骨折未愈合前髓钉适宜载荷不应超过196N,过载势必金属弱化,出现过载应变疲劳包申格(Bauschinger)效应,以致引起髓钉弯曲断裂,影响骨愈合.

    Abstract:

    Fresh specimen of human femutn was measured with electrical technique to observeand analyze the stress - strain relationship under different loadings.In patients with transverse fracture of the femur treated with bone lengthening and internal fixation of medullary pins, the effects of loading compression and deformity endurance of the internal fixation were determined.It was found that when a loading of 980N was given, the compression of the medial side of the femoral shaft was- 8.04?106?1.96?106pa,higherthan posterior side.At the same time, the lateral side of the corresponding transverse section sustained-8.82?106?1.27?106pa,higher than ante-nolateral side.It was also shown that the stability of the fracture fragments is dependent upon a reliable internal fixation. When the closely contacted fractured ends were under loading, both bone and the medullary pins sustained the compression loading stress of which 62% was sustained by the medullary pins and 38% by the bone tissue.When the femur was lengthened,the filling of the defect in the compression stress area with a large Piece of bone tissue from the ileum could effectively increase the anti-bending loading and anri-compression strength o: the femur.Before the healing of fracture, the loading of the medullary Pm should not exceed 196N. Over loading is bound to result in the weakening and plastic deformty the pin metal,which is known as 'Baushinger effect'. Consequently, the medullary pin will be bonded and even broken to delay the healing of fracture. 原

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滑利,周仲安,吴梅英,许建忠.实验性股骨髓钉内固定生物力学探讨[J].医用生物力学,1997,12(2):108-111

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