骶髂螺钉LX 固定方式的生物力学特性分析
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Biomechanical Study of Sacroiliac Screw Fixation withLX Technique
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    摘要:

    目的 研究骶髂螺钉LX固定方式与目前常规骶髂螺钉固定方式的拔出强度、刚度、能量吸收,确定比较符合人体生物力学要求的固定方式。方法 8具甲醛固定湿润成人尸体的正常骨盆标本,平均年龄23~45岁。骨密度测量排除骨质疏松,排除畸形、肿瘤、外伤等异常。将骨盆等分锯成两半,左侧组采用骶髂螺钉LX固定,置入正、负应力骶髂拉力螺钉,沿着骶髂关节复合体的压力带和张力带轴线,分别置入骶髂关节复合体的张力带和压力带;右侧组置入常规骶髂拉力螺钉。测量拧紧力矩、轴向拔出力、相对位移、应变、能量吸收。结果 拧紧力矩与骨密度、拧紧力矩与轴向拔出力、轴向拔出力与骨密度之间存在明显的正相关关系(P<0.05)。左侧组拔出力为(1158.10±29.20)N,比右侧组(791.2±44.6)N高32%(P<0.05)。右侧组的吸收能量为(6.52±0.78)J,左侧组的吸收能量为(11.75±1.45)J,左右两侧总的能量相比,左侧比右侧大(P<0.05)。结论 骶髂螺钉LX固定方式的强度和刚度均高于常规骶髂螺钉固定,拔出螺钉需要的能量亦大,具有生物力学优势,有利于骶髂复合体修复,更符合人体工程学要求。

    Abstract:

    Objective To compare the stiffness, pull-out strength and energy absorption of two different sacroiliac screw fixation techniques under different loading conditions to determine the new fixation method more congruous with human biomechanics requirements. Methods Eight bone specimens of human pelvis of 23 to 45 year-old were used. No deformity, osteoporosis, tumor or trauma was found in all the specimens after gross anatomy, X-ray and BMD (bone material density) inspection. The eight pelvis were cut into halves and divided into two groups. Sixteen sacroiliac screws by using LX method were inserted into the left sides (Group one), the negative stress sacroiliac screw was inserted into the tension band of sacroiliac complex, the positive stress sacroiliac screw was inserted into the compression band. Eight ordinary sacroiliac screws were inserted into the right sides (Group two). The insertion torque, pull-out strength, relative migration, energy absorption ofeach screw were measured. Results The pull-out strength of the sacroiliac screws using LX method were higher than that of the ordinary sacroiliac screw (P<0.05). There exist obviously positive correlations between the insertion torque and the pull-out strength, the BMD and the pull-out strength, the BMD and the insertion torque (P<0.05). The energy absorption of the ordinary sacroiliac screws was higher than that of the pressure screws and the tension screws (P<0.05), but the total energy absorption was higher in the sacroiliac screws using LX method when compared with that of the ordinary sacroiliac screws (P<0.05). Conclusion The stiffness, pull-out strength and absorption energy of sacroiliac screws using LX method were biomechanically superior to that of ordinary sacroiliac screw. Therefore, the new sacroiliac screws fixation technique which is more congruous with human biomechanics requirements would be recommended for better stability of the reconstructed pelvis.

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李明,徐荣明,王以进,校佰平,傅国美,薛波.骶髂螺钉LX 固定方式的生物力学特性分析[J].医用生物力学,2006,21(1):72-76

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