锁定钢板和髓内钉内固定治疗肱骨外科颈骨折的生物力学研究
A biomechanical study on treatment of humeral surgical neck fractures with locking plate and intramedullary nail
陈琦 1张弛 2罗轶 1程邦君 1何耀华2
作者信息
- 1. 上海市第六人民医院金山分院骨科,上海 201599
- 2. 上海市第六人民医院骨科,上海 200030
- 折叠
摘要
目的 观察锁定钢板和髓内钉在肱骨外科颈骨折固定中的生物力学特征,比较二者的抗压刚度和失效载荷.方法 纳入20例人工肱骨标本,建立外科颈骨折模型并随机分为2组,A组采用PHILOS钢板固定(n=10),B组采用髓内钉固定(n=10),比较两组轴向压缩试验抗压刚度、剪切力压缩试验抗压刚度、失效载荷.结果 A组轴向压缩试验抗压刚度为(166.5±19.7)N/mm,B组轴向压缩试验抗压刚度为(202.6±16.8)N/mm,A组轴向压缩试验抗压刚度小于B组,差异有统计学意义(t=4.409,P＜0.001).A组剪切力压缩试验抗压刚度为(145.9±37.7)N/mm,B组剪切力压缩试验抗压刚度为(191.1±16.5)N/mm,A组剪切力压缩试验抗压刚度小于B组,差异有统计学意义(t=3.472,P=0.003).A组轴向压缩试验失效载荷为1 675～2 000N,B组的轴向压缩试验失效载荷均为2 000N,B组整体失效载荷高于A组.结论 在肱骨外科颈骨折的内固定中,髓内钉相对于PHILOS钢板在轴向压缩试验、剪切力压缩试验和失效载荷中拥有更佳的力学性能.
Abstract
Objective To observe the biomechanical characteristics of locking plate and intramedullary nail in the fixation of surgical neck fractures of the humerus,and to compare their compressive stiffness and failure load.Methods Twenty artificial humeral specimens were included to establish a surgical neck fractures model and randomly divided into two groups.Group A was fixed with PHILOS plate(n=10),while group B was fixed with intramedullary nail(n=10).The axial compression test com-pressive stiffness,shear compression test compressive stiffness,and failure load were compared between the two groups.Re-sults The compressive stiffness of group A in the axial compression test was(166.5±19.7)N/mm,while group B in the axial compression test was(202.6±16.8)N/mm.The compressive stiffness of group A in the axial compression test was smaller than that of group B,and the difference was statistically significant(t=4.409,P＜0.001).The compressive stiffness of group A in the shear compression test was(145.9±37.7)N/mm,while group B in the shear compression test was(191.1±16.5)N/mm.The compressive stiffness of group A in the shear compression test was smaller than that of group B,and the difference was statisti-cally significant(t=3.472,P=0.003).The failure load of axial compression test in group A was 1 675-2 000 N,and the failure load of axial compression test in group B was both 2 000 N.The overall failure load of group B was higher than that of group A.Conclusion In the internal fixation of humeral surgical neck fractures,intramedullary nail has better mechanical properties compared to PHILOS plate in axial compression tests,shear compression tests,and failure loads.
关键词
肱骨外科颈骨折/锁定钢板/髓内钉/生物力学Key words
Humerus surgical neck fracture/Locking plate/Intramedullary nail/Biomechanics引用本文复制引用
基金项目
上海市金山区卫生健康委科研项目(JSKJ-KTMS-2020-06)
出版年
2024
NETL
NSTL
万方数据