摘要
目的 比较髋臼横断骨折不同内固定方法臼顶负重区的应力分布 ,以评价不同治疗方法的有效性。 方法 取成年男性防腐尸体骨盆 5个 (含双侧股骨中上段 )。标本分为如下各组 :完整骨盆 ;前柱单钢板内固定 (A) ;后柱单钢板内固定 (B) ;前柱单钢板加后柱单钢板内固定(C) ;前柱拉力螺钉加后柱单钢板内固定 (D)。用特制的夹具将骨盆和股骨固定于单足站立中立位 ,去除髋关节囊 ,将压敏片贴于股骨头上 ,分别测量各组标本髋臼臼顶负重区平均应力及峰值应力。 结果 完整骨盆组的臼顶负重区应力、峰值应力分别为 (1 .32± 0 .4 3)、(2 .1 7± 0 .2 0 )MPa ;A组分别为 (2 .73± 0 .6 8)、(3.2 3± 0 .4 0 )MPa;B组分别为 (2 .91± 0 .6 5 )、(3.32± 0 .4 4 )MPa ;C组分别为 (2 .0 4± 0 .32 )、(2 .72± 0 .35 )MPa;D组分别为 (2 .0 1± 0 .33)、(2 .6 9± 0 .33)MPa。完整骨盆组与A、B、C、D四组比较 ,差异均有显著性或非常显著性意义 (P <0 .0 1 ,0 .0 1 ,0 .0 5 ,0 .0 5 ) ,A组与B组、C组与D组差异无显著性意义 (P >0 .0 5 ) ,A、B两组与C、D两组间差异均有显著性意义 (P <0 .0 5 )。 结论 对于髋臼横断骨折 ,即使给予解剖复位内固定 ,髋臼臼顶负重区的应力分布也不能恢复至正常。
Objective To compare the stress distribution in the dome region of acetabulum after different internal fixations for transverse acetabular fractures so as to evaluate the effectiveness of each fixation. Methods Five embalmed pelves including bilateral middle and upper parts of the femur from adult male corpse were harvested and divided into five groups, ie, intact pelvis group (Group I), anterior column plate group (Group A), posterior column plate group (Group B), anterior column plate and posterior column plate group (Group C) and anterior column lag screw plus posterior column plate group (Group D). Before loading, the entire capsule of the hip joint was removed so that the pressure-sensitive films could be fixed on the surface of the femoral head. The mean pressure and the peak pressure in the dome region of the acetabulum were measured with pressure translation system. Results The mean pressure and the peak pressure were (1.32±0.43) MPa and (2.17±0.20) MPa, respectively in the Group I, (2.73±0.68) MPa and (3.23±0.40) MPa, respectively in the Group A, (2.91± 0.65) MPa and (3.32±0.44) MPa, respectively in the Group B, (2.04±0.32) MPa and (2.72± 0.35) MPa, respectively in the Group C and (2.01±0.33) MPa and (2.69±0.33) MPa, respectively in the Group D. The least significant difference multiple comparison on the mean pressure and the peak pressure in five groups showed that there was significant difference in the Groups A, B, C and D compared with the Group I (P<0.01, P<0.01, P<0.05 and P<0.05, respectively). There was no significant difference between the Group A and the Group B (P>0.05) as well as between the Group C and the Group D (P>0.05). There was significant difference between Groups A, B and Groups C, D (P<0.05). Conclusions For the transverse acetabular fractures, the mean pressure and the peak pres- sure in the dome region can not recover to normal even after anatomical reduction and internal fixation. Compared with the single column fixation, double column fixation can decrease the mean pressure and the peak pressure and is a better method for transverse acetabular fractures.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2004年第12期743-746,共4页
Chinese Journal of Trauma
