摘要
目的：通过对改良型Ｇａｍｍａ钉（ＭＧＮ），麦氏鹅头钉（ＭＮＰ）和多根斯氏针（ＭＳＰ）治疗的５９例粗隆部骨折的回顾性随访和生物力学分析，以明确三者在临床应用和生物力学方面的利弊．方法：选用尸体股骨７对，将标本制成两部分和四部分粗隆间骨折模型，分别用ＭＧＮ，ＭＮＰ和ＭＳＰ固定，后在ＷＪ－１０Ａ型万能试验机上给予纵向载荷．指标包括最大失效载荷，构件刚度以及动载荷记录指标．结果：与ＭＳＰ和ＭＮＰ比较，ＭＧＮ固定的骨折模型承受的平均最大载荷为２９００Ｎ，ＭＳＰ平均为１７００Ｎ，ＭＮＰ为１２００Ｎ，ＭＧＮ组较ＭＮＰ组大６０％（Ｐ＜０．０５），较ＭＳＰ组大４１％（Ｐ＜０．０５）．通过临床分析发现ＭＧＮ，ＭＮＰ和ＭＳＰ三者在骨折愈合时间方面无显著性差异，但ＭＧＮ在术后负重时间明显较ＭＮＰ和ＭＳＰ短．结论：ＭＧＮ将髓内钉和加压螺钉结合在一起，固定骨折牢固，手术创伤小，患者负重早，康复迅速．ＭＧＮ具有更大的强度、刚度和抵抗动载荷能力．
Objective: The advantages and disadvantages of Mclaughlin nail plate (MNP), multi Steinmann's pins (MSP) and modified Gamma nail (MGN) were determined through the retrospective clinical study and biomechanical analysis. Methods: Seven pairs of cadaver femurs were developed into two different fracture models fixed with MNP, MSP or MGN respectively, and then subject to the longitudinal loading in WJ 10A universal testing system. Results: Compared with the MNP or MSP models, the MGN models are able to stand the greater loading. According to our clinical results, the operation of MGN was performed with smaller incision, less intraoperative bleeding, shorter screening time and earlier time of weight bearing in comparison with MNP, however, there were no significant differences in the bone healing duration between the both. Conclusion: MGN represents the higher stiffness and excellent capability against the static longitudinal loading and its operation can be performed with smaller skin incision, less intraoperative bleeding. MSP is proved to be a simple and useful device.
出处
《第四军医大学学报》
1996年第6期437-440,共4页
Journal of the Fourth Military Medical University
关键词
股骨骨折
GAMMA钉
鹅头钉
interfrochanteric fracture/management Gamma nail Mclaughlin nail Steinmann's pin biomechanics
