摘要
目的 设计适合国人使用的分叉式动力型交锁髓内钉。方法 对成年人新鲜不成对胫骨 2 1根的髓腔形态及峡部皮质厚度作一系统的CT、X线片测量。结果 上端松质骨区和下端松质骨区分别占胫骨总长度约 1/ 4,最狭窄区位于胫骨总长的约2 / 3位置 ,狭窄腔矢状径和冠状径为 :CT :1 131± 0 2 82cm、 1 0 83± 0 2 14cm ,X线片 :1 2 95± 0 2 85cm、 1 2 34± 0 385cm。胫骨结节与中心轴线距离CT :0 45 1± 0 132cm。CT检测发现 :越靠近两侧平台其两端松质骨密度明显增高。国人胫骨髓腔长度 :CT :32 5 6 5± 2 6 11cm ,X线片 :33 786± 2 86 1cm。据所测结果 :自行设计的分叉式动力型交锁钉弯曲部位在6 5cm ,弯曲角度为 12°,钉体直径为 0 9、 1 0cm ,长度分为 2 8～ 34cm七种。分叉钢棒尾端长出钉尾主体 1 5～ 2 0cm。结论 通过新鲜尸体胫骨实验 7例 ,110例临床胫腓骨骨折病人治疗 ,证明该内固定器设计合理 ,钉的选择可根据峡部矢状径及扩髓与否来决定。
Objective To design a new fork dynamic interlocking intramedullay nail which mighkbe suitable for Chinese adult.Methods Unpaired fresh tibias cavity morphology and isthmic cortex thickness were measured according to their CT and X-ray films.Results Both the distal and proximal cancellous bone are about 1/4 of the total length of the tibia,the most narrow part is located on 2/3 of the tibia,the sagittal diameter and coronary diameter of the narrow part is:CT:1.131±0.282 cm,1.083±0.214 cm,X-ray film:1.295±0.285 cm,1.234±0.385 cm.The distance between the tubercle of tibia and central axis is:CT:0.451±0.132 cm.According to the CT,we found that the nearer with the plateau,the denser the cancellous bone.The length of tibia cavity is:CT:32.565±2.611 cm,X-ray:33.786±2.861 cm.According to the above paramenters,our nails were designed as follows:bending part located at the 6.5 cm distal of the nail body;curvature is 12°;nail body diameter is 0.9 and 1.0cm;nail length is from 28 to 34cm;the distal end of the fork is 1.5～2.0cm longer than the main body.Conclusion Our newly disigned nail is suitable for Chinese adult according the above measurement and 110 cases treatment;one should choose a right nail according to the isthmic saggital diameter and wherether or not to ream.
出处
《骨与关节损伤杂志》
2001年第5期348-351,共4页
The Journal of Bone and Joint Injury
