人工股骨头置换治疗粗隆间骨折假体柄初始稳定性的生物力学研究

Biomechanics of initial stability of intertrochanteric fractures treated with cemented femoral head

  • 摘要: 目的 本研究通过生物力学实验评估小粗隆复位固定对假体柄稳定性的影响。方法 应用新鲜冷冻湿润成年尸体股骨标本和SQK型人工双动半髋关节假体制作三组实验试件:常规骨水泥型人工双动股骨头置换,模拟粗隆间骨折后复位固定小粗隆的骨水泥型人工双动股骨头置换,骨水泥重建股骨距并置入人工双动股骨头后将小粗隆骨折块复位。将试件进行10 000次循环测试,测定每个试件每隔1 000次循环假体柄的下沉移位数据。结果 时间-位移曲线显示,三个试验组的轴向位移随循环次数增加而增大,其中常规置换组在所有时间节点的位移均值最小,骨水泥重建组的位移均值最大。三个试验组试件完成最终第10 000次循环测试后,其轴向位移数据的均值差异不具有统计学意义;常规置换组的位移均数最小,数据的变异程度也最小;小粗隆固定组与骨水泥重建组之间,骨水泥重建组位移均数和变异程度更大。结论 在粗隆间骨折的两个实验组中假体柄的下沉趋势整体大于常规骨水泥型人工股骨头置换组,骨水泥重建股骨距组的位移数据较小粗隆固定组变异及下沉趋势更大。

     

    Abstract: Objective To study whether reduction fixation of lesser trochanter influences the stability of prosthesis through biomechanical experiments. Methods Freshly frozen cadaveric femur samples and SQK hip-joint prosthesis were used for normal cement hemiarthroplasty,lesser trochanter fixation,and cement reinforcement,respectively.Vertical migration data were detected when the prosthesis was tested 10 000 times. Results The time-migration curve showed that the vertical migration in 3 groups increased with the number of cycles.The vertical migration value of prosthesis was the smallest for normal cement hemiarthroplasty and the greatest for cement reinforcement at all time points.No statistical difference was found in vertical migration value of prostheses for lesser trochanter fixation and cement reinforcement after they were tested 10 000 cycles.The mean vertical migration value and variation were the smallest for normal cement hemiarthroplasty and the greatest for lesser trochanter fixation and cement reinforcement. Conclusion The vertical migration value of prosthesis is greater for lesser trochanter fixation and cement reinforcement.The vertical migration value and variation of prosthesis are greater for cement enforcement than for lesser trochanter fixation.

     

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