• 医学文献
  • 知识库
  • 评价分析
  • 全部
  • 中外期刊
  • 学位
  • 会议
  • 专利
  • 成果
  • 标准
  • 法规
  • 临床诊疗知识库
  • 中医药知识库
  • 机构
  • 作者
热搜词:
换一批
论文 期刊
取消
高级检索

检索历史 清除

医学文献 >>
  • 全部
  • 中外期刊
  • 学位
  • 会议
  • 专利
  • 成果
  • 标准
  • 法规
知识库 >>
  • 临床诊疗知识库
  • 中医药知识库
评价分析 >>
  • 机构
  • 作者
热搜词:
换一批

锁定钢板结合不同腓骨植骨方式治疗肱骨近端骨折的生物力学稳定性分析

Biomechnical stability of proximal humeral fracture fixated by a locking plate plus different fibular allografts

摘要:

目的 通过生物力学实验观察髓腔内腓骨放置方式的改变是否能改变肱骨近端骨折模型的抗内翻作用. 方法对6例(12肩)尸体标本的肱骨外科颈作楔形截骨,男3例,女3例;死亡时平均年龄为83岁(75~87岁).将尸体左、右双侧肱骨随机平均分入A、B两组(n=6),取自体腓骨植骨(不分左右).所有腓骨均于腓骨干最细小、粗细均匀处截骨.其中A组采用常规竖直放置腓骨(截取8 cm),B组斜行放置腓骨(截取6 cm).使用肱骨近端内固定锁定系统(PHILOS)进行固定后,对肱骨近端反复施加内翻应力,直到模型出现内固定失效,记录并比较两组的加压次数、造成1 mm形变的加压次数以及两组模型每次加压后的平均形变量. 结果 A、B两组模型均可以观察到肱骨头螺钉切割外侧皮质,钢板发生了不同程度的松动.A组、B组发生内固定失效时的加压次数分别为(31 338±5 994)、(30 608±8 015)次,发生1 mm形变时需要的加压次数分别为(2 808±1 501)、(3 153±2 024)次,每次加压造成的平均形变量为(0.52±0.39)、(0.53±0.47) μm/次,以上项目两组间比较差异均无统计学意义(P>0.05). 结论相较肱骨髓内竖直放置腓骨而言,倾斜放置腓骨在抗内翻稳定性方面并没有明显优势,因此在手术中无需使用更复杂的倾斜放置方式.

更多
abstracts:

Objective To investigate the ability of locking plate construct plus fibular autograft that varies in way of augmentation to withstand varus stresses in a model of proximal humeral fracture.Methods Wedge osteotomy was conducted in the humeral surgical necks of 12 shoulders from 6 cadaveric specimens to create models of proximal humeral fracture.There were 3 males and 3 females;their average age at death was 83 years (from 75 to 87 years).The 12 left and right cadaveric humeri were randomly divided into equal groups A and B (n =6) for autogenous iliac bone graft.All the fibular autografts were harvested without distinction from the thinnest and even part of the fibular shaft.A fibular autograft of 8 cm was placed vertically in group A while a fibular autograft of 6 cm was placed slantly in group B.After the fractures were fixated with the proximal humerus internal fixation locking system (PHILOS),varus stress was repeatedly applied to the proximal humerus until the internal fixation failed in the fracture model.The 2 groups were compared in terms of number of compression,number of compression leading to 1 mm deformation,and average shape variable after each press.Results Cut-out of the lateral cortex of the humeral head by the humeral screw and plate loosening to different extents were observed in both groups.The number of compression leading to internal fixation failure was 31,338 ± 5,994 for group A and 30,608 ± 8,015 for group B;the number of compression leading to 1 mm deformation was 2,808 ± 1,501 for group A and 3,153 ±2,024 for group B;the average shape variable after each press was 0.52 ±0.39 μm/time for group A and 0.53 ±0.47 μm/time for group B.All the above comparisons between the 2 groups showed no significant differences (P > 0.05).Conclusion As locking plate construct plus slant fibular autograft augmentation provides no more strength to withstand repetitive varus stresses than locking plate construct plus vertical fibular autograft augmentation,it is not necessary to adopt the former way of augmentation in clinic practice for proximal humeral fracture.

More
  • 浏览:141
  • 下载:172

加载中!

相似文献

  • 中文期刊
  • 外文期刊
  • 学位论文
  • 会议论文

加载中!

加载中!

加载中!

加载中!

扩展文献

特别提示:本网站仅提供医学学术资源服务,不销售任何药品和器械,有关药品和器械的销售信息,请查阅其他网站。

  • 客服热线:4000-115-888 转3 (周一至周五:8:00至17:00)

  • |
  • 客服邮箱:yiyao@wanfangdata.com.cn

  • 违法和不良信息举报电话:4000-115-888,举报邮箱:problem@wanfangdata.com.cn,举报专区

官方微信
万方医学小程序
new翻译 充值 订阅 收藏 移动端

官方微信

万方医学小程序

使用
帮助
Alternate Text
调查问卷