股骨粗隆间骨折采用改良L形钢板内固定的生物力学原理与临床应用

作者自1994年始采用自行设计L形钢板内固定治疗不稳定股骨粗隆间骨折60例，平均随访25个月，X线片显示骨折愈合时间6～13周，平均8．9周，伤肢功能在3个月内基本恢复正常，无骨折延迟愈合及髋内翻现象。为论证改良L形钢板的优点，本文采用8具新鲜尸股骨沿着它的外侧、内侧骨皮质粘贴6个应变片，观察股骨近端应变和位移分布，以检验改良L形钢板固定粗隆间骨折的效果。在实验前后将股骨粗隆造成二部分或四部分骨折。利用实验结果给制成应变和位移图，并与鹅头打固定组相比较。在载荷加至1800N时比较两种内固定器械的生物力学性能。结果表明，在治疗不稳定粗隆间骨折中，L形钢板比鹅头钉更具有生物力学的优势。

BIOMECHANICAL PRINCIPLE AND CLINICAL APPLICATION OF INTERTROCHANTERIC HIP FRACTURES USING L STEEL PLATE INTERFIXATION

In this paper, we introduce a development of clinical L steel plate since 1994 year, which useddevice for the interfixation of unstability fracture 60 cases in the intertrochanteric hipfractures.Sixty cases were treated in this manner, a long-term follow-up 25 months in average revealedoverall excellent results. Bone union was obtained in 8.9 weeks with satisfaxtory function of thelimbs in all patiebts. We examined the effect of the L steel plate on strain and displacent in theproximal femur, using eight cadaver femora instrumented with six strain gauges along the medialand lateral cortices. Before and after experimentally created two-part and four-part fractures. Strainpatterns and screw motion were compaerd. With previously obtained values for a sliding hip screwdevice. the biomechanical characteristics of the two devices were loaded to 1800N.Experimentalresults showed, the L steel plate appear to offer distinct biomechanical adventage over the SHS inthe treatment of unstable intertrochanteric fractures.