髋臼周围肿瘤切除腓骨重建骨盆环的应变研究

目的探讨髋臼周围肿瘤切除后腓骨重建骨盆环的应变。方法选择健康成人尸体骨盆标本6例，按照Ennecking对骨盆肿瘤Ⅱ型切除标准行髋臼周围切除，行腓骨重建骨盆环；双足站立位，在0～500N垂直分级载荷下，采用应变片及应变花对重建后骨盆关键部位的应变进行检测，并和正常骨盆各对应点的应变值进行对照。结果与正常组比较，重建骨盆各测点应变变化较大。在双足站立位，500N垂直载荷下，重建侧骨盆之骶块最大主应变明显小于完整骨盆（P〈0．05）；而健侧髋臼弓状线应变稍增大；双侧耻骨上支应变绝对值增大、由正常状态下的压应变变为拉应变。结论利用人体双足站立位髋臼周围肿瘤Ⅱ型切除腓骨重建骨盆环的生物力学模型进行检测；用腓骨重建的骨盆具有与正常骨盆相似的应变，但不能完全恢复骨盆正常的应力传导功能。

Study on the strain of the pelvic ring reconstructed with fibula following periacetabular tumor resection

Objective To analyze the straining on the reconstructed pelvic ring following periacetabular tumor resection. Methods Six pelvic specimens of healthy adult cadavers were involved in this study. The periacetabular resection was performed just as Ennecking＇s type 11 tumor resection and the pelvic ring was then reconstructed with fibula. The strains in the key regions of both the normal and the reconstructed pelvis were measured by strain gauges and rosettes when axial loading from the proximal lumbar was applied by MTS load cell in the gradient of 0 - 500N with body in bilateral foot standing status. Then a comparative study of the strain values was done between the two groups. Results Compared with that in the normal pelvis, the change of strains in the reconstructed pelvis was found bigger. Under an axial loading of 500N in bilateral foot standing the strain change on the lateral sacral mass of the reconstructed pelvis was significantly smaller than that of the normal pelvis （ P 〈 0.05 ）, while the strain on the linea arcuata of opposite healthy iliac bone only increased a little. The absolute value of the strain on the superior rami of the pubis increased with normal compressive strain altering to tensile strain. Conclusion Measurement on the biomechanical models of pelvic ring reconstruction following periacetabular tumor type 11 resection revealed that after reconstruction with fibula the pelvis regained the similar strain with the normal one, but could not restore the normal stress conducting function of the pelvis .