改进型逆行旋入钉的生物力学测试

背景：目前，对于肱骨骨折主要以顺行旋入式髓内钉和传统带锁髓内钉治疗为主，但是该方法容易引起患者肩袖损伤等。相关研究结果显示，逆行髓内钉能够解决上述问题。 目的：分析改进型逆行旋入钉的生物力学测试结果，为临床上进一步推广使用提供依据。 方法：①根据人体肱骨解剖特点，对肱骨标本进行生物力学测试。②选取西安交通大学医学院附属红会医院骨外科2013年12月至2015年1月收治的80例肱骨骨折患者，采用随机数字方法将患者分为改进后旋入钉组和原型钉组，各40例，分别植入改进型钉和原型钉。 结果和结论：①改进后旋入钉抗轴向压缩、抗拉伸、抗扭转、抗弯曲性能显著优于原型钉(P < 0.05)。②改进后旋入钉组患者临床疗效优良率显著高于原型钉组。两组患者植入后均未出现感染，金属断裂和内固定松动等并发症。提示和传统旋入钉相比，改进型逆行旋入钉优势较多，生物力学设计更合理，且操作也更加简单，患者治疗后并发症发生率较低，适合临床应用。中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Biomechanical test of improved retrograde screwed nail

BACKGROUND:At present, humeral fractures can be mainly treated by antegrade screwed intramedullary nail and traditional interlocking intramedullary nail, but above methods easily induce rotator cuff injury. Results of relevant study revealed that retrograde intramedullary nailing can solve the above problems. OBJECTIVE:To analyze biomechanical test results of retrograde improved screwed nail and to provide a basis for the further clinical use. METHODS:(1) According to the anatomical characteristics of the human humerus, specimens of humerus were subjected to biomechanical test. (2) A total of 80 cases of humeral fractures were selected from the Orthopeadic Surgery of Xi’an Red Cross Hospital Affiliated to Xi’an Jiaotong University School of Medicine from December 2013 to January 2015. Patients were randomly divided into improved nail group and prototype nail group (n=40), which were given improved nail and prototype nail, respectively.  RESULTS AND CONCLUSION:(1) Anti-axial compression, anti-tension, anti-torsion, and anti-bending functions were significantly better in the improved screwed nail than in the prototype nail (P < 0.05). (2) The excellent and good rate of clinical curative effects was significantly higher in the improved nail group than in the prototype nail group. No infection, metal fracture or internal fixation loosening occurred in all patients of the two groups. These findings suggest that compared with traditional screwed nail, retrograde improved screwed nail had more advantages, more reasonable biomechanical design, more simple operation, and lower incidence of complications, so it is fit for clinical application.