加压钢板固定术后内植物失败的生物力学分析

目的 探讨内固定失败的生物力学原因。方法 在用有限元方法对普通加压钢板固定股骨干骨折进行应力分析的基础上,分析了内植物失败病例34例的失败原因。结果 除手术操作和内植物自身的缺陷外,许多因素如钢板的安放位置、钢板长度、螺钉安放不足、螺钉选择不当、骨折端有间隙、骨皮质有缺损等方面均影响骨折的稳定性和钢板的安全性。结论 应强调骨折内固定中的生物力学原则,尽可能避免应力集中,以保证内植物确实达到坚强有效的内固定作用。

BIOMECHANICAL ANALYSIS OF INTERNAL IMPLANT FAILURE AFTER INTERNAL FIXATION OF COMPRESSING STEEL PLATE

Objective To study the biomechanical reasons of internal fixation failure. Methods On the bases of FEM stress analysis of internal fixation of femur fractue with common compressing steel plate, 34 internal implant failures were reported. Results Besides the manipulation of operation and the limitation of internal implant itself, many factors such as the position and the length of steel plate, screws' not being set completely, improper selection of screw, gaps in bone cross - section, and defects of cortical bone all have important influence on the stability and safety of steel plate. Conclusion Biomechanical influence should be emphasized in the internal fixation of bone fracture, stress concentration should consider properly, so that the rigid and effective fixation function of internal implant could be ensured.