加压空心钉式外固定架与动力髋螺钉治疗老年股骨转子间骨折的生物力学比较

目的评价加压空心钉式外固定架(PHN-EFP)和动力髋螺钉(DHS)治疗老年股骨转子间骨折的生物力学效果。方法采集8具新鲜人体股骨标本,进行贴片模拟临床生物力学试验,比较两种固定方法的生物力学特性。结果与DHS相比,PHN-EFP在抗压、抗弯和抗扭等生物力学性能上具有优势,失效载荷高于DHS 13%,差异具有统计学意义(P<0.05)。结论 PHN-EFP治疗老年股骨转子间骨折具有生物力学优势,手术操作方便,固定可靠,尤其对于老年股骨转子间骨折的治疗是理想的术式。

The biomechanical evaluation of pressured hollow nail-external fixation and dynamic hip screw for intertrochanteric fractures of aged

Objective To evaluate biomechanical performance of pressured hollow nail-external fixation(PHN-EFP) and dynamic hip screw(DHS) via biomechanical test on embalmed femurs of human cadavers.Methods 8 matched pairs of embalmed femur of the aged cadavers which have similar bone mineral density scanned by DEXA were selected,the fracture model was created through the intertrochanteric ridge by hand-saw and was fixed with PHN-EFP(experimental group,group A) or DHS(control group,group B).The biomechanical test to simulate clinical application was manipulated to contrast biomechanical performance of both sides.Results the fracture model fixed with PHN-EFP was predominant over DHS in biomechanical performance,PHN-EFP provide adequate anti-bending stiffness stability and satisfactory anti-torsion biomechanical properties.Conclusions PHN-EFP can be used as an effective method to treat intertrochanteric hip fractures of aged with the advantages of simple procedure,minimal invasion and hemorrhage,stable fixation.