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Gamma钉远端锁钉对股骨粗隆间骨折应力分布的影响
引用本文:赵广跃,侯得门.Gamma钉远端锁钉对股骨粗隆间骨折应力分布的影响[J].第四军医大学学报,1997,18(3):270-273.
作者姓名:赵广跃  侯得门
作者单位:第四军医大学西京医院骨科,西安交通大学材料力学实验室
摘    要:研究Gamma钉固定股骨粗隆间骨折远端使用一枚锁钉是否影响股骨近端的应力分布。方法;在3对新鲜尸体股骨近端内外侧皮质上设置6枚电阻应变片,测定不同稳定状态的粗隆间骨折使用其远端一枚或两枚锁相对股骨近端应力分布的影响。随着骨折稳定性下降,Gamma钉能承担大部分股骨近端尤其是经肌骨矩的载荷,这虽然有利于骨折早期愈合,但不利于后期改建。

关 键 词:内固定  生物力学  股骨骨折

Biomechanical evaluation of strain distribution of the proximal femur locked with one distal screw in Gamma nail
Zhao Guangyue ,Han Yisheng ,Hou Demen ,Li Hua ,Li Rensheng.Biomechanical evaluation of strain distribution of the proximal femur locked with one distal screw in Gamma nail[J].Journal of the Fourth Military Medical University,1997,18(3):270-273.
Authors:Zhao Guangyue  Han Yisheng  Hou Demen  Li Hua  Li Rensheng
Institution:Zhao Guangyue 1,Han Yisheng 1,Hou Demen 2,Li Hua 2,Li Rensheng 1 1Department of Orthopedics,Xijing Hospital,Fourth Military Medical University,Xi'an 710033 2Division of Machanics Materials,Xi'an Jiao Tong University
Abstract:Objective: A biomechanical study was performed to analyze the strain distributions of proximal femurs in the experimental intertrochanceric fractures. Methods: A total number of 6 fresh cadaver femurs were selected to form two part or four part fracture models. Six straingauges were placed on the surface of medial and lateral cortices of the models to evaluate the strain alterations of proximal femurs, and the models were fixed by either one or two distal interlocking screws. Results: The Gamma nail represented the excellent biomechanical characteristics of bearing considerable amount of loading on proximal femur with the decrease of fracture stability, especially on the calcar area.The strains on proximal femurs might be available for fracture healing, but may affect bone remoldeling due to the influences of stress shielding. Conclusion: According to the results, the insertion of one or two distal interlocking screws does not change the patterns of proximal femoral strain, and stress focus is shown on the lateral cortex near the distal screw hole, which might play some role in the occurrence of secondary fracture of femur at the tip of the nail. The Gamma nail with one distal interlocking screw seems to be feasible clinically.
Keywords:intertrochanteric fracture  internal fixation  biomechanics
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