"Y"形板在肱骨髁部骨折中的应用

目的探讨采用Y形钢板内固定治疗肱骨髁部骨折的疗效。方法本组17例肱骨髁部骨折,按AO／ASIF分类法:A3型5例,C1型14例,C2型5例,C3型3例,均采用Y形钢板内固定手术治疗。结果随访11～30个月,按改良Cassebaum评价,优11例,良4例,可2例,优良率88％。结论应用Y形钢板内固定治疗肱骨髁部骨折是一种较好的方法,可取得满意的疗效。     

股骨髁上骨折四种内固定的生物力学评估

目的：对股骨髁上骨折4种内固定方法进行生物力学测试评估，为临床治疗提供较全面，客观的依据，方法：取16具新鲜尸体股骨标本，造成股骨髁上骨折模型（AO分类的C1型），分别用股骨髁上逆行交锁髓内钉（GSHN），动力髁螺钉（DCS），L形髁钢板（L－CCP）,Ender钉固定，利用实验应力分析和有限元分析方法对股骨髁上骨折和内固定系统的力学性能进行比较研究。结果：在轴向应力实验中，GSHN固定优于DCS，L－CCP和Ender钉内固定（P＜0．01），在扭转实验中，GSHN和DCS优于L－CCP和Ender钉（P＜0．01），尤以DCS为最佳，结论：采用GSHN和DCS内固定生物力学强刚度最佳，优于其它内固定方法，值得临床推广应用。     

不同内固定器固定股骨髁上骨折的生物力学比较

背景：治疗股骨髁上骨折的内固定方法很多,其中主要有偏心位固定的钢板类和中心位固定的髓内钉类。由于两者生物力学特性的差异,在治疗股骨髁上骨折的临床疗效也不同。 目的：对治疗股骨髁上骨折的两种固定器进行生物力学对比,探讨两种固定器固定股骨髁上骨折时的应力分布差异,从而为临床选择理想的内固定器提供理论依据。 方法：选择12套成人尸体股骨,将股骨髁上横行锯断,制作股骨髁上骨折模型。将骨折标本解剖复位后,按照手术操作方法用微创内固定系统和逆行交锁髓内钉固定。在骨折断面及钉道周围共粘贴6个电阻应变片,然后将骨折模型分别置于Zwick Z100电子万能材料实验机及扭转试验机(RNJ-500)上,以线性载荷0-400 N、扭转载荷0-20 N•m加载,分析局部应力,测量两种固定器在相同载荷条件下骨折断面及钉道周围应力的大小和分布特点。 结果与结论：在实验载荷条件下,逆行交锁髓内钉组和LISS钢板组骨折断端和钉道周围应力均随着轴向载荷和扭转载荷的增大而增大。在同一轴向载荷下,逆行交锁髓内钉组较LISS钢板组在6个测试应变点应变值大(P < 0.01);在同一扭转载荷下,LISS钢板组较逆行交锁髓内钉组在6个测试应变点应变值大(P < 0.01)。 结果显示,逆行交锁髓内钉固定股骨髁上骨折中可明显降低应力遮挡,从而利于应力传导,并具有良好的抗扭转能力,从生物力学角度可以推广使用。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;组织工程全文链接：     

新型股骨转子间骨折内固定器(记忆合金钉板)的生物力学评价

目的:对治疗骨质疏松性股骨转子间骨折的新型内固定器进行生物力学评价。方法:设计一种新型的股骨转子间骨折内固定器,用福尔马林固定的经X线片证实为骨质疏松并排除骨折和肿瘤的尸体股骨标本11根,模拟股骨转子间骨折,随机分为记忆合金钉板固定组(6例)和DHS固定组(5例)并进行生物力学测试,比较两组股骨头垂直位移1mm时的压缩刚度、加载350N时的股骨头垂直位移、股骨颈扭转1°时的扭矩、扭矩为3.5Nm时股骨颈的扭转角度。结果:记忆合金钉板与DHS固定比较,上述指标经统计学分析,P值分别为0.930、0.248、0.417、0.622,差异无显著性意义;但记忆合金钉板较DHS固定,骨质的进一步破坏少,能保持股骨近段结构上的完整性。结论:记忆合金钉板内固定骨质破坏少、固定可靠,能有效治疗骨质疏松性股骨转子间骨折。     

单、双侧接骨板内固定治疗干骺端粉碎股骨远端骨折的生物力学比较

目的 比较单、双侧接骨板治疗干骺端粉碎股骨远端骨折的生物力学稳定性。方法22根人工股骨标本建立干骺端粉碎股骨远端骨折（AO分型：C2.3）模型,随机分成2组,每组11根。单钢板组用外侧远端解剖锁定板固定,双钢板组外侧用远端解剖锁定板、内侧用直型锁定接骨板固定。每组标本中5根进行垂直加压,3根进行循环垂直加压测试,检测干骺端内侧间隙压缩位移,剩余3根进行极限加压测试,记录固定失败时的最大负荷。结果 垂直加压测试中,单钢板组平均内侧压缩位移为(2.61±0.28) mm,双钢板组为(0.46±0.08) mm。循环垂直加压测试中,单钢板组平均内侧压缩位移为(1.56±0.12) mm,双钢板组为(0.43±0.05) mm。极限加压测试中,单钢板组平均最大负荷为(5 567±338) N,双钢板组为(9 147±186) N,每组差异都有统计学意义（P<0.05)。结论 双钢板固定干骺端粉碎股骨远端骨折的内侧抗压缩能力较单钢板固定显著增强,使股骨远端内侧结构更加稳定,有助于病人早期功能康复锻炼。     

骨干骨折压力侧皮质缺损钢板内固定的生物力学研究

目的 :评价压力侧骨皮质缺损时钢板内固定的即刻稳定程度 ,明确压力侧皮质骨块复位的重要性。方法 :6具新鲜股骨标本 ,于中段造成蝶形皮质缺损 ,测定正常股骨 ,单纯钢板内固定及对侧皮质骨块复位钢板内固定的垂直压缩、三点弯曲及抗扭转能力 ,比较不同固定方法在相同载荷下的位移。结果 :正常股骨在 5 0 0N垂直压力下的垂直位移 ,3 0 0N压力下的三点弯曲位移及 10N .m下的旋转角位移分别为 0 .82mm ,1.5 6mm和 0 .82° ,仅应用钢板于张力侧内固定后的三项位移分别为 8.2 9mm ,10 .5 9mm和9.11° ,应用钢板内固定对侧皮质骨块复位后分别为 1.78mm ,5 .15mm和 6.75° ,三项指标间均有非常显著性差异。结论 :当存在压力侧骨皮质缺损时 ,钢板固定骨块复位时的稳定性较单纯应用钢板内固定时好。应重视恢复钢板对侧皮质骨块的复位 ,恢复内侧的支撑力 ,以防止内固定的失败     

双扁形髓内钉系统的研制及生物力学比较研究

自行设计一种双扁形髓内钉系统用于股骨远段骨折内固定，它是用２枚扁钉由股骨内外髁捭插入，尾部通过横栓连接形成整体结构。将２９根股骨髁上截骨标本分别用双扁形髓内钉系统、Ｌ形髁钢板、Ｅｎｄｅｒ钉、Ｒｕｓｈ钉固定，施行非破坏性内收，过伸西方向抗弯及破坏性扭转测试，结果显示：本器械抗弯、抗扭性能明显优于Ｅｎｄｅｒ钉及Ｒｕｓｈ钉；过伸抗弯性能与Ｌ形髁钢板比较无显著性差异；其自身过伸抗弯优于内收抗弯性能。     

骨骺生长滑动钢板的设计及生物力学研究

目的:通过生物力学试验对骨骺部生长滑动钢板生物力学性能进行评估,检测其避免产生骨骼纵向生长抑制的特殊结构是否影响其力学性能。方法:根据青少年股骨髁部的解剖特点设计出适用于青少年儿童股骨髁部骨折的内固定滑动钢板,并选用7具新鲜人体尸体股骨标本并制作骨折模型,行左右侧对比,左侧行滑动钢板固定,右侧行普通钢板固定,用MTS实验机进行三点弯曲、轴向压缩、扭转试验测试比较两种钢板力学性能。结果:力学试验显示轴向刚度(N/mm):滑动钢板数值为1766.88±106.30,普通钢板数值为1831.74±62.80,P=0.877>0.05;三点弯曲(跨距:8cmN/mm):滑动钢板数值为752.17±31.44,普通钢板数值为793.84±24.52,P=0.838>0.05;抗扭转(Nm/度):滑动钢板数值为3.29±0.26,普通钢板数值为3.62±0.15,t=-0.544,P=0.606>0.05。三项指标滑动钢板和普通钢板之间差异均无显著性。结论:可滑动钢板具有一定的力学强度,能够为骨折愈合提供可靠的固定强度。     

股骨髁间骨折采用L形髁钢板+螺栓内固定的生物力学分析

目的：论证股骨髁间骨折采用Ｌ型髁钢板＋螺钢板＋螺栓,Ｌ形髁钢板,加压钢板＋螺栓固定,比较三种不同内固定方式的优劣,并为临床提供科学依据。方法：用９具新鲜股骨尸标本以实验应力分析法和有限元现论计算法对股骨髁间骨折内固定进行力学分析。结果：证明Ｌ形髁钢板＋螺椎内固定优于Ｌ形髁钢板,加钢板＋螺栓固定,应力和髁间位移两者具有显著性差异（Ｐ〈０．０１）结论：Ｌ形髁钢板＋螺栓联合固定是治疗股骨髁间骨折较好的内     

股骨远端骨折采用股骨髁上交锁髓内钉固定的生物力学研究与临床应用

目的：对股骨远端骨折不同内固定方法进行定量生物力学评价,为临床治疗提供理论依据。方法;从理论和实验上对股骨Y形骨折,应用三种不同内固定方法加以固定,进行实验应力分析。结果：发现在受同等载荷条件下,髁上交锁髓内钉固定方法最佳,而采用加压钢板固定的股骨髁强刚度较度（P＜0．05）。结论：采用股骨髁上交锁髓内钉固定方法优于其它内固定方法,值得临床推广应用。     

双侧股骨内外侧髁解剖学

目的测量股骨髁的某些形态参数,确定股骨髁在形态方面是否存在左右差异。方法收集郑州大学解剖学教研室的股骨111个(左侧64个和右侧47个),用游标卡尺测量相关数据。结果股骨的平均双髁宽度为左侧(7.79±0.56)cm,右侧(7.66±0.40)cm(P0.05)。内侧髁长度相对值是左侧(6.09±0.53)cm和右侧(5.97±0.41)cm(P0.05);外侧髁长度为左侧(6.06±0.43)cm和右侧(6.00±0.41)cm(P0.05);髁间宽度为左侧(1.92±0.24)cm和右侧(1.83±0.16)cm(P0.05);髁间深度为左侧(2.94±0.25)cm和右侧(2.90±0.25)cm(P0.05)。提示双侧的股骨髁各项数据在统计学上没有明显的差别。结论双侧股骨髁的一致性可能是设计全膝关节假体的理论基础,健侧膝关节可用于术前制作患侧模板。     

Prominent,constricted ears with malformed condyle of the mandible

We report on several relatives in 5 generations of one family with prominence of the ears, with a marked constriction at the junction between the lower and middle thirds of the pinna. Computerized tomography and radiographs in the propositus and his affected father showed abnormalities of the condyle of the mandible. The propositus had more severe changes in the condyle with microstomia and reduced range of motion of the mandible in the temporomandibular joint. There was no hearing loss or abnormalities of the bones of the middle ear. Am. J. Med. Genet. 75:449–452, 1998. © 1998 Wiley-Liss, Inc.     

The correlation between femoral condyle radii and subject height

In the sagittal plane, the distal femoral condyles can be modeled using anterior and posterior circle segments. The aim of this study was to investigate how the radii of these segments vary with subject height. The MRI scans of 20 male and 20 female knees were analyzed with a computer to extract the radii of each condyle segment. These radii were then correlated with the patient's height. The anteromedial radii ranged from 22.6 to 32.6 mm. The posteromedial radii ranged from 15.4 to 26.3 mm. The anterolateral radii ranged from 19.7 to 30.4 mm. The posterolateral radii ranged from 15.2 to 23.6 mm. The radii had a strong correlation with patient height, with some differences between sexes. Linear regressions of the data yielded equations for estimating condyle radii from height. These radii estimations can be helpful in the clinical assessment of knee movement and treatment outcome. Clin. Anat. 22:517–522, 2009. © 2009 Wiley‐Liss, Inc.     

周期性张应力促进兔髁状突软骨细胞的增殖

背景：髁状突是下颌最重要的生长区之一,终生具有生长改建能力。在体内条件下,细胞力学的功能研究因其所处生理环境的复杂性、刺激因素传导的不定向性、实验条件的不易控制性而很难得到满意结果,应力刺激对髁状突软骨细胞的直接影响需要进一步行体外研究。 目的：观察周期性张应力对体外培养兔髁状突软骨细胞生长增殖的影响。 方法：体外分离培养及鉴定兔髁状突软骨细胞,在细胞培养至第3代时使用细胞加力装置对细胞施加强度为10%,频率为6循环/min的周期性张应力,作用时间分别为1,6,12和24 h,并设置未加力组作为对照。应用流式细胞仪检测细胞生长周期,应用MTT法分析细胞的增殖活性。 结果与结论：在周期性张应力下,髁状突软骨细胞流式细胞仪检测结果显示在加力6 h和12 h,加力组细胞生长周期开始有显著性变化,在24 h达到实验最大值,差异有显著性意义(P < 0.01)。MTT检测结果示细胞生长活跃,在6,12 h与对照组有明显变化,在24 h达到实验最大值,差异有显著性意义(P < 0.01)。提示周期性张应力可明显促进髁状突细胞增殖,在24 h内具有持续促进作用。 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程全文链接：     

An optimized medial parapatellar approach to the goat medial femoral condyle

Goats or sheep are the preferred animal model for the preclinical evaluation of cartilage repair techniques due to the similarity of the goat stifle joint to the human knee. The medial femoral condyle of the stifle joint is the preferred site for the assessment of articular cartilage repair, as this is the primary location for this type of lesion in the human knee. Proper surgical exposure of the medial femoral condyle is paramount to obtain reproducible results without surgical error. When applying the standard human medial arthrotomy technique on the goat stifle joint, there are some key aspects to consider in order to prevent destabilization of the extensor apparatus and subsequent postoperative patellar dislocations with associated animal discomfort. This paper describes a modified surgical technique to approach the medial femoral condyle of the caprine stifle joint. The modified technique led to satisfactory exposure without postoperative incidence of patellar luxations and no long‐term adverse effects on the joint.     

CT-based morphological analysis of the posterior femoral condyle in patients with trochlear dysplasia

Background

The anterior part of the distal femur in trochlear dysplasia has been well investigated; however, to date, posterior morphological characteristics have not been well studied. This study aimed to evaluate whether the posterior femoral condyle in patients with trochlear dysplasia differs from those without trochlear dysplasia.

Comparison of medial and lateral posterior femoral condyle articular cartilage wear patterns

Background

While degenerative changes to the articular cartilage of the anterior and distal portions of the femoral condyles have been well studied in the literature, the changes that occur on the posterior femoral condyle are not as clear. The purpose of this study was to assess the difference in articular cartilage thickness between the medial and lateral posterior femoral condyles in knees undergoing unicompartmental knee arthroplasty.

69例股骨髁骨折的手术治疗分析

目的探讨手术治疗股骨髁部骨折的临床效果。方法对我院2009年9月至2011年9月收治的69例股骨髁部骨折患者手术后的临床资料进行回顾性分析,了解患者手术治疗后随访情况,评估患者术后骨折愈合和关节活动恢复效果。结果对所有患者随访6-18个月,按照Kolmenrt评定标准对临床疗效进行判定,其中评分为优48例（69．57％）,良17例（24．64％）、一般3例（4．35％）、差1例（1．44％）,优良率为94．21％。结论手术治疗股骨髁骨折疗效肯定,并发症少,骨折愈合较好,总体疗效令人满意。     

下颌骨髁突支架的个体化设计与初步构建

Objective To explore the method of designing and manufacturing the mandibular condyle scaffold individually by rapid prototyping technologies and reverse engineering.Methods Cranial CT image data were processed in Mimics software for reconstruction of one side of ramus of mandible, and were inputted into Solidworks software to edit by the format of stl. A negative mold of the mandibular condyle scaffold was obtained. The mold was fabricated by resin materials utilizing rapid prototyping. Biomaterials were filled into the resin mold. When the materials were cured, we eliminated the resin mold and acquired a multi-pores three dimensional mandibular condyle scaffold model. The general morphology and microstructure of the scaffold model were observed by scanning electron microscopy (SEM). Results The mandibular condyle scaffold made of biomaterials was accordance with the one our computer designed. SEM observation revealed that the model was made of collagen in the cartilage-like layer and calcium phosphate cement/poly (lactic- co-glycolic acid) in the bone-like layer. Conclusion It is feasible to fabricate mandibular condyle scaffold individually by using reverse engineering and rapid prototyping technology.     

Median (third) occipital condyle

Abnormalities of the craniovertebral junction, most of which are associated with the occipital bone, are of interest not only to anatomists but also to clinicians because many of these deformities produce clinical symptoms. The occipital bone in humans is formed by the fusion of the sclerotomes corresponding to the roots of the hypoglossal nerve. In lower vertebrates, the cranial half of the first cervical sclerotome forms a separate bone between the atlas and occipital bone, the proatlas; in man it may contribute to anomalous structures around the foramen magnum. One such structure, a median occipital condyle, which exhibited an articular facet for the odontoid process, was observed in an adult male skull at the anterior margin of the foramen magnum. This anomaly is discussed in light of available literature.