三维内固定治疗骨盆后环不稳定骨折的生物力学研究

目的 探讨骨盆后环骨折脱位两种内固定方式的生物力学差异.方法 将6具成人新鲜尸体骨盆标本分别进行正常的生物力学测试,之后模拟Denis-Ⅰ型骨盆骶骨骨折,标本先后行改良Galveston系统固定与改良Galveston系统加骶骨棒固定骨盆后环,对固定后的骨盆进行垂直方向和扭转方向的骨盆生物力学测试.结果 在垂直压缩时,改良Galveston系统加骶骨棒固定组右侧骶髂关节垂直和水平位移比改良Galveston系统固定组小,但是两者之间差异无统计学意义(P＞0.05).在扭转压缩时,改良Galveston系统加骶骨棒固定组右侧骶髂关节水平位移比改良Galveston系统固定组小,两者之间差异有统计学意义(P＜0.05).结论 改良Galveston系统固定与骶骨棒固定叠加会增加骨盆后环的抗扭转稳定性.

Biomechanical study on three-dimensional internal fixation for unstable posterior pelvic ring fracture

Objective To compare the biomechanical difference of two internal fixation approaches for the posterior pelvic ring fracture dislocation.Methods Six fresh adult cadaver pelvic specimens were tested biomechanically.Then,the specimens were subjected to Denis-I sacral pelvic fracture.The specimen was first fixed with improved Galveston fixation and then with improved Galveston fixation plus sacral rod.Biomechanical tests were performed from vertical and reversed directions on the fixed pelvis.Results Under vertical compression,the biomeehanical value of the improved Galveston fixation plus sacral rod was lower than that of the improved Galveston fixation,with no statistical difference between two methods(P ＞ 0.05).Under the reversed compression,the biomeehanieal value of the improved Galveston fixation plus sacral rod was lower than that of the improved Galveston fixation,with statistical difference between two groups(P ＜ 0.05).Conclusion The improved Galveston fixation combined with sacral rod can increase the anti-reverse stability of the posterior pelvic ring.