解剖型矩形髓内钉的生物力学评价及临床应用初步报告

目的：为进一步完善矩形髓内钉在胫骨骨折中的应用，克服其操作时容易交叉，对胫骨上段骨折固定力学性能较差等不足，作者设计了胫骨解剖型可屈性矩形髓内钉，并将其与原矩形髓内钉进行生物力学比较后初步应用于临床。方法：将新鲜成人胫骨标本制造胫骨上１／３ 与中１／２ 横断骨折模型，分别用２ 种矩形髓内钉进行固定，并进行生物力学测试。结果：对胫骨上１／３ 骨折，解剖型矩形髓内钉的抗弯能力是普通矩形髓内钉的２－５ 倍（ 冠状面） 和４－３ 倍（ 矢状面） ，抗扭能力是后者的３－９ 倍；对胫骨中段骨折，解剖型矩形髓内钉的抗弯能力是后者的１－８ 倍（ 冠状面） 和１－５ 倍（ 矢状面） ，抗扭能力为１－６ 倍。结论：解剖型矩形髓内钉是在研究胫骨髓腔解剖学特点基础上进行设计的，其生物力学特性优良，初步临床应用已取得了较好效果，值得进一步推广。

A Preliminary Report of A New Anato mic Based Flexible Rectangle Shaped Intra medullary Nail :Bio mechanical Evalua tion And Clinical Use

Objective :In order to im prove the use of the rectangle shaped intram edullary nail(RSIN)in the tibial fracture , overcom e their defects of easy to cross while operation and disable to fix firmly w hen used in the upper tibial fracture ,a new anatomic based flexible rectangle shaped intra medullary nail( AFRIN) was designed and evaluated by bio mechanical tests and clinical use .Methods :Six pair offresh adult tibias were divided into four groups .The upper one third and middle one third trans verse tibialfracture m odels were produced .The RSIN and AFRIN were fixed to the models and tested separately .Results :The bending mo ment of AFRINis 2-5 times (in sagittal plane)and 4-3 tim es(in coronary plane)to RSINin upper one third fracture m odels and 1-8 times and 1-5 timesin the middle one second fracture m odels .The twist m om ent are 3-9 times and 1-6 tim es separately .Conclusions :The ABFINis designed on the base of studying the tibial medullary cavity shape ,its easy to operationand biom echanical advantages m ake the preliminary clinical use good .