上肢骨干天鹅型记忆接骨器的设计与临床应用

目的：研究应用于上肢骨干骨折与骨不连内固定的新型记忆合金接骨器。方法：利用镍钛合金与上肢骨干解剖生理的特性和特征，采用光弹，电测及三维有限元法研制天鹅型记忆接骨器（SMC），临床应用于锁骨、肱骨、尺桡骨干骨折与骨不连188例243根，平均随访2．25年。结果：SMC在轴向多点位抗剪、折、旋、持骨力98．40－125．05N；在纵向，将152－196N的记忆应力作用于骨断端。骨不连92例106例，平均术后3．8个月，不连处为类骨板样骨替代，骨折93例134根，平均术后2．6个月骨折处为骨板样愈合，全部病例无感染，无取出本器后再骨折和因本器所致的关节功能障碍，优良率98．76％，结论：SMC多点位轴向持骨，纵向加压、是治疗上肢骨干骨折与骨不连新而有效的技术与方法。

Design and clinical application of swan-like memory compressive connector for upper limb diaphysis

Objective:To develop a new memory compressive connector for treating fracture and nonunion of upper limb diaphysis. Methods:According to the special mechanics action of nitinol memory alloy and the anatomic mechanics characters of upper limb diaphysis, a nitinol connector named swan like memory compressive connector (SMC) was designed. The biomechanics test included photoelasticity, electrometric method and three dimensional (3D) finite element analysis were employed. In clinical application, the connector had been used in clavicle, humerus, ulna and radius fractures and nonunion (in 188 cases 243 bones). The average follow up time was 2.25 years. Results:The multiple points holding force of SMC was 98.40 125.05 N, which was axially anti shearing, anti bending and anti torsion. And there were 152 196 N memorial compressive force at the fracture site. In nonunion group, after an average of 3.8 months, the nonunion sites were substituted by plate like bone in 106 bones in 92 cases. In fracture group, after an average of 2.6 months, the fracture sites were substituted by plate bone in 134 bones in 93 cases. There were no infection, refracture after remove of SMC and dysfunctions of joint caused by SMC. The rate above good was 98.76%. Conclusion:SMC, which holding bone on multipoint axially, and compressing bone longitudinally, is a new and effective technique for fracture and nonunion of upper limb diaphysis.