一种用于治疗股骨干骨折的新型髓内钉固定装置：生物力学研究

A new intramedullary nailing device for the treatment of femoral shaft fractures: a biomechanical study.

作者信息

Wang Guodong, Pan Tao, Peng Xinsheng, Wang Jun

机构信息

Department of Orthopaedics of The Sixth Affiliated Hospital of Sun Yat-sen University, No.19, Yuancuxin Street, Tianhe District, Guangzhou, Guangdong Province, China.

出版信息

Clin Biomech (Bristol). 2008 Mar;23(3):305-12. doi: 10.1016/j.clinbiomech.2007.10.017.

DOI:10.1016/j.clinbiomech.2007.10.017

PMID:18079030

Abstract

BACKGROUND

The treatment of choice for early mobilization of femoral fractures is surgery, which traditionally employs plates and screws or intramedullary nails. We examined the biomechanical properties of a new femoral nail system. The new intramedullary propping nailing system, made of a stainless-steel alloy, consists of a nail shaft, inner rod, tensile screw, end cape and two interlocked screws.

METHODS

Intramedullary propping nailing biomechanics was compared with that of the Grosse and Kempf nail when securing transverse fractures in 10 pairs of cadaveric femurs. The axial compressive, bending, torsional stiffness, and strain values were calculated.

FINDINGS

The intramedullary propping nailing system had torsional stiffness (0.50 Nm/ degrees ) and bending stiffness (699.74 and 670.84 N/mm of lateral and frontal bending, respectively) comparable with the Grosse and Kempf nail (0.35 Nm/ degrees , 644.85 and 606.32 N/mm of lateral and frontal bending, respectively). Intramedullary propping nailing system produced a significantly higher compressive stiffness (1.67 and 1.50 x 10(6) N/mm, respectively) than the Grosse and Kempf nail in the medial and anterior aspects (0.86 and 1.32x10(6)N/mm, respectively). Although no significance was found in comparison with Grosse and Kempf of the strain of each aspect, intramedullary propping nailing system yielded a significantly better-distributed strain (F=1.007, P=0.401).

INTERPRETATION

Biomechanically, the intramedullary propping nailing system is safe and able to provide good abutment of the nail to the bone. The intramedullary propping nailing system produces a more extensive and tight contact between the nail and bone than the application of Grosse and Kempf nail.

摘要

背景

股骨骨折早期活动的首选治疗方法是手术，传统上采用钢板螺钉或髓内钉。我们研究了一种新型股骨钉系统的生物力学特性。这种新型髓内支撑钉系统由不锈钢合金制成，包括钉体、内杆、拉力螺钉、端帽和两个互锁螺钉。

方法

在10对尸体股骨上固定横行骨折时，将髓内支撑钉的生物力学与Grosse和Kempf钉进行比较。计算轴向压缩、弯曲、扭转刚度和应变值。

结果

髓内支撑钉系统的扭转刚度（0.50 Nm/度）和弯曲刚度（外侧弯曲和前侧弯曲分别为699.74和670.84 N/mm）与Grosse和Kempf钉（分别为0.35 Nm/度，外侧弯曲和前侧弯曲分别为644.85和606.32 N/mm）相当。髓内支撑钉系统在内侧和前侧产生的压缩刚度（分别为1.67和1.50×10⁶ N/mm）明显高于Grosse和Kempf钉（分别为0.86和1.32×10⁶ N/mm）。虽然与Grosse和Kempf钉相比，各方面的应变没有显著差异，但髓内支撑钉系统产生的应变分布明显更好（F = 1.007，P = 0.401）。