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应用髋臼三维记忆合金内固定系统治疗髋臼后壁骨折的生物力学研究

Biomechanical study of posterior wall acetabular fracture fixation using acetabular tridimensional memory alloy-fixation system.

作者信息

Xin-wei Liu, Shuo-gui Xu, Chun-cai Zhang, Qing-ge Fu, Pan-feng Wang

机构信息

Department of Orthopaedic Surgery, Changhai Hospital, The Second Military Medical University, No. 168 Changhai Road, Shanghai 200433, China.

出版信息

Clin Biomech (Bristol). 2010 May;25(4):312-7. doi: 10.1016/j.clinbiomech.2010.01.008. Epub 2010 Feb 2.

Abstract

BACKGROUND

We developed the acetabular tridimensional memory alloy-fixation system (ATMFS), which is made of NiTi shape memory alloy, according to the specific mechanical properties of biological memory material, nitinol alloy and measured distribution of contact area and pressure between the acetabulum and the femoral head of cadaveric pelvis.

METHODS

Six formalin-preserved cadaveric pelvis were used for this investigation. Pressure-sensitive film was used to measure contact area and pressure within the anterior, superior, and posterior regions of the acetabulum. The pelvis were loaded under the following four conditions: (1) intact; (2) following a creation posterior wall fracture defect; (3) following reduction and standard internal fixation with reconstruction plate; (4) following reduction and internal fixation with a new shape memory alloy device named ATMFS. A posterior wall fracture was created along an arc of 40-90 degrees about the acetabular rim.

FINDINGS

Creation of a posterior wall defect resulted in increased load in the superior acetabulum (1422N) as compared to the intact condition (762N, P=0.007). Following reduction and internal fixation, the load distributed to the superior acetabulum (1486N) was not statistically different from the defect condition. Following the fixation with ATMFS, the load seen at the superior region of the actabulum (936N) was less than fixation with reconstruction plate and was not different from intact state (P=0.4).

INTERPRETATION

These data indicate that the use of ATMFS as a fracture internal fixation device resulted a partial restoration of joint loading parameters toward the intact state. ATMFS fixation may result in a clinical benefit.

摘要

背景

我们根据生物记忆材料镍钛诺合金的特定力学性能以及测量得到的尸体骨盆髋臼与股骨头之间的接触面积和压力分布,研发了由镍钛形状记忆合金制成的髋臼三维记忆合金固定系统(ATMFS)。

方法

本研究使用了6具经福尔马林保存的尸体骨盆。采用压敏膜测量髋臼前、上、后区域内的接触面积和压力。在以下四种情况下对骨盆施加负荷:(1)完整状态;(2)制造后壁骨折缺损后;(3)复位并使用重建钢板进行标准内固定后;(4)复位并使用名为ATMFS的新型形状记忆合金装置进行内固定后。沿髋臼边缘以40 - 90度的弧度制造后壁骨折。

结果

与完整状态(762N,P = 0.007)相比,制造后壁缺损导致髋臼上部负荷增加(1422N)。复位并内固定后,分布到髋臼上部的负荷(1486N)与缺损状态相比无统计学差异。使用ATMFS固定后,髋臼上部区域的负荷(936N)小于使用重建钢板固定,且与完整状态无差异(P = 0.4)。

解读

这些数据表明,使用ATMFS作为骨折内固定装置可使关节负荷参数部分恢复至完整状态。ATMFS固定可能带来临床益处。

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