三孔与四孔滑动髋螺钉在逆行髓内钉治疗同侧股骨转子间和股骨干骨折中的生物力学测试

Biomechanical Testing of a 3-Hole Versus a 4-Hole Sliding Hip Screw in the Presence of a Retrograde Intramedullary Nail for Ipsilateral Intertrochanteric and Femur Shaft Fractures.

机构信息

Faculty of Medicine, Department of Surgery, University of Toronto, Toronto, ON, Canada.

Orthopaedic Biomechanics Lab, Victoria Hospital, London, ON, Canada.

出版信息

J Orthop Trauma. 2018 Aug;32(8):419-424. doi: 10.1097/BOT.0000000000001179.

DOI:10.1097/BOT.0000000000001179

PMID:29664884

Abstract

OBJECTIVE

The goal of this study was to compare a 3-hole versus a 4-hole sliding hip screw (SHS) in the presence of a retrograde intramedullary (RIM) nail for fixing intertrochanteric and comminuted midshaft femur fractures.

METHODS

Mechanical tests were performed on 10 matched pairs of human cadaveric femurs that were osteotomized and then fixed using a 3-hole SHS versus the traditional "gold standard" 4-hole SHS in the presence of an RIM nail.

RESULTS

Data showed no differences between the 3-hole SHS with RIM nail versus 4-hole SHS with RIM nail for stiffness (281 ± 127 vs. 260 ± 118 N/mm, P = 0.76), clinical failure at 10 mm of hip displacement (2014 ± 363 vs. 2134 ± 614 N, P = 0.52), or ultimate mechanical failure (3476 ± 776 vs. 3669 ± 755 N, P = 0.12).

CONCLUSIONS

For this fracture pattern, a 3-hole SHS with RIM nail may be a suitable surgical alternative to the traditional "gold standard" method because it provides the same biomechanical properties while potentially reducing surgical time, blood loss, and hardware used.

摘要

目的

本研究旨在比较逆行髓内钉（RIM）固定下三孔与四孔滑动髋螺钉（SHS）治疗股骨转子间和粉碎型股骨干骨折的效果。

方法

对 10 对配对的人体股骨标本进行了力学测试，这些标本均经过截骨处理，然后分别使用三孔 SHS 和传统的“金标准”四孔 SHS 加 RIM 钉固定。

结果

数据显示，三孔 SHS 加 RIM 钉与四孔 SHS 加 RIM 钉在刚度（281±127 与 260±118 N/mm，P=0.76）、10mm 髋关节位移时的临床失效（2014±363 与 2134±614 N，P=0.52）或最终机械失效（3476±776 与 3669±755 N，P=0.12）方面均无差异。