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[股骨成形术增强预防骨质疏松性髋部骨折的生物力学研究]

[Biomechanical study on femoroplasty-augmentation for prevention of osteoporotic hip fractures].

作者信息

Wu Shao-Kun, Wu Yao-Jun, Gu Zhi-Qian, Yang Lei

机构信息

Department of Orthopaedics, Huamei Hospital, University of Chinese Academy of Science, Ningbo 315010, Zhejiang, China.

出版信息

Zhongguo Gu Shang. 2020 Jun 25;33(6):572-5. doi: 10.12200/j.issn.1003-0034.2020.06.017.

Abstract

OBJECTIVE

To explore whether femoral plasty can improve the fracture resistance of osteoporotic femoral specimens and prevent hip fracture, and to compare the difference of mechanical strength changes between two different femoral plasty methods in osteoporotic femoral specimens, so as to determine the best strengthening area of the plasty.

METHODS

Eighteen pairs of fresh osteoporotic femur specimens were collected and divided into two groups, A and B, 9 pairs in each group. Nine fresh osteoporotic femur specimens in each group were randomly selected for enhancement, and the corresponding contralateral specimens were used as control group. In group A1, the enhancement areas were femoral head, femoral neck, femoral trochanter and subtrochantericregion. And in group B1, the enhancement areas were femoral head, femoral neck and femoral trochanter region. The amount of cement injected into the femoral neck was recorded and the surface temperature of the femoral neck was measured. All specimens were biomechanically tested under simulated falls. Load-displacement curves, final loads were recorded. The final energy and stiffness of specimens were calculated. The biomechanical differences between the specimens of the enhancement group and those of the corresponding control group were compared, and the mechanical changes of the specimens by two different enhancement methods were compared.

RESULTS

Compared with the control group, the ultimate load and energy of the specimens in the enhanced group increased significantly, but the stiffness did not change significantly. There was no significant difference in final load and energy between specimens strengthened by two different methods.

CONCLUSION

Femoral plasty has the advantages of minimally invasive, simple operationand remarkable effect. It can be used as a new method to prevent osteoporotic hip fracture.

摘要

目的

探讨股骨成形术能否提高骨质疏松性股骨标本的抗骨折能力并预防髋部骨折,比较两种不同股骨成形术方法在骨质疏松性股骨标本中力学强度变化的差异,以确定成形术的最佳强化区域。

方法

收集18对新鲜骨质疏松性股骨标本,分为A、B两组,每组9对。每组随机选取9个新鲜骨质疏松性股骨标本进行强化,相应对侧标本作为对照组。A1组的强化区域为股骨头、股骨颈、股骨转子及转子下区域。B1组的强化区域为股骨头、股骨颈及股骨转子区域。记录注入股骨颈的骨水泥量,并测量股骨颈表面温度。所有标本在模拟跌倒情况下进行生物力学测试。记录载荷-位移曲线、最终载荷。计算标本的最终能量和刚度。比较强化组标本与相应对照组标本的生物力学差异,比较两种不同强化方法对标本力学的影响。

结果

与对照组相比,强化组标本的极限载荷和能量显著增加,但刚度无明显变化。两种不同方法强化的标本最终载荷和能量无显著差异。

结论

股骨成形术具有微创、操作简单、效果显著等优点。可作为预防骨质疏松性髋部骨折的新方法。

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