Martinek H, Egkher E, Wielke B, Spängler H
Acta Orthop Scand. 1979 Dec;50(6 Pt 1):675-9. doi: 10.3109/17453677908991292.
The biomechanical behaviour of pertrochanteric fractures stabilized by means of an angled plate or flexible condylar nails was characterized by mechanical testing. The stability and the types of motion occurring under dynamic load in the vicinity of the fracture and the effect on the implant were examined. The mechanical test results corroborated clinical experiences. In the case of extramedullary anchorage of implants, stability under load is possible only if an intact cortex on the medial side of the fracture guarantees the bearing of compressive load. With flexible condylar nails, however, it is possible to achieve a permanent load capacity up to approximately 100 kp, even if medial support is lacking, by putting the fracture in a valgus position so that the load-bearing arm is shortened. It was also possible to estimate the actual loading on the operated leg within the immediate postoperative phase by means of the "stabilization effect".
通过角钢板或弹性髁钉固定的转子周围骨折的生物力学行为通过力学测试进行了表征。研究了骨折附近在动态载荷下的稳定性和运动类型以及对植入物的影响。力学测试结果证实了临床经验。对于植入物的髓外固定，只有当骨折内侧完整的皮质保证能够承受压缩载荷时，才能在载荷下实现稳定。然而，使用弹性髁钉时，即使缺乏内侧支撑，通过使骨折处于外翻位从而缩短承重臂，也能够实现高达约100kp的永久承载能力。借助“稳定效应”还能够在术后即刻阶段估算手术侧腿的实际负荷。
