Sasamoto N
Nihon Seikeigeka Gakkai Zasshi. 1984 Feb;58(2):171-88.
The intramedullary nailing method described by Küntscher is used widely now as an excellent treatment of the fracture of the long bone. However, it is well known from clinical experience that fracture fixation of the clover leaf nail is not so strong and especially rotational fixation is very poor. For the purpose of re-evaluating fracture fixation mechanism with Küntscher's nail, the following studies were performed. Osteotomized human cadaveric femur was fixed with the clover leaf nail in an ordinary manner. This osteosynthesis model was imbedded in plastic resin (RIGOLAC) in situ. Afterwards this model was cut into specimens 1.5 cm in thickness. The contact area between the bone and the nail was investigated macroscopically and roentgenographically on each specimen. Stress distribution in cross section of some commercially available clover leaf nails was investigated by the technique of photoelastography. Total expansive force of the clover leaf nail was obtained by the calculation based on the measured values. From these investigations the author concludes that the clover leaf nail does not fix the fracture by the expansive spring mechanism only, as was originally claimed by Küntscher.
如今，孔氏髓内钉固定法作为长骨骨折的一种理想治疗方法被广泛应用。然而，临床经验表明，三叶草形髓内钉的骨折固定效果并不理想，尤其是其抗旋转能力较差。为了重新评估孔氏髓内钉的骨折固定机制，我们进行了以下研究。将截骨后的人尸体股骨以常规方式用三叶草形髓内钉固定。将此骨接合模型原位嵌入塑料树脂（RIGOLAC）中。之后，将该模型切成厚度为1.5厘米的标本。对每个标本的骨与髓内钉之间的接触面积进行宏观和X线检查。采用光弹性成像技术研究了几种市售三叶草形髓内钉横截面的应力分布情况。根据测量值计算得出三叶草形髓内钉的总扩张力。通过这些研究，作者得出结论，三叶草形髓内钉并非如孔氏最初所主张的那样仅通过扩张弹簧机制固定骨折。
