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[粗隆周围截骨术在髓外和髓内骨固定方法中的承载能力及变形的实验研究]

[Experimental studies of the loading capacity and deformation of pertrochanter osteotomies in extra and intramedullary osteosynthesis methods].

作者信息

Friedl W, Mischkowsky T, Schult W, Friedl W H

出版信息

Unfallchirurgie. 1984 Apr;10(2):59-65. doi: 10.1007/BF02588379.

Abstract

52 human femora were examined for stabilization behaviour of pertrochanteric osteotomies as well as the significance of the osteotomy angle by intramedullary osteosynthesis with Ender nailing and by extramedullary osteosynthesis using a 145 degrees angular plate. The maximum stress tolerance of both osteosynthesis procedures in femora with flat angle osteotomies is only marginally different, but the stress tolerance of Ender nailing is much less in the steep osteotomies. With steep osteotomy angle the plastic as well as the entire distorsion of the osteosynthesis increased considerably. The distorsion following Ender nailing compared to the 145 degrees angular plating is approximately the same. With increased osteoporosis a decrease of stability and an increase of distorsion is found. This correlation is even more pronounced by steep angular osteotomy. In some cases the exact opposite can be found, so that the maximum stress can not be concluded from the osteoporosis degree found on an x-ray.

摘要

对52根人股骨进行了研究,以探讨转子周围截骨术的稳定行为,以及采用恩德斯髓内钉进行髓内骨固定和使用145度角钢板进行髓外骨固定时截骨角度的意义。在平角截骨的股骨中,两种骨固定方法的最大应力耐受性仅略有不同,但在陡坡截骨中,恩德斯髓内钉的应力耐受性要低得多。随着截骨角度变陡,骨固定的塑性变形以及整体变形显著增加。与145度角钢板固定相比,恩德斯髓内钉固定后的变形大致相同。随着骨质疏松症的加重,稳定性降低,变形增加。这种相关性在陡坡角截骨中更为明显。在某些情况下,可能会发现完全相反的情况,因此无法从X线片上发现的骨质疏松程度推断出最大应力。

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