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AO张力带技术用于髌骨不同部位骨折内固定的生物力学研究
金敬华1, 潘志军2, 薛德挺
1.临海市第二人民医院骨科;2.浙江大学医学院附属第二医院骨科
摘要:
目的通过生物力学实验来研究AO张力带技术用于髌骨不同部位骨折内固定的力学稳定性,从而为髌骨骨折的治疗提供理论依据。方法取8具新鲜成人尸体膝关节,于髌骨中点、髌骨上下1/3及1/4用线锯将髌骨做成横行骨折模型,按AO张力带技术采用克氏针加钢丝固定建成实验力学模型,对股四头肌进行加载测试,加载负荷以骨折端分离1mm为实验终点,记录加载的力、髌骨骨折端分离的位移,并进行统计学分析。结果根据髌骨骨折端分离位移1mm为失效的约定,在1/2部位AO张力带能达到最大的张力为(452.2±15.1)N;在上1/3部位AO张力带能达到最大的张力为(361.2±12.3)N;在下1/3部位AO张力带能达到最大的张力为(351.0±5.6)N;在上1/4部位AO张力带能达到最大的张力为(226.7±5.8)N;在下1/4部位AO张力带能达到最大的张力为(215.3±13.1)N。结论按照正常人单膝关节生理负荷为350~400N计算,在髌骨1/2及1/3横行骨折AO张力带技术均能达到人体的生理载荷,在1/4部位则不能达到人体的生理载荷。
关键词:  髌骨骨折 治疗 AO 张力带技术 生物力学
DOI:
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基金项目:
Biomechanical study of AO tension band for patellar fractures at different levels
JIN Jinghua,PAN Zhijun,XUE Deting
Linhai Second People's Hospital
Abstract:
Objective To evaluate the stability of AO tension band for the fixation of patellar fractures at different levels. Methods Transverse patellar fractures models at middle, upper and lower 1/3, upper and lower 1/4 levels were created with fretsaw in 8 cadaver joints. AO tension bands were used to fix the fractured patellar bone for biomechanical study. A force to quadriceps femoris was loaded until the fractures sites were displaced to 1mm. Results When fracture sites displaced to 1mm, the largest loading in the middle level, upper 1/3, lower 1/3, upper 1/4 and lower 1/4 transverse fractures was (452.2 ±15.1)N, (361.2±12.3)N, (351.0±5.6)N, (226.7±5.8)N and (215.3±13.1)N, respectively. Conclusion As a normal single knee physiolog- ical loading 350N-400N, AO tension bands can provide sufficient stability for middle, upper 1/3 or lower 1/3 transverse patellar fractures, but the stability may be insufficient for upper or lower 1/4 transverse patellar fractures.
Key words:  Patellar fracture Ttreatment AO tension band technique Biomechanical study