【作者】 林斌；

【导师】 陈建庭； 金大地；

【作者基本信息】 第一军医大学 ， 骨外科学， 2000， 硕士

【摘要】 目的：研制一种使用简易、固定可靠的新型四肢长管骨骨折内固定器械——自带内锁髓内针，并对其生物力学性能进行测试，同时小组病例临床应用，为临床安全应用提供依据。方法：①采用国际标准的316L医用不锈钢根据生物学固定的原则自行设计加工生产自带内锁髓内针。②对自带内锁髓内针进行生物力学测试：新鲜成人股骨标本6副，在其中下段造成横断骨折并2cm的骨缺损，分别用自带内锁髓内针、国产交锁髓内针、Ender氏针和梅花针内固定，在MTS力学试验机上测量各种器械的抗旋转、抗短缩、和抗三点弯曲刚度，并用SPSS统计软件对结果进行GLM-General Factorial ANOVA分析。③用自带内锁髓内针治疗股骨骨折16例，用Klemn标准对疗效进行评价。结果：自带内锁髓内针的抗旋转、抗短缩刚度稍低于国产的交锁髓内针，但无统计学意义（P＞0.05），抗三点弯曲刚度大于国产交锁髓内针（P＜0.05）。其抗旋转、抗短缩和抗三点弯曲刚度则明显优于Ender氏针、梅花针（P＜0.01）。临床应用16例，根据Klemn的评价标准，结果优10例，良5例，可1例，优良率93.8％。结论：自带内锁髓内针治疗长管骨骨折固定可靠，符合生物学固定的要求，该器械结构合理、安全、简单、实用，具有一定的临床推广应用价值。更多还原

【Abstract】 Objective: A new kind of internal fixture, Self Bring Interlocking Nail (SBIN), was developed, which was easy to be used and could develop firm fixation for long bone fracture. In order to provide experiment and clinical data for safe clinical practice, the biomechanic test and preliminary clinical application were performed. Methods: The SBIN was designed according to biological fixation principle and made of 31 6L stainless steel. Six pairs of fresh adult moist cadaveric femur specimens were used to manufacture fracture model of femur shaft in low 1/3 part with 2cm bone defect and were divided into two groups. Group 1 was fixed using SBIN and KUntscher nail by turn. Group 2 was fixed by homemade interlocking nail and Ender’s nail. Biomechanic test was performed on all specimens and the data were analysed by statistic SPSS software (GLM-General Factorial ANO VA). 16 cases with femur shaft fracture were treated by SBIN, the clinical results were divided into three groups according to Klemn’s criteria. Results: The stiffness of SBIN in resisting to rotation and axial displacement were close to that of the homemade interlocking nail. But there was no significance between two nails (P>O.05) .The stiffness to resist bending of SBIN was larger than that of homemade interlocking nail significantly (P<0.0 1). The stiffness in resisting rotation, axial displacement and bending were larger than that of the Kuntscher nail and Ender’s nail significantly (P<0.0 1). Excellent clinical results were obtained in 10 cases, good in 5 cases. The excellent and good rate was 93.8%. Conclusions: Being used in long bone fracture, the internal fixture of SBIN was firm, dependable and accorded with the principle of biological fixation. The instrument structure was in reason, safe, simple and practical .It could be widely used in clinical practice.更多还原