双矩形髓内钉与加压钢板治疗肱骨干骨折的生物力学比较及疗效分析

摘要

Objective　To search for a better internal fixation method in the treatment of humeral shaft fracture by comparing biomechanics and clinical results of double rectangle intramedullary nail and compressed plate.Methods　Fracture models were produced in 12 wet humeral bones specimens of adult cadavers.The models were randomly divided into two groups.Three bones of each group were fixed with double rectangle intramedullary and other three bones of each group were fixed with compressed plate.Three point bending test,twisting test and stretching test were done and analysed.Results　The results of bending test and torsion test revealed that the double rectangle intramedullary nail was better than the compressed plate for the fixation of humeral shaft fracture.However,in strething test,the two fixation methods showed no significant difference.Conclusion　The rectangle intramedullary nail is more suitable than compressed plate for the treatment of humeral shaft fracture.%目的　通过双矩形髓内钉和加压钢板两种不同内固定物治疗肱骨干骨折的生物力学对比,探讨有利于肱骨干骨折后的骨修复的内固定方法。方法　以成人尸体湿骨制备骨折模型,随机用双矩形髓内钉和加压钢板两种方法固定后进行四点弯曲试验、扭转试验和拉伸试验,并结合临床疗效分析。结果　测试数据经统计学检验,矩形髓内钉组的四点弯曲试验和扭转试验均优于钢板组(P<0.01),结果有显著差异,而拉伸试验中矩形髓内钉和加压钢板组无显著差异(P>0.05)。结论　在肱骨干骨折的治疗中,双矩形髓内钉固定较加压钢板内固定更适合骨折愈合所需的生物力学环境,且临床效果较后者优。