目的：观察分析股骨外侧壁在股骨粗隆间骨折锁定加压钢板（PF-LCP）内固定中的生物力学作用。方法采用成人尸体股骨标本9具，制成股骨粗隆间骨折AO 分型A1型骨折，随机分为A、B、C三组，每组3具，对照组制成股骨外侧壁损伤，观察1组行PF-LCP内固定并保留外侧壁完整，观察2组行PF-LCP内固定但制成外侧壁损伤，三组股骨标本采用万能材料测试机进行压缩承载试验，比较骨折断端压缩时的间隔位移情况及骨折远、近端沿粗隆间的滑动位移情况，同时观察比较三组股骨标本的最大承载力。结果在压缩后观察1组和观察2组的断端间隔距离均大于对照组（P<0.05），且观察1组大于观察2组（P<0.05）；观察1组骨折端的间距压缩位移显著小于对照组和观察2组（P<0.01）；观察1组和观察2组的骨折远、近端滑动位移均小于对照组（P<0.01），且观察1组小于观察2组（P<0.05）；观察1组和观察2组的最大载荷力均显著大于对照组（P<0.01）。结论 PF-LCP内固定是治疗股骨粗隆间骨折的有效方式，具有较强的坚固性和稳定性，并且保留股骨粗隆外侧壁的完整能够增强骨折端的稳定性，提高固定治疗效果。%Objective Analysis biomechanical role of lateral femoral trochanteric wall in intertrochanteric fracture fixation with locking compression plate (PF-LCP). Methods 9 adult femur specimens of intertrochanteric fracture were caused by AO fracture classification of A1 type, they were randomly divided into A group,tB group and C group,every group had 3 specimens. The lateral wall of A group was damaged. The B group and C group were treated by PF-LCP,and the lateral wall of the B group was good,but the lateral wall of C group was damaged. Three groups of specimens were compression load test with universal testing machine,and the maximum carrying capacity was observed. The fracture spacing,the displacement of the fracture spacing stump and the sliding distance of the fracture fragments along the intertrochanteric were measured with calipers. Results The displacement of the fracture spacing stump of the three groups before compression were not significant differences (P>0.05). The fracture spacing of the B group and C group were greater than the A group,and the B group was greater than the C group,they all were significant differences (P<0.05). The displacement of the fracture spacing stump of the B group was less than the C group and the A group,there were significant differences (P<0.01),but there was no difference between the displacement of the fracture spacing stump of the C group and the A group (P>0.05). The sliding distance of the fracture fragments of the B group and C group were less than the A group,and the B group was less than the C group,there all had significant differences (P<0.05). The maximum carrying capacity of the B group and Cgroup were significantly higher than the A group,they were significant differences (P<0.01),and there was no difference between the maximum carrying capacity of the B group and the C group (P>0.05). Conclusion The PF-LCP fixation is an effective way to treat intertrochanteric fractures,it has strong robustness and stability,and complete retention of the lateral wall can enhance the stability of the intertrochanteric fracture and improve the therapeutic effect.
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