三种固定方法治胫骨骨折的生物力学比较.pdf

nI-，：：．‘I ～ 一 目 录 eoooooo 中文摘要eoeoooooo…………………………………………………o o…1 oooooooooooJoo………………………………oooooooooooooooooooooooo…3 英文摘要o 研究论文三种固定方法治疗胫骨骨折的生物力学比较 前言··································································”一““”··6翮蔷“”””“””””“”””””“””””””““”””””””””””““””6 O 00000B OOOO…………………………………………………7 材料与方法O o oooooooooo eo0 ooeo 结果eo o··························一·····…··············”””·9 附l虱··············································································lO 附表··································································”·······”·14 讨论···········································································”·15 结论·····························································，················22 参考文献………………………………………………………………22 综述外固定架在创伤骨折中的应用……………………………………25 致谢·································································“······“”·”一“35 个人简历……………………………………………………………………36 中文摘要 三种固定方法治疗胫骨骨折的生物力学比较 摘 要 目的：胫骨因解剖部位特殊，其全长1／3位于皮下，容易受到损伤， 胫骨骨折是常见的骨折，尤其中段骨折发生率高。其特点是开放性、粉碎 性骨折多，局部血运差，易发生延迟愈合或骨不连等并发症。外固定架治 疗胫骨干骨折具有手术操作简单、手术时间短、术中出血少、手术远离骨 折部位，不剥离骨膜不加重骨折处周围软组织损伤，能最大限度保留骨折 断端的血运，其固定牢固稳定，有利于骨折处纤维骨痂形成和血管重建， 有利于患者早期功能锻炼，骨折愈合后外固定方便去除的优点，但外固定 架也有其缺点，如针道感染、骨折移位、延迟愈合、不愈合、畸形愈合等。 髓内针治疗长骨干骨折很符合生理、生物学特征，取得了非常满意的效果， 其特点是对骨折周围软组织、骨膜损伤小，有利于骨折的愈合及软组织的 恢复。但髓内钉治疗胫骨骨折术后也存在相应的并发症，如锁钉、髓内钉 断裂，骨折不愈合、畸形愈合或延迟愈合、术中接触放射线量大、创伤性 膝关节炎、术后膝关节疼痛不缓解等。如何科学、合理的选择骨折固定物 一直是困扰临床骨科医生的难题。理想的固定物既要牢固固定、又要避免 应力遮挡及尽量减少手术对骨及软组织的损伤。本文通过对双、单边外固 定架和髓内钉的固定强度生物力学进行比较，了解其稳定程度。以其能为 胫骨中段骨折手术固定物临床适应症的选择