骨生物力学教材Effects of screw holes on the biomechanics of long tubular bones.ppt

Effects of screw holes on the biomechanics of long tubular bones Background As an orthopedic medical student,we all know that nail plate internal fixation remains an popular option in long shaft bone fractures in clinical practice,fracture healing and screw holes remained after removed the internal fixation will stay for a long time ,if this time the patients don’t pay attention to protect themselves,or the doctors couldn’t give the patients correct guidance about rehabilitation training,it can cause fracture again. According to the literature, after removed the internal fixation of long tubular bone,the percentage of fracture again is 22% .The reasons are as follows:firstly,  consolidate steel plate induces local stress screening,this leads to the decrease of strength of local bone cortex.Secondly,the existing of screw holes reduces the biomechanics of long tubular bone.Currently, the relationship between the screw holes remained after removed the internal fixation and the instability of mechanics is not very clear. Materials and methods Materials:thirty-eight sanhuang chicken of either gender,aged approximately 2.5 months,each weighing 1.2–1.5 kg. Methods:seventy-six pieces sanhuang cock tibia were selected and randomly divided into 7 groups:control group,1.5mm unicortical one hole, bicortical 3 holes and bicortical 5 holes,and 2.5mm unicortical one hole, 3 holes and bicortical 5 holes.The control group had normal complete cortex; the 1.5mm and 2.5mm unicortical one hole, bicortical 3 holes, and bicortical 5 serves as corresponding number screw holes.All the specimens of 7 groups were subjected to single three- points bending test. Results 1、When there are bone structure destructions,the maximal bending loads of 1.5mm unicortical one hole [(16.69±0.66)% of the average outer diameters of tubular bone(transverse diameter+vertical diameter)/2],and bicortical 3 holes did not differed significantly from that of the control group[