本文選題：脛骨髁間嵴撕脫骨折 + 固定方式生物力學(xué)　； 參考：《中國(guó)人民解放軍醫(yī)學(xué)院》2015年碩士論文

【摘要】：目的比較脛骨髁間嵴撕脫骨折不同固定方式的生物力學(xué)性能及評(píng)估關(guān)節(jié)鏡下編織線(xiàn)領(lǐng)帶結(jié)套扎固定法的臨床療效。方法1、取豬膝關(guān)節(jié)48只,隨機(jī)分為縫線(xiàn)領(lǐng)帶結(jié)套扎組、縫線(xiàn)固定組、空心螺釘組、單縫合錨釘組、雙縫合錨釘組及生物無(wú)結(jié)鎖定錨釘組,每組8例。統(tǒng)一制作脛骨髁間嵴撕脫骨折模型,分別用上述六種固定方式造模。生物力學(xué)測(cè)試包括疲勞試驗(yàn)及單次拔出試驗(yàn)。每例標(biāo)本先行200周期疲勞試驗(yàn),再行拔出試驗(yàn),直至拔出失敗。比較各組最大失敗載荷、失效載荷、剛度及位移。2、總結(jié)編織線(xiàn)領(lǐng)帶結(jié)套扎固定治療脛骨髁間嵴骨折病例,并對(duì)其臨床療效進(jìn)行評(píng)估。結(jié)果1、失敗載荷：編織線(xiàn)領(lǐng)帶結(jié)套扎組生物無(wú)結(jié)鎖定錨釘組雙縫合錨釘組縫線(xiàn)固定組空心螺釘組單縫合錨釘組,組間差異具有統(tǒng)計(jì)學(xué)意義(P0.01)；2、失效載荷：生物無(wú)結(jié)鎖定錨釘組編織線(xiàn)領(lǐng)帶結(jié)套扎組雙縫合錨釘組縫線(xiàn)固定組空心螺釘組縫合錨釘組,組間差異具有統(tǒng)計(jì)學(xué)意義(P0.05)；3、剛度：生物無(wú)結(jié)鎖定錨釘組編織線(xiàn)領(lǐng)帶結(jié)套扎組、雙縫合錨釘組、縫線(xiàn)固定組、空心螺釘組及縫合錨釘組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05),編織線(xiàn)領(lǐng)帶結(jié)套扎組、雙縫合錨釘組、縫線(xiàn)固定組、空心螺釘組及縫合錨釘組組間無(wú)顯著性差異(P0.05);4、循環(huán)位移：編織線(xiàn)領(lǐng)帶結(jié)套扎組生物無(wú)結(jié)鎖定錨釘組雙縫合錨釘組空心螺釘組縫合錨釘組縫線(xiàn)固定組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);5、臨床采用編織線(xiàn)領(lǐng)帶結(jié)套扎法治療60例病人,隨訪(fǎng)時(shí)間4月-12年,平均5.6年。術(shù)后切口皆一期愈合,無(wú)感染及血管、神經(jīng)損傷等并發(fā)癥。末次隨訪(fǎng)患肢膝關(guān)節(jié)功能恢復(fù)良好,主動(dòng)屈伸活動(dòng)范圍均可達(dá)1300-00-00,Lachman試驗(yàn)及前抽屜試驗(yàn)均陰性。術(shù)后lysholm評(píng)分(93.8±3.6)較術(shù)前(31.0±4.2)明顯改善,差異具有統(tǒng)計(jì)學(xué)意義(P0.05),臨床療效良好。結(jié)論1、編織線(xiàn)領(lǐng)帶結(jié)套扎固定、生物無(wú)結(jié)鎖定錨釘固定或雙縫合錨釘固定治療脛骨髁間嵴撕脫骨折穩(wěn)定性?xún)?yōu)于縫線(xiàn)固定、空心螺釘固定及縫合錨釘固定。2、關(guān)節(jié)鏡下編織線(xiàn)領(lǐng)帶結(jié)套扎固定治療脛骨髁間嵴撕脫骨折方法簡(jiǎn)便,經(jīng)濟(jì)實(shí)用,臨床療效可靠。
[Abstract]:Objective to compare the biomechanical properties of different fixation methods for avulsion fracture of tibial intercondylar ridge and to evaluate the clinical effect of arthroscopic tie fixation. Methods 1.Forty eight pig knee joints were randomly divided into suture tie ligation group, suture fixation group, hollow screw group, single suture anchor nail group, double suture anchor nail group and biological no-knot locking anchor group, with 8 cases in each group. The avulsion fracture model of tibial intercondylar crest was made by using the above six fixation methods. Biomechanical tests include fatigue tests and single pull-out tests. Each specimen was subjected to 200 cycles of fatigue test, and then to pull-out test until the pull-out failed. The maximum failure load, stiffness and displacement of each group were compared. The cases of tibial intercondylar crest fracture were summarized and the clinical effect was evaluated. Results 1. Failure load: no knot locking anchor group, double suture anchor screw group, hollow screw group single suture anchor group, knit tie ligation group, no knot locking anchor nail group, double suture anchor screw group, single suture anchor screw group; The difference between the two groups was statistically significant (P 0.01) and the failure load was as follows: biological no-knot locking anchor group, knit thread tie knot ligation group, double suture anchor nail group, hollow screw fixation group, hollow screw group, suture anchor nail group, The difference between the two groups was statistically significant (P 0.05). The stiffness of the two groups was as follows: no locking anchor nail group, knit tie ligation group, double suture anchor nail group, suture fixation group, hollow screw group and suture anchor nail group. The difference was statistically significant (P 0.05), tie binding group, double suture anchor nail group, suture fixation group, There was no significant difference between the hollow screw group and the suture anchor group. There was no significant difference between the two groups (P 0.05). The circular displacement: the biological no knot locking anchor group, the double suture anchor nail group, the double suture anchor group, the hollow screw group, the suture anchor group, the suture fixation group. The difference was statistically significant (P 0.05). 60 patients were treated with weaving tie ligation. The follow-up time was from 4 months to 12 years, with an average of 5.6 years. All the incisions healed at the first stage without complications such as infection and injury of blood vessels and nerves. At the last follow-up, the knee function of the affected limb recovered well, and the active flexion and extension activities were all negative in the Lachman test and the anterior drawer test. The postoperative lysholm score (93.8 鹵3.6) was significantly improved than that before operation (31.0 鹵4.2). The difference was statistically significant (P 0.05). Conclusion 1. The stability of tibial intercondylar avulsion fracture treated by tie knot ligation, biological locking anchor fixation or double suture anchor fixation is superior to suture fixation. The treatment of avulsion fracture of tibial intercondylar crest with hollow screw fixation, suture anchor nail fixation and arthroscopic tie fixation was simple, economical and practical, and the clinical effect was reliable.
【學(xué)位授予單位】：中國(guó)人民解放軍醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R687.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 劉玉杰;王俊良;齊瑋;王志剛;李春寶;魏民;李眾利;蔡，

本文編號(hào)：1934680