本文選題：生物力學(xué) + 夾針螺栓�。� 參考：《天津醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:20世紀(jì)50年代,前蘇聯(lián)醫(yī)生Ilizarov發(fā)明了Ilizarov環(huán)形外固定支架。與其他類型外固定支架不同,該外固定支架維持骨段相對(duì)穩(wěn)定位置的穩(wěn)定性需要小直徑穿骨針提供,穿骨針的張力具有決定性意義。在對(duì)穿骨針進(jìn)行拉張及外固定支架承受負(fù)荷時(shí),張力的維持就需要夾針螺栓-穿骨針界面的壓力及摩擦力來(lái)完成。本實(shí)驗(yàn)通過(guò)研究在擰緊固定螺栓后、移除拉張器后及施加軸向壓縮載荷后穿骨針張力的變化情況,比較孔洞型螺栓,溝槽型螺栓,孔洞型螺栓+墊片,溝槽型螺栓+墊片四種不同類型夾針螺栓組合,10Nm、15Nm、20Nm三種不同螺栓固定扭矩對(duì)Ilizarov外固定支架穿骨針張力丟失的影響。方法:實(shí)驗(yàn)選用7根質(zhì)地、外形相同的直徑為30mm,長(zhǎng)度為176mm的聚乙烯塑料(Polyethylene,PE)棒代替脛骨橫斷形骨折近端骨干,并分為A、B、C、D、E、F、G七組。兩相同質(zhì)地、相同型號(hào)的180mm不銹鋼環(huán)之間用3根相同的240mm長(zhǎng)螺紋桿連接,螺紋桿分布均勻并且兩環(huán)平行,兩環(huán)間距為100mm。在上端環(huán)的一側(cè)內(nèi)部安裝張力傳感器,并保證傳感器的穿骨針連接位點(diǎn)與環(huán)在同一水平。傳感器與信號(hào)轉(zhuǎn)換及傳輸裝置相連。下端環(huán)連接底座,距離為100mm。將組裝好的外固定支架套在PE棒上,PE棒近端距近端環(huán)50mm,PE棒置于兩環(huán)中央并與之垂直。用電鉆在兩個(gè)環(huán)的平面各交叉穿入2枚相同型號(hào)2.0mm穿骨針,兩針在水平面上呈垂直狀態(tài),并且針垂直于PE棒。A組采用孔洞型螺栓(I型),B組采用溝槽型螺栓(II型),C組采用孔洞型螺栓+墊片(III型),D組采用溝槽型螺栓+墊片(IV型)。四組夾針螺栓的固定扭矩通過(guò)扭力扳手給定15Nm。E組、F組、G組均使用臨床上最常見(jiàn)使用最多的溝槽型螺栓(II型),固定扭矩分別采用10Nm、15Nm、20Nm。4枚穿骨針利用拉張器拉張1275N后固定于各環(huán)。同一環(huán)上的兩枚穿骨針的拉張同時(shí)進(jìn)行。在夾針螺栓固定后松開拉張器前,移除拉張器后,觀察并記錄穿骨針張力的變化。之后在電子萬(wàn)能實(shí)驗(yàn)機(jī)上對(duì)A-G七組力學(xué)模型提供800N的軸向壓縮載荷。每個(gè)模型測(cè)試3次,每次更換穿骨針及螺栓,實(shí)驗(yàn)結(jié)果取平均值。將實(shí)驗(yàn)數(shù)據(jù)用SPSS22.0分析軟件進(jìn)行統(tǒng)計(jì)處理,采用方差分析(Analysis of Variance,ANOVA)進(jìn)行組間比較。結(jié)果:1、不同夾針螺栓固定實(shí)驗(yàn)中,A、B、C、D四組穿骨針的張力值,在擰緊螺栓時(shí)分別為1234.7±4.3N、1236.9±10.6N、1243.5±11.1N、1247.8±7.0N;在移除拉張器時(shí)張力分別為1097.3±28.2N、1117.6±6.7N、1190.1±11.8N、1194.3±11.0N;在加載800N的軸向壓縮載荷后,張力值分別為836.7±8.4N、895.3±7.2N、1001.0±8.2N、1055.2±6.7N。采用方差分析(AnalysisofVariance,ANOVA)進(jìn)行數(shù)據(jù)分析,可見(jiàn)A、B、C、D四組的張力值在擰緊螺栓時(shí)沒(méi)有統(tǒng)計(jì)學(xué)差異(p0.05),四種螺栓的作用沒(méi)有明顯區(qū)別;在移除拉張器時(shí),AB兩組的張力值沒(méi)有統(tǒng)計(jì)學(xué)差異(p0.05),CD兩組的張力值也沒(méi)有統(tǒng)計(jì)學(xué)差異(p0.05),但AB兩組與CD兩組之間有統(tǒng)計(jì)學(xué)差異(p0.05),AB兩組的張力值低于CD兩組。在加載800N的軸向壓縮負(fù)載后,四組的張力值兩兩比較均有統(tǒng)計(jì)學(xué)差異(p0.05),D組的張力值高于C組高于B組高于A組。2、螺栓固定扭矩實(shí)驗(yàn)中,E、F、G三組的張力,在擰緊螺栓時(shí)分別為1251.8±5.6N、1234.8±3.2N、1211.5±27.7N;在移除拉張器時(shí)張力值分別為1008.0±6.6N、1120.9±9.0N、1128.4±8.6N;加載800N的軸向壓縮載荷后,張力值分別為812.7±7.7N、931.3±5.9N、942.0±35.0N。采用方差分析(AnalysisofVariance,ANOVA)進(jìn)行數(shù)據(jù)分析。E、F、G三組的張力值,在擰緊螺栓時(shí),組間比較沒(méi)有統(tǒng)計(jì)學(xué)差異(p0.05),三種扭矩的作用沒(méi)有明顯區(qū)別;在移除拉張器時(shí),FG組之間沒(méi)有統(tǒng)計(jì)學(xué)差異(p0.05),E組張力值要低于FG組;在800N軸向壓縮載荷后,F G組之間沒(méi)有統(tǒng)計(jì)學(xué)差異(p0.05),E組的張力值要低于E G組。結(jié)論:本實(shí)驗(yàn)對(duì)應(yīng)用孔洞型螺栓、溝槽型螺栓、孔洞型螺栓+墊片、溝槽型螺栓+墊片四種不同類型夾針螺栓,及10Nm、15Nm、20Nm三種不同固定扭矩的外固定支架穿骨針在擰緊螺栓時(shí)、移除拉張器時(shí),以及施加800N軸向壓縮載荷后的張力變化進(jìn)行了記錄和分析。初步得出結(jié)論如下:在對(duì)外固定支架施加軸向壓縮載荷之前,針的張力就已經(jīng)發(fā)生一定程度的丟失,四種螺栓類型及三種螺栓固定扭矩的力學(xué)表現(xiàn)沒(méi)有明顯差別。當(dāng)移除拉張器后,張力會(huì)進(jìn)一步丟失,擁有墊片夾針螺栓組合的實(shí)驗(yàn)組,其張力丟失量要少于未應(yīng)用墊片的實(shí)驗(yàn)組。應(yīng)用高扭矩實(shí)驗(yàn)組的張力丟失量要少于低扭矩的實(shí)驗(yàn)組。在對(duì)外固定支架施加800N軸向壓縮載荷后,張力的丟失量最顯著,四種夾針螺栓類型的作用有顯著區(qū)別。溝槽型螺栓與墊片組合維持張力的能力最好,其次是孔洞型螺栓與墊片組合及單純溝槽型螺栓,單純孔洞型螺栓維持張力的能力最差。高扭矩的實(shí)驗(yàn)組的張力丟失量少于低扭矩組。
[Abstract]:Objective: in 1950s, the former Soviet doctor Ilizarov invented the Ilizarov ring external fixator. Unlike other type of external fixator, the stability of the external fixator to maintain the relatively stable position of the bone segment requires a small diameter puncture. The tension of the needles is decisive. The tension and external fixation of the needles are made. When the load is loaded, the tension is maintained by the pressure and friction of the needle bolt interface. This experiment is to compare the changes of the tension of the bone needle after the tightening of the fixed bolt and the axial compression load, and compare the hole type bolts, groove bolts, hole type bolts + gasket, groove stud type studs. The effect of three different bolts of 10Nm, 15Nm, 20Nm on the tension loss of the Ilizarov external fixator through the bolt combination of four different types of bolts and bolts. Method: the experiment selected 7 textures, the same diameter was 30mm, the length of the polyethylene plastic (Polyethylene, PE) was substituted for the proximal tibia fracture of the tibial transverse fracture. It is divided into seven groups of A, B, C, D, E, F, G. The same type of 180mm stainless steel rings are connected with 3 same 240mm long threaded rods, the threaded rods are evenly distributed and the two rings are parallel, and the two ring spacing is 100mm. in the side of the upper end ring, and the attachment site of the needle is at the same level as the ring. The sensor is connected with the signal conversion and transmission device. The lower end ring connects with the base, the distance is 100mm., the assembled external fixer is set on the PE rod, the near end of the PE rod is from the near end ring 50mm, the PE bar is placed in the center of the two ring and perpendicular to it. With the electric drill, 2 phases of the same type 2.0mm wear needle and the two needle are hanging on the horizontal plane at the plane of the plane of the two rings. Straight state, and the needle perpendicular to the PE bar.A group adopts hole type bolt (I type), B group adopts groove bolt (II type), C group adopts hole type bolt + gasket (III type), D group adopts groove bolt + gasket (IV type). The fixed torque of four groups of needle bolts is given by torque wrench for given 15Nm.E group, F group, G group are the most commonly used clinical use Groove bolt (II type), fixed torque using 10Nm, 15Nm, 20Nm.4 needle to pull the needle to pull 1275N after pulling the 1275N fixed to each ring. The tension of the needle on the same ring is carried out simultaneously. Before the bolt is fixed, the tension device is removed, and the tension changes of the needle are recorded and recorded. Then the electronic omnipotence is used. The axial compression load of the A-G seven groups of mechanical models was provided on the test machine. Each model was tested 3 times, each time was replaced by the needle and bolt, the experimental results were averaged. The experimental data were statistically processed by SPSS22.0 analysis software, and the variance analysis (Analysis of Variance, ANOVA) was used for comparison between groups. Results: 1, different pin bolts were fixed. In the experiment, the tension values of the four groups of A, B, C and D were 1234.7 + 4.3N, 1236.9 + 10.6N, 1243.5 + 11.1N, 1247.8 + 7.0N, respectively, and the tension was 1097.3 + 28.2N, 1117.6 + 6.7N, 1190.1 + 11.8N and 1194.3 + 11.0N when the tension removes were removed, and the tension values were 836.7 +, 895.3, 10, 10, 10, respectively, respectively, after loading the axial compression load. 1 + 8.2N and 1055.2 + 6.7N. were analyzed by variance analysis (AnalysisofVariance, ANOVA). The tension values of A, B, C, D four groups were not statistically different when tightening the bolts (P0.05), and there was no significant difference between the four kinds of bolts. The tension values of the AB two groups were not statistically different (P0.05) and the tension values of the two groups of CD two were also in the removal of the tension device. There was no statistical difference (P0.05), but there was a statistical difference between the AB two groups and the CD two groups (P0.05). The tension value of the AB two groups was lower than that of the CD two group. The tension values of the four groups were statistically different after loading the axial compression load of 800N, and the tension value of the D group was higher than that in the C group. The tension of the three groups was 1251.8 + 5.6N, 1234.8 + 3.2N and 1211.5 + 27.7N when the bolts were tightened, and the tension values were 1008 + 6.6N, 1120.9 + 9.0N and 1128.4 + 8.6N respectively when removing the tension device. After loading the axial compression load of 800N, the tension values were 812.7 + 7.7N, 931.3 + 5.9N and 942 + 35.0N. using variance analysis (AnalysisofVariance, ANOVA). Data analysis of.E, F, G three groups of tension values, when tightening the bolt, there is no statistical difference between groups (P0.05), there is no significant difference between the three kinds of torque; in the removal of tension, there is no statistical difference between the FG groups (P0.05), the tension value of the E group is lower than that of the FG group; there is no statistical difference between the F G groups after the axial compression of 800N (P0.05). The tension value of the E group is lower than that of the E G group. Conclusion: in this experiment, four different types of pin bolts with hole type bolt, groove bolt, hole type bolt + gasket, groove bolt + gasket, and three different fixed torque external fixers of 10Nm, 15Nm, and 20Nm are used to remove the tension holder and apply the axial pressure of 800N when the bolt is tightened. The tension changes after the loading are recorded and analyzed. Preliminary conclusions are drawn as follows: the tension of the needle has been lost to a certain extent before the axial compression load is applied to the external fixator. The mechanical performance of the four bolt types and the fixed torque of the three bolts is not clearly different. When the tension is removed, the tension will go further. The loss, the experimental group with the combination of the gasket and the bolt combination, has less tension loss than the experimental group of the non applied gasket. The tension loss of the high torque experimental group is less than the low torque experimental group. After the 800N axial compression load is applied to the external fixator, the loss of tension is the most significant. The effect of the four types of pin bolts is obvious. Difference. Groove bolt and gasket combined to maintain the best ability to maintain tension, followed by hole type bolts and gasket combination and pure groove bolt, simple hole type bolt to maintain the worst ability to maintain tension. High torque test group of tension loss is less than the low torque group.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R687.3

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