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首页> 外文期刊>Journal of orthopaedic research >Lag screws for hip fracture fixation: Evaluation of migration resistance under simulated walking.
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Lag screws for hip fracture fixation: Evaluation of migration resistance under simulated walking.

机译：用于髋部骨折固定的滞后螺钉：模拟行走下的抗迁移性评估。

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Previous mechanical studies concerning cut-out of lag screws for pertrochanteric hip fractures have relied on static or dynamic uniaxial loading regimens to induce construct failure by varus collapse and superior cut-out. However, the hip is loaded in a multiplanar, dynamic manner during normal gait. We designed a hip implant performance simulator (HIPS) system to evaluate lag screw cut-out under multiplanar loading representative of normal gait. Five surrogate pertrochanteric fracture specimens with lag screw fixation were loaded up to 20,000 cycles using a biaxial rocking motion (BRM) gait simulation protocol. Another five specimens were loaded using a standard uniaxial loading protocol. The BRM loading group exhibited combined varus collapse (5.4+/-2.9 degrees ) and backward rotation (7.2+/-2.8 degrees ). The uniaxial loading group exhibited four times less varus collapse (1.4+/-1.1 degrees ) as compared to the BRM group, and only negligible rotation. For correlation of lag screw migration in surrogate specimens to that in native bone, six human cadaveric specimens were subjected to BRM loading. The degree of varus collapse (8.5+/-7.7 degrees ) and rotation (7.2+/-6.4 degrees ) in cadaveric specimens were comparable to that in surrogate specimens, with the surrogate specimens showing significantly less variability. The results demonstrate that accounting for clinically realistic multiplanar loading vectors significantly affects implant migration, and therefore should be considered when evaluating the fixation strength of hip screw implants.
机译：先前有关股骨转子周围骨折拉力螺钉切出的力学研究依赖于静态或动态单轴加载方案，以通过内翻塌陷和上切开引起结构破坏。但是，在正常步态中，髋部以多平面动态方式加载。我们设计了一种髋关节植入物性能模拟器（HIPS）系统，以评估代表正常步态的多平面载荷下的拉力螺钉切口。使用双轴摇摆运动（BRM）步态模拟方案，用拉力螺钉固定的五个替代性转子粗隆性骨折标本加载了20,000个周期。使用标准的单轴加载方案加载另外五个样本。 BRM负荷组表现出内翻塌陷（5.4 +/- 2.9度）和向后旋转（7.2 +/- 2.8度）。与BRM组相比，单轴加载组的内翻塌陷（1.4 +/- 1.1度）少四倍，并且旋转可忽略不计。为了使替代标本中的拉力螺钉迁移与天然骨中的标本螺钉迁移相关，对六个人体尸体标本进行了BRM加载。尸体标本的内翻塌陷度（8.5 +/- 7.7度）和旋转度（7.2 +/- 6.4度）与替代标本相当，替代标本的变异性明显较小。结果表明，考虑到临床上现实的多平面载荷向量会显着影响植入物的迁移，因此在评估髋螺钉植入物的固定强度时应予以考虑。

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