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中华关节外科杂志(电子版) ›› 2018, Vol. 12 ›› Issue (02) : 203 -208. doi: 10.3877/cma.j.issn.1674-134X.2018.02.011

所属专题: 文献

基础论著

倒刺型记忆合金人工腕关节假体的生物力学测试
蔡兴博1, 杨俊宇1, 丁晶1,(), 徐永清1, 宋慕国1, 马金星1   
  1. 1. 650000 昆明医科大学研究生部,解放军昆明总医院骨科
  • 收稿日期:2017-06-06 出版日期:2018-04-01
  • 通信作者: 丁晶
  • 基金资助:
    云南省重点新产品开发计划(2015BC004)

Biomechanical test of barbed memory alloy artificial wrist prosthesis

Xingbo Cai1, Junyu Yang1, Jing Ding1,(), Yongqing Xu1, Muguo Song1, Jinxing Ma1   

  1. 1. Kunming general hospital of the people's liberation army Department of orthopedic, Kunming 650000, China
  • Received:2017-06-06 Published:2018-04-01
  • Corresponding author: Jing Ding
  • About author:
    Corresponding author: Ding Jing, Email:
引用本文:

蔡兴博, 杨俊宇, 丁晶, 徐永清, 宋慕国, 马金星. 倒刺型记忆合金人工腕关节假体的生物力学测试[J]. 中华关节外科杂志(电子版), 2018, 12(02): 203-208.

Xingbo Cai, Junyu Yang, Jing Ding, Yongqing Xu, Muguo Song, Jinxing Ma. Biomechanical test of barbed memory alloy artificial wrist prosthesis[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2018, 12(02): 203-208.

目的

通过对比倒刺型腕关节假体置换前后的腕关节活动度差异,以及假体抗拔出测试,初步评价倒刺型镍钛记忆合金人工全腕关节假体的生物力学特性。

方法

搜集6例正常新鲜人体前臂(南方医科大学解剖教研室提供)。纳入标准:新鲜冰冻成人前臂,腕关节可自由活动;排除标准:腕关节存在骨折、脱位、骨肿瘤等情况的非正常前臂。使用配对t检验对在术前术后Cortex动作捕捉系统中对比腕关节在掌曲、背伸、尺偏、桡偏四个方向上的最大活动度进行比较。在Elector Force高精度生物材料试验系统上对腕关节假体施加拔出力,拔出力以2 N/s递增,直至假体出现2 mm以上的位移,记录假体松动瞬间的拔出力。使用独立样本t检验对桡骨组件和腕骨组件假体松动瞬间拔出力进行比较。

结果

术后腕关节在背伸、尺偏、桡偏的活动度较术前无统计学差异(P>0.05)。术前掌屈方向最大活动度为(75.0±3.5)°,术后掌屈方向最大活动度为(52.6±3.2)°,二者差异有统计学意义(t=14.69 ,P<0.05)。桡骨组件平均抗拔出力为(164±15)N,腕骨组件抗拔出力平均为(512±38)N,二者差异有统计学意义(t=-20.859, P<0.05)。

结论

倒刺型记忆合金人工腕关节假体在活动范围、抗拔出方面基本满足生物力学需求,具有应用于临床的潜在价值。

Objective

objective To evaluate the biomechanical characteristics of Ni-ti barb wrist prosthesis.

Methods

Six cases of normal human fresh forearm were collected (provided by department of anatomy, Southern Medical University). Inclusion criteria: fresh frozen adult forearm; the wrists were free to move. Exclusion criteria: fracture, joint dislocation or bone tumor on the adult forears. In the Cortex motion capture system, the range of motion (ROM) of wrist prosthesis was compared in flexion, extension, ulnar deviation, and radial deviation before and after total wrist arthroplasty (TWA). The data were analysed by paired t test. In the Elector Force high precision biological material test system, the prostheses were loaded with an increasing pull-out force 2 N per second, until the prosthesis displacement was more than 2 mm. The prosthesis loosening pull-out force at the moment was recorded. Independent sample t test was used to compare the pull-out force of the radial component and wrist component .

Results

ROM of wrist prosthesis in extension, ulnar deviation, and radial deviation showed no statistical difference (P>0.05) before and after TWA. For preoperative maximum flexion was (75.0±3.5) °, postoperative maximum flexion was (52.6±3.2) °, which showed significant difference (t=14.69, P<0.05). The pull-out force of radius prosthesis was (164±15) N, and the pull-out force of metacarpal prosthesis was (512±38) N, which was statistically different( t=-20.859, P< 0.05) .

Conclusion

Ni-ti barb wrist prosthesis can basically meet ROM and pull-out resistance of the daily biomechanics demands, which has some potential value of clinical application.

图3 三维运动测量系统
图5 包埋后的标本
图8 C臂透视下确认假体安装位置
图7 假体安装过程。图A 示骨科摆锯于头状骨腰部进行截骨;图B 示切除近排腕骨和部分远排腕骨;图C 示截骨面上进行钻孔及扩髓;图D 示腕骨组件安装完成;图E 示腕骨组件安装完毕后进行桡骨截骨;图F 示桡骨截骨完成;图G 示桡骨钻孔扩髓完成;图H 示桡骨组件安装完成;图I 示高分子聚乙烯关节球安装完成;图J 示逐层缝合关节囊、软组织与皮肤
图9 抗拔出测试实验。图A 为桡骨组件;图B 为腕骨组件
表1 术前术后腕关节活动度[°,n=6,(±s)]
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