《中国康复理论与实践》

《中国康复理论与实践》 ›› 2009, Vol. 15 ›› Issue (01): 48-50.

• 基础研究 • 上一篇    下一篇

髋臼周围肿瘤切除腓骨移植重建骨盆环的稳定性实验研究

游木荣1;俞光荣1;贾永伟1;荆志振1;李兵1;陈博2;丁祖泉2   

  1. 1.同济大学附属同济医院骨科，上海市 200065;2.同济大学生物力学中心，上海市 200091
  • 收稿日期:2008-08-07 修回日期:2008-09-18 出版日期:2009-01-01 发布日期:2009-01-01
  • 通讯作者: 俞光荣

Experimental Study on Stability of Pelvic Ring Reconstruction Using Fibular Autograft for Periacetabular Tumor Type Ⅱ Resection

YOU Mu-rong, YU Guang-rong, JIA Yong-wei, et al   

  1. Department of Orthopaedics, Tongji Hospital of Tongii University, Shanghai 200065, China
  • Received:2008-08-07 Revised:2008-09-18 Published:2009-01-01 Online:2009-01-01

PDF (PC)

被引次数

7

摘要： 目的 评价髋臼周围肿瘤切除后腓骨移植重建骨盆环的稳定性。方法 选择健康成人尸体骨盆标本6具，按照Ennecking对骨盆肿瘤Ⅱ型切除标准行髋臼周围切除，采用双排腓骨移植附加钢板(Plates)、椎弓根棒(PR组)、侧棒(LR)、骶髂棒(SIR)4种内固定重建骨盆环；模拟双足站立位，施加0～500 N垂直分级载荷，CCD采集骨盆图像，基于Image J软件采用数字标记点质心跟踪法对重建后的骨盆进行检测，并与正常骨盆相同载荷下位移进行对照分析。结果 双足站立位，垂直载荷下4种重建工况骨盆以健侧股骨头为支点在冠状面向患侧产生线性下移及旋转运动。500 N载荷下，LR及Plates重建骨盆S1椎体垂直位移及冠状面上的旋转角度没有发生突变，其冠状面旋转及轴向稳定与完整骨盆没有明显差异；而SIR重建骨盆的稳定性及对称性严重破坏。结论 生理载荷下，髋臼周围肿瘤切除后腓骨移植Plates及LR重建具有与完整骨盆近似的轴向及旋转稳定力学性能。

关键词: 骨肿瘤, 骨盆, Ⅱ型切除重建

Abstract: Objective To evaluate the stability of the pelvic ring reconstruction using fibular autograft for periacetabular tumor type Ⅱ resection. Methods 6 adult cadaveric specimens were tested. The periacetabular tumor resection models were established according to Ennecking's type Ⅱ resection. The resected pelvic rings were reconstructed with double-fibular graft fixed by four internal fixation techniques including plates, pedicle-rods (PR), lateral-rods (LR) or sacral-iliac rods (SIR). Axial loading from the proximal L3 vertebral body was applied by MTS load cell in the gradient of 0～500 N in the double feet standing state. Images in front view were obtained using CCD camera. Based on Image J software, displacement of the first sacral vertebrae （S1） of the reconstructed pelvis and intact pelvis were calculated using digital maker tracing method with center-of-mass algorithm. Results The rotational movements and vertical displacement of S1 around the normal side femoral head of the reconstructed pelvis in coronary plane were found in simulated bilateral leg standing position. The average vertical load-displacement and load-angular rotation curve of S1 in coronary plane were approximately linear behavior under the vertical load 500 N. The average vertical displacement and angle of S1 in coronary plane had not overacted. The stability of axial direction and rotation had not changed significantly when reconstructed by LR or Plates compared with the intact pelvis, but the SIR did. Conclusion Plates and LR fixation were more stabile for periacetabular tumor type Ⅱ resection.

Key words: bone neoplasms, pelvis, type Ⅱ resection and reconstruction