补锌对兔实验性颧骨骨折愈合影响的生物力学研究

通过对１８只实验性颧骨骨折新西兰兔在骨折愈合过程中采用补锌和未补锌两种方法,来比较研究补锌对骨折部位的生物力学影响,进而阐明锌对骨折愈合的作用。     

Ender针固定胫骨骨折的生物力学实验研究

通过对以Ender氏针固定的9根干燥尸体胫骨的力学试验。测定了骨及针的应力和应变,骨的相对位移及成角,证明该法能提供既稳定又存在微量的相对位移的特殊力学环境,针及骨分别负重,与生理状态应力相适应,此时针与骨之间的应力重分配既符合骨折愈合的生物力学原理,又具有较大的临床意义。     

骨折愈合中骨再生的生物学和生物力学

一、骨再生的生物学1.骨骼的生长和发育骨骼的生长和发育涉及很多细胞和组织的分化和增殖,虽然其过程复杂,却精确有序。在胚胎发育阶段,长骨先形成一个间充质细胞团块,然后软骨化形成软骨基质。随着发育的渐进,软骨细胞肥大,细胞外基质开始矿化,形成初级骨化中心。软骨细胞通过     

骨折磁疗愈合仪治疗骨折延迟愈合

骨折延迟愈合是指骨折在正常愈合所需的时间内,仍未能达到骨折完全愈合的标准。临床症状与体征：４个月的异常活动;骨端在移位或试做负重时,产生疼痛;畸形与肌萎缩;负重功能丧失;骨传导音降低。我科应用骨折磁疗愈合仪治疗骨折延迟愈合３０例收到了满意效果。３０例患者中应用骨折磁疗愈合仪４０天骨痂形成的２０例,５０天骨痂形成的１０例。治疗方法１将患肢固定在不负重石膏管形内,安置线圈时须用Ｘ线准确定位,使两线圈中心与骨延迟愈合部位对准,并彼此相对平行。２两线圈固定后,将线圈插入仪器前面板输出插座中,开启电源开关…     

重组成骨生长肽对骨折愈合影响的实验研究

目的成骨生长肽(osteogenic growthpeptide,OGP)是具有促进成骨和刺激造血等多方面作用的14肽。本实验旨在研究重组OGP(rOGP)的促成骨活性。方法一、检验动物模型骨折后不同时期血清Ca、P、AKP(碱性磷酸酶)水平;二、作骨折断端病理切片;以观察rOGP对骨折愈合的影响。结果．rOCP具有降低血清Ca,升高血清P、AKP及加速骨折愈合的作用,且其促成骨效果明显优于目前临床常用的促成骨生物制剂骨宁注射液。结论     

膝关节不稳对骨折愈合的影响(附3例临床分析)

目的:探讨膝关节不稳对骨折愈合的影响。方法:回顾性分析我院收治3例患者因早期未能准确诊治膝关节交叉韧带损伤,而导致同侧股骨干骨折术后不愈合的临床资料。我们从生物力学角度分析,交叉韧带对膝关节生理性制导及稳定作用,反之损伤后膝关节的生理运动一定程度的丧失,以及随之而来的载荷传导紊乱,从而导致膝关节不稳。膝关节不稳所引起骨折端应力改变,其对骨折愈合将产生怎样的影响。结果:如未能及时修复交叉韧带在患者股骨干骨折术后行CPM锻炼及部分负重行走时将传导以骨折断端以一种剪切、旋转的应力,同时下肢垂直的纵向压应力将难以传导至骨折端,可能导致股骨干骨折术后的延缓愈合甚至不愈合。结论:膝关节不稳定可引起同侧肢体骨折端的应力改变,可能导致骨折的延缓愈合甚至不愈合。     

膝关节不稳对骨折愈合的影响（附3例临床分析）

目的：探讨膝关节不稳对骨折愈合的影响。方法：回顾性分析我院收治3例患者因早期未能准确诊治膝关节交叉韧带损伤,而导致同侧股骨干骨折术后不愈合的临床资料。我们从生物力学角度分析,交叉韧带对膝关节生理性制导及稳定作用,反之损伤后膝关节的生理运动一定程度的丧失,以及随之而来的载荷传导紊乱,从而导致膝关节不稳。膝关节不稳所引起骨折端应力改变,其对骨折愈合将产生怎样的影响。结果：如未能及时修复交叉韧带在患者股骨干骨折术后行CPM锻炼及部分负重行走时将传导以骨折断端以一种剪切、旋转的应力,同时下肢垂直的纵向压应力将难以传导至骨折端,可能导致股骨干骨折术后的延缓愈合甚至不愈合。结论：膝关节不稳定可引起同侧肢体骨折端的应力改变,可能导致骨折的延缓愈合甚至不愈合。     

Three-dimensional Simulation of Fracture Repair in the Human Tibia

Finite element models of bones can be generated based on images obtained non-invasively in the clinic. One area where such models may prove useful is in the assessment of fracture healing of long bones. To establish the feasibility of such a proposal, a three dimensional finite element model of a fractured tibia was generated, and a model of tissue differentiation and bone regeneration was used to simulate the progress of healing under two different loading magnitudes. Healing is successful under the lower load and unsuccessful under the higher load--this proves that the model has the potential to identify loads that would cause healing to fail. Following a proposal by Richardson et al. [J. Bone Jt Surg. Vol. 76B (1994) pp. 389-394] that the bending stiffness can be used to assess the extent of healing, the bending stiffness was computed during healing--it was shown that the stiffness changed in a similar manner that observed clinically. In conclusion, the paper establishes that 3D computer simulation could be a tool for assessment of the fracture healing under different orthopedic treatments.     

胫骨平台后侧骨折的手术治疗

目的：探讨对于胫骨平台后侧骨折患者的手术治疗方法及治疗效果。方法：选取本院2010年4月至2012年1月间采用手术治疗的胫骨平台后侧骨折患者23例设为治疗组,本组所有患者均采用后外侧入路的内固定手术治疗方法。另选取同期采用保守治疗的胫骨平台后侧骨折患者20例设为对照组。两组患者治疗后均获得12个月以上的随访。针对两组患者治疗后骨愈合时间、膝关节功能评分以及治疗总有效率等情况进行回顾性对比分析。结果：所有两组患者经治疗后,治疗组患者骨愈合时间明显低于对照组（P〈0．05）,其结果具有统计学意义。且经随访后,治疗组患者膝关节功能评分显著高于对照组（P〈0．05）。而两组患者经综合评价其治疗总有效率对比差异也具有显著性（P〈0．05）,且结果具有统计学意义。结论：对于胫骨平台后侧骨折患者采用后外侧入路的内固定手术治疗拥有显著的临床疗效。此术式具有对骨折部位起到很好的显露及复位稳定等优点,且在治疗效果及患者膝关节功能恢复情况等方面明显优于其它治疗方式。故此方法安全、有效,不失为治疗胫骨平台后侧骨折的首选治疗方法。     

Fracture analysis for biological materials with an expanded cohesive zone model

In this study, a theoretical framework for simulation of fracture of bone and bone-like materials is provided. An expanded cohesive zone model with thermodynamically consistent framework has been proposed and used to investigate the crack growth resistance of bone and bone-like materials. The reversible elastic deformation, irreversible plastic deformation caused by large deformation of soft protein matrix, and damage evidenced by the material separation and crack nucleation in the cohesive zone, were all taken into account in the model. Furthermore, the key mechanisms in deformation of biocomposites consisting of mineral platelets and protein interfacial layers were incorporated in the fracture process zone in this model, thereby overcoming the limitations of previous cohesive zone modeling of bone fracture. Finally, applications to fracture of cortical bone and human dentin were presented, which showed good agreement between numerical simulation and reported experiments and substantiated the effectiveness of the model in investigating the fracture behavior of bone-like materials.     

Analysis of the independent power of age-related,anthropometric and mechanical factors as determinants of the structure of radius and tibia in normal adults. A pQCT study

To compare the independent influence of mechanical and non-mechanical factors on bone features, multiple regression analyses were performed between pQCT indicators of radius and tibia bone mass, mineralization, design and strength as determined variables, and age or time since menopause (TMP), body mass, bone length and regional muscles’ areas as selected determinant factors, in Caucasian, physically active, untrained healthy men and pre- and post-menopausal women. In men and pre-menopausal women, the strongest influences were exerted by muscle area on radial features and by both muscle area and bone length on the tibia. Only for women, was body mass a significant factor for tibia traits. In men and pre-menopausal women, mass/design/strength indicators depended more strongly on the selected determinants than the cortical vBMD did (p<0.01-0.001 vs n.s.), regardless of age. However, TMP was an additional factor for both bones (p<0.01-0.001). The selected mechanical factors (muscle size, bone lengths) were more relevant than age/TMP or body weight to the development of allometrically-related bone properties (mass/design/strength), yet not to bone tissue “quality” (cortical vBMD), suggesting a determinant, rather than determined role for cortical stiffness. While the mechanical impacts of muscles and bone levers on bone structure were comparable in men and pre-menopausal women, TMP exerted a stronger impact than allometric or mechanical factors on bone properties, including cortical vBMD.     

Influence of teeth, alveoli, and periodontal ligaments on torsional rigidity in human mandibles.

We investigated the influence of teeth, periodontal ligaments, and alveoli on the structural integrity of human mandibles loaded in torsion. Surface bone strain was recorded from the mandibular corpus below the first molar on each of four specimens. These specimens were loaded by an external force that caused primarily torsion about the long axis of the corpus, and bone strain was recorded under the following conditions: 1) all supporting structures intact, 2) all supporting structures intact and the M1 loaded by a simulated bite force, 3) M1 removed and 4) alveolar bone of the M1 removed. For comparative purposes, experiments were also designed to investigate the effects of intermittent holes on the torsional rigidity of a baboon femur. This permitted comparison of the mechanical behavior of the mandibles with that of a more homogeneous bony member. These experiments suggest that the presence of teeth within alveoli has a measurable role in the maintenance of torsional rigidity. The condition of the periodontal ligament also appears to influence these stress-bearing capabilities. Moreover, the alveolar bone supporting the teeth also provides structural support for countering torsional loads. For the specific case of corpus twisting, the mandible does not behave as a member with open or closed sections as predicted by theoretical models. The observed magnitudes of bone strain, however, conform more closely to the predictions generated by a closed-section model.     

Curvature of the forelimb bones of anthropoid primates: Overall allometric patterns and specializations in suspensory species

It has previously been reported that brachiating primates, particularly gibbons, are characterized by distinctively straight forelimb long bones, yet no hypotheses have been proposed to explain why straight limb bones may be adaptive to suspensory locomotion. This study explores quantitatively the curvature of the long bones in 13 species of anthropoid primates and analyzes the functional consequences of curvature in biomechanical terms. These analyses demonstrate that, whereas the humeri of gibbons and spider monkeys are functionally less curved than those of other taxa, the ulnae of brachiators are neither more nor less curved than those of other anthropoids, and the gibbon radius is far more curved than would be predicted from body size alone. The humerus is likely significantly less curved in brachiators because of its torsion-dominated loading regime and the greatly increased stress magnitude developed in torsionally loaded curved beams. The large curvature of the radius is localized in the region of attachment of the supinator muscle. Analysis presented here of muscle mass allometry in catarrhines demonstrates that gibbons are characterized by an extremely massive supinator, and the large radial curvature is therefore most likely due to forearm muscle mechanics. This study also demonstrates that the overall pattern of limb bone curvature for anthropoids is distinct from the pattern reported for mammals as a whole. This distinctive scaling relationship may be related to the increased length of the limb bones of primates in comparison to other mammals.     

Development and design of a novel loading device for the investigation of bone adaptation around immediately loaded dental implants using the reindeer antler as implant bed

The assessment of the behavior of immediately loaded dental implants using biomechanical methods is of particular importance. The primary goal of this investigation is to optimize the function of the implants to serve for immediate loading. Animal experiments on reindeer antlers as a novel animal model will serve for investigation of the bone remodeling processes in the implant bed. The main interest is directed towards the time and loading-dependant behavior of the antler tissue around the implants. The aim and scope of this work was to design an autonomous loading device that has the ability to load an inserted implant in the antler with predefined occlusal forces for predetermined time protocols. The mechanical part of the device can be attached to the antler and is capable of cyclically loading the implant with forces of up to 100 N. For the calibration and testing of the loading device a biomechanical measuring system has been used. The calibration curve shows a logarithmic relationship between force and motor current and is used to control the force on the implant. A first test on a cast reindeer antler was performed successfully.     

外伤性颈椎骨折脱位的颈椎椎弓根螺钉内固定治疗及其临床疗效分析

目的：探讨颈椎椎弓根螺钉内固定治疗外伤性颈椎骨折脱位的临床疗效。方法：回顾性分析2010年6月至2012年7月我院采用颈椎椎弓根内固定治疗颈椎骨折脱位28例。损伤部位：C16例,C22例,C3～43例,C43例,C54例,C5～65例,C63例,C6～72例。脱位程度：I度脱位20例,II度脱位5例,III度脱位1例,Ⅳ度脱位2例。ASIA分级：A级2例,B级1例,C级3例,D级4例,E级17例。全部病例术前均行x线、CT及MRI检查并根据其结果行个体化椎弓根钉置入。术前和术后按ASIA神经功能评估方法评价手术疗效。结果：28例均获得8～18个月随访,平均随访12个月,随访期内无一例死亡。其中置入螺钉140枚,有128枚位置正确,12枚存在不同程度偏差,无手术相关并发症,无神经损伤加重。ASIA分级：A级3例中的1例恢复至D级,2例恢复至B级,B级1例恢复至C级,C级3例中的1例恢复至D级,2例恢复至E级,D级4例恢复至E级,E级17例仍为E级。结论：颈椎椎弓根钉内固定是治疗外伤性颈椎骨折脱位安全有效。     

Influence of fracture gap size on the pattern of long bone healing: a computational study

Following fractures, bones restore their original structural integrity through a complex process in which several cellular events are involved. Among other factors, this process is highly influenced by the mechanical environment of the fracture site. In this study, we present a mathematical model to simulate the effect of mechanical stimuli on most of the cellular processes that occur during fracture healing, namely proliferation, migration and differentiation. On the basis of these three processes, the model then simulates the evolution of geometry, distributions of cell types and elastic properties inside a healing fracture. The three processes were implemented in a Finite Element code as a combination of three coupled analysis stages: a biphasic, a diffusion and a thermoelastic step. We tested the mechano-biological regulatory model thus created by simulating the healing patterns of fractures with different gap sizes and different mechanical stimuli. The callus geometry, tissue differentiation patterns and fracture stiffness predicted by the model were similar to experimental observations for every analysed situation.