| Objective: The iliopsoas muscle consist of the iliacus and psoas muscle. The iliacus fan-shaped, starting from the iliac fossa; psoas muscle is long, since the lumbar vertebral body and transverse process, two muscles down crosspoint, through the inguinal ligament deep side, stop to the lesser trochanter of femur. The main function of the iliopsoas muscle: proximal support, its pull from down to up, the contraction to make ham flexing, running in the thigh can have great relationship between speed and power swing and exalt and iliopsoas muscle contraction rapidly before. While in the far side support, both sides at the same time the iliopsoas muscle contraction, trunk flexion and pelvis, and as the movement is completed when the leg pressing operation to obtain the forward force to create good conditions.Intertrochanteric fracture of the femur is refers to between the base of neck of femur rotor fracture to small level, is a common clinical types of hip fracture. It occurs in osteoporotic elderly patients, incidence of all fractures 3%-4%. According to the biomechanical properties can be divided into fracture is the stability of fracture and unstable intertrochanteric fracture, fracture of the medial cortex after stability is to complete, while the unstable fracture refers to the posteromedial cortex by pulverizing, leading to lesser trochanter of femur free, causing the loss of iliopsoas muscle point.With the development of medical technology and the internal fixation materials, operation treatment has become the basic principle of intertrochanteric fractures of the femur, however, operation for the treatment of intertrochanteric fractures in dealing with the lesser trochanter of femur is still in a blank state, in previous studies, some people use lag screws to fix, and others use femoral lesser trochanter reductor to fixed, these are not resetthe unified method and standard, along with the progress of the society, people have gradually increased for the understanding of operation treatment, reconstruction of iliopsoas muscle, the repair of lesser trochanter of femur, reconstruction of iliopsoas muscle function by more and more people pay more attention to. This research uses biomechanical experiment to measure and analysis the data after a new type of hook plate reengineering the stop of iliopsoas muscle, proves that the new type hook plate can reconstruct the iliopsoas muscle function after reengineering the stop of iliopsoas muscle.Methods:The design and manufacture of the new type of hook plate.1 According to the shape of anatomical location and the anatomical location of the lesser trochanter of femur, combined with operation for the treatment of intertrochanteric fractures internal fixation material location, design and produce new hook plate which is made of stainless steel.2 The comparison of biomechanical experiment on the new type of hook plate and traditional lag screw.2.1 Using the type of CSS-44020 biomechanical machine(Changchun Research Institute of experimental machine)( biomechanical test machine installation of experimental software :Test Expert.NET) respectively operate the one-off tensile fracture experiment.on the human cadaver specimens and the pig cadaveric specimens iliopsoas.2.2 Respectively using lag screws and new type of hook plate reconstruction of iliopsoas muscle after removing the lesser trochanter of human cadaver specimens and the pig cadaveric specimens, and uses the CSS-44020 biomechanical testing machine to do the one-off tensile fracture experiment.2.3 The resulting data is analysised by SPSS19.0 statistical package, compared with three groups of Levene biomechanical measurement data analysis.3 The application in operation of new type of hook plate in the treatment of intertrochanteric fracture of femur.Select unstable intertrochanteric femoral fracture patients,operate by experienced physicians in using the new hook plate to reconstruct iliopsoas muscle stop and repair the lesser trochanter operation, Intraoperative fluoroscopy view the effect.Results: For the timely processing of the data in computer,The maximum force(Fm),the total energy(Wt),and the fracture stress(Rf) etc can be drawn from the sample.After the statistical analysis,we can learn that the human body specimen group Fm(omplete iliopsoas group)(72.19±13.48)>Fm(new type hook plate group)( 68.23±12.75) > Fm(lag crew group)(65.73±12.28),there is no statistically significant difference between the three(P>0.1);Wt(complete iliopsoas group)( 0.36±0.09)>Wt(new type hook plate group)(0.32±0.08)>Wt(lag crew group)( 0.29±0.07), there is no statistically significant difference between the three(P>0.1);Rf(complete iliopsoas group)( 39.40±8.51) > Rf( new type hook plate group)(37.50±8.10) > Rf(lag crew group)( 35.19±7.60),there is no statistically significant difference between the three(P>0.1).the pig body specimen group Fm(complete iliopsoas group)(88.64±16.56)>Fm(new type hook plate group)(79.27±14.81)>Fm(lag crew group)(75.67±14.14),there is no statistically significant difference between the three(P>0.1);Wt(complete iliopsoas group)( 0.54±0.13)>Wt(new type hook plate group)(0.49±0.12)>Wt(lag crew group)( 0.41±0.10), there is no statistically significant difference between the three( P > 0.1); Rf(complete iliopsoas group)( 42.75±9.23)>Rf(new type hook plate group)(39.05±8.94)>Rf(lag crew group)( 36.57±7.49) there is no statistically significant difference between the three(P>0.1)Intraoperative application of the new type of hook plate is simple, convenient.It reduces the destruction of the fracture of the lesser trochanter surrounding soft tissue and blood supply.Meanwhile it pull the lesser trochanter to its anatomical position.Conclusions: In biomechanical experiment, according to the obtained data can be learned, in human cadaver specimens and pig cadaver specimens in the data set,there is no statistical significance in comparison between the complete iliopsoas muscle group,new type hook-plate group, lag screw group.It identify the fact that the new type hook plate can reconstruct the iliopsoas muscle function after reengineering the stop of iliopsoas muscle. Using lag screws reset the lesser trochanter can reconstruct the iliopsoas muscle function. The new hook plate can be operated in incision and leads to minor trauma.It partially restore the anatomy of the lesser. |
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