利用X线平片分析骨折愈合的等效最弱截面

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	利用X线平片分析骨折愈合的等效最弱截面
其他题名	Using radiographs to analyze equivalent weakest transverse interface of fracture healing
	钟红刚; 刘斌; 张万强; 董福慧; 孟和; 钱民全
发表期刊	医用生物力学
	2011-04-15
卷号	26 期号:2 页码:142-149
ISSN	1004-7220
摘要	目的地提取X线平片中包含的骨折愈合力学信息,为临床骨折愈合治疗过程定量判断愈合程度提供有效并且简便实用的方法.方法 12只家兔胫骨中部横断造成骨折模型,并穿针进行滑动固定.利用力传感器在胫骨中部体表从前向后横向手动加载.通过安装在滑动固定器上的微位移传感器测量断端活动位移.采用计算机数据采集系统记录加载力值P和滑动架滑动位移ΔL关系曲线.以K=P/ΔL值代表带滑动固定器兔胫骨整体等效抗弯刚性.每周测量1次.采用经过数字化改造的手提X线机每周拍摄正,侧位X线片;在delphi软件开发环境中编写图像处理和计算程序.在X线正,侧位片灰度分析基础上,沿胫骨轴向扫描计算寻找等效最弱截面并计算其等效抗弯截面惯性矩,得到定量的抗弯刚度和断裂强度判据.结果家兔骨折愈合拆架时间分布在29~41 d.在正侧位X线片上获得计算机模拟的等效最弱截面分界线,且得到其抗弯截面惯性矩.最弱抗弯截面惯性矩与最强抗弯截面惯性矩的比值随愈合时间逐渐升高.侧位片比值术后第1周为(0.31±0.17),第2周为(0.34±0.13),第3周为(0.43±0.20),第4周为(0.56±0.23).正位片位片比值术后第1周为(0.40±0.19),第2周为(0.47±0.16),第3周为(0.56±0.20),第4周为(0.66±0.11).家兔骨折胫骨在体抗弯刚性测试所得K值术前平均为(3.976±4.986)N.μm-1,术后第1周为(0.679±1.026)N.μm-1,术后第2周为(2.115±3.233)N.μm-1,术后第3周为(3.459±4.723)N.μm-1,术后第4周为(4.788±4.831)N.μm-1.从1~4周愈合过程,X线片计算得到的最弱抗弯截面惯性矩和最强抗弯截面惯性矩的比值与K值之间具有很好的相关性.结论外骨痂生长有较强规律性,并且在普通正侧位X线平片易于辨认.从骨折近端和远端分别生长的骨痂在愈合进程中逐渐合拢,最终弥合.本文所述方法较好地反映了实际读片感觉
其他摘要	Objective An effective but simple method for quantifying the fracture healing progress was provided to obtain more information on fracture healing mechanics from plain X-ray film.Method Twelve rabbits were used for experimentally osteotomy at the middle tibiae,each of which was fixed by the sliding fixator with four pins of 1.5 mm diameter,with mini transducer of displacement measuring the sliding micro movement between the fractured bone fragments,denoted as ΔL.The bending rigidity,denoted as K = P/ ΔL,of the rabbits’tibia(withsliding fixator together) were recorded by computer data assembling system once a week,where P was the load on the fracture site from anterior of the tibia by manual operation of a loading transducer.The anterior-posterior and lateral radiographs were also taken every week by digitally upgraded X-ray radioscope.The effective weakest transverse curved interfaces were found,and the equivalent bending moments of inertia were calculated from the radiographs automatically,by gray scan along the longitudinal axis of the tibia upon the image programs edited in Delphi programming environment.And they were used for quantitative description of the rigidity of the healing bone.Results The sliding fixators were removed in 29～41 days after the osteotomy.Ratios of the minimum to the maximum of equivalent bending moments of inertia for each fracture bone were calculated.And they were found to increase via the healing time.The means of the ratios of all twelve rabbits calculated from lateral radiographs were(0.31 ± 0.17) for the first week,(0.34 ± 0.13) for the second week,(0.43 ± 0.20) for the third week,and(0.56 ± 0.23) for the fourth week after the osteotomy,respectively.From anterior-posterior radiographs,the means of the ratios were(0.40 ±0.19),(0.47 ±0.16),(0.56 ±0.20),and(0.66 ±0.11),respec-tively.These ratios were significantly correlated with the bending rigidity K of the fracture tibia of the rabbits.The means of K value was(3.976 ±4.986)N.μm-1 before the operation,and(0.679 ± 1.026)N.μm-1 for the first week,(2.115 ±3.233)N.μm-1 for the second week,(3.459 ± 4.723)N.μm-1 for the third week and(4.788 ± 4.831)N.μm-1 for the fourth week after the operation,respectively.Conclusions The growth of external callus has its own rules.It can be distinguished from plain radiographs easily,and it grows from either side of the fracture site and meets together gradually,filling up the gap at the fracture site at last.The methods described in this paper could reflect the feeling when reading the radiographs.
关键词	X射线骨折愈合最弱截面抗弯刚性力学性能影像分析生物力学
学科领域	力学
URL	查看原文
收录类别	EI ; CSCD
语种	中文
项目资助者	北京市自然基金资助项目(7072050)
CSCD记录号	CSCD:4176411
引用统计	被引频次：2[CSCD] [CSCD记录]
文献类型	期刊论文
条目标识符	http://dspace.imech.ac.cn/handle/311007/45129
专题	微重力重点实验室
通讯作者	钟红刚
推荐引用方式 GB/T 7714	钟红刚,刘斌,张万强,等. 利用X线平片分析骨折愈合的等效最弱截面[J]. 医用生物力学,2011,26,2,:142-149.
APA	钟红刚,刘斌,张万强,董福慧,孟和,&钱民全.(2011).利用X线平片分析骨折愈合的等效最弱截面.医用生物力学,26(2),142-149.
MLA	钟红刚,et al."利用X线平片分析骨折愈合的等效最弱截面".医用生物力学 26.2(2011):142-149.

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