| Objectives: To provide the data for the design of internal fixation device for the treatment of Subtrochanteric Fractures in Skeletally Immature Adolescents,we measured the anatomic data of the proximal femur parameters and investigated its geometric character in Chinese children (5-10years);Design and making a new type of instrument for the reestablishment of trochanter surrounding in children;To determine if the anatomical proximal femur bone plate can provide stable fixation stability in fixing subtrochanteric fractures in skeletally immature adolescents through comparative biomechanical studies.Methods:1. Anatomical Measurement Anatomic data of the proximal femur was measured in 30 normal Chinese children cadavers ,we compared and analyzed the anatomic data with the imageology result.2. Design and Making of the Anatomical Proximal Femur Bone Plate Based on the anatomical datas and the biomechanical characters of the proximal femur ,a new type of instruments is designed and manufactured for the treatment of subtrochanteric fractures in Skeletally Immature Adolescents.3. Biomechanical Studies of the Anatomical Proximal Femur Bone Plate in the Fixation of Subtrochanteric Fractures in Children. Using a paired experimental design ,one member of each matched pair was randomly assigned to be fixed with anatomical proximal femur bone plate and the contralateral side was fixed with Reconstruction Plate.Six matched pairs of the fracture models specimens tested in three modes:⑴the anti-axial compression tests.⑵anti-bend test⑶anti-torsion test.The index included radio-degree(the descening displace),the axial stiffness, the bending stiffness ,the torsional stiffness. We compared the index of our instruments with Reconstruction Plate.Result:1. Anatomical Measurement a : 21.84±3.96mm ; b: 65.39±14.24mm; c: 24.36±4.19mm; d: 35.80±8.81mm; e: (ɑ) 141.51±6.70°; f(:?)15.44±2.36°; g: 20.70±4.32mm; h: 26.79±5.39mm; i: 54.74±11.84mm2. Design and Making of the Anatomical Proximal Femur Bone Plate we design the the Anatomical Proximal Femur Bone Plate into left and right uses in our research.The specially made cancellated bone screw was upgraded from typical cancellated bone screw of AO company,and it have a smooth anterior extremity,This spical design can avoid epiphyseal disk damage in abstracto. The Anatomical Proximal Femur Bone Plate can be insertion three screw in proximal end ,with two cancellated bone screw insertion along the collum femoris ,and the third os integumentale screw into calcar femorale.3. Biomechanical Studies of the Anatomical Proximal Femur BonePlate in the Fixation of Subtrochanteric Fractures in Children. The comparison of bending experiment :radio-degree of the Anatomical ProximalFemur Bone Plate is smaller than that of Reconstruction Plate at 300N(Anatomical Plate group: 1.00±0.40mm, Reconstruction Plate group:1.66±0.38mm ,they had different in statistic P<0.05); The stiffness to resist bending of Anatomical Plate was larger than that of Reconstruction Plate significantly(Anatomical Plate group:336.06±25.47N/M, Reconstruction Plate group: 113.13±28.69N/M,P<0.05) . The stiffness of Anatomical Plate in resisting to rotation were close to that of the Reconstruction Plate. But there no significance between two Plates(Anatomical Plate group: 3.24±0.74Nm/degree, Reconstruction Plate group: 2.59士0.37Nm/degree,P>0.05).The value of axial stiffness was 217.99士71.31N/mm (Anatomical Plate group),191.22士52.35N/mm(Reconstruction Plate group),There are no different in statistic(P>0.05).Conclusion:1. It is the first time to measure the anatomic data of the proximal femur parameters in Chinese children (5-10years),and this research provide the basis for the manufacture and ues of the instruments and added the new content for anatomy.2. The Anatomical Proximal Femur Bone Plate for children is a new type of ideal internal fixation device and its biomechanical property can meet the reestablishment of trochanter surrounding in Skeletally Immature Children.3. The Anatomical Proximal Femur Bone Plate for children could be taken as an ideal instrument with good biomechanical feature for the fixation of Subtrochanteric Fractures in Children. |
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