中文摘要：

目的：通过生物力学研究,对比两种治疗肱骨近端骨折内固定结构的力学特性,为临床应用提供理论基础。方法将36根经防腐处理的成人肱骨干随机平均分为6组：试验组（A1髓内钉压缩组、A2髓内钉拉伸组、B1锁定板压缩组、B2锁定板拉伸组）和对照组（C1压缩对照组、C2拉伸对照组）。试验前对所有肱骨干标本进行骨密度检查,计算小组间有无显著性差异以排除骨质情况对固定稳定性的影响。所有标本均拍摄前、后位及侧位 X 线片,以排除术前骨折及其他骨病。试验组按照统一标准制作肱骨近端3部分外科颈大结节骨折模型。A1、A2组使用施乐辉 TRIGENTM 钛合金肱骨交锁髓内钉固定,肱骨远端为2枚交锁髓内钉固定,肱骨近端为4枚交锁髓内钉固定。B1、B2组使用 AO 肱骨近端锁定钛板内固定,肱骨远端为3枚皮质骨螺钉固定,肱骨近端为5枚松质骨螺钉固定。C1、C2组不做骨折模型及固定。对 A1、B1、C1组进行轴向压缩试验,对 A2、B2、C2组进行轴向拉伸试验,以固定失效为试验终止点。分别记录极限载荷和位移曲线,计算刚度。试验结果用SPSS 12.0版软件进行统计学分析,P 〈0.05为差异具有统计学意义。结果（1）A1、B1组的极限压缩载荷低于 C1组（t =2.712、t =2.389,P 值均〈0.05）,A1、B1组间比较差异无统计学意义（t =1.951,P 〉0.05）,A2、B2组的极限拉伸载荷低于 C2组（t =3.194、t =3.201,P 值均〈0.05）,A2、B2组间比较差异无统计学意义（t =2.136,P 〉0.05）；（2）A1、B1组的刚度低于 C1组（t =2.826、t =2.837,P 〈0.05）,A1、B1组间比较差异无统计学意义（t =2.004,P 〉0.05）,A2、B2组的刚度低于C2组（t =2.357、t =2.481,P 值均〈0.05）,A2、B2组间比较差异无统计学意义（t =2.108,P 〉0.05）。结论肱骨近端交锁髓内钉和锁定接骨板在抗压缩和抗拉伸方面的生物力学强度无明显差异,交锁髓内钉可以提?

英文摘要：

Background Proximal humeral fracture is a common fracture in elderly patients with osteoporosis,locking plate and intramedullary nail fixation are the most popular methods for its surgical treatment at present.There are advantages and disadvantages for both methods of internal fixation treatment.Currently,the choice of internal fixation method is a problem faced by traumatic orthopedic doctors. In this study we used proximal humeral locking plate or interlocking intramedullary nail for fracture fixation in vitro human samples with anticorrosive treatment tosimulate theload condition of shoulder joint after internal fixation,measured and calculated the axial load and stiffness of the fracture model,and discussed the fixed strength of the two internal fixation＆amp;nbsp;devices.We also analyzed the characteristics of these two kinds of internal fixation methods from the perspective of biomechanics.Methods （1）Selection of humeralsamples.A total of 36 humeralsamples with antiseptic treatment wereselected from 18 specimens of 60-85 years old,including 14 male samplesand 22 female samples.The X-ray films of the samples were taken to exclude congenital deformity,fracture and tumor.We appliedUnigamma X-ray Plus bone mineral density instrument to measure bone mineral density （humeral head area were unified delimited）,results in each group were recorded for variance analysis.（2）Construction of fracture model with internal fixation.According to Neerclassification and the method introduced by Kwon,we produced three-partproximal humeral fracture model.We cut the humeral head with a oscillating saw at the surgical neck plane,the thickness of saw blade was 1 mm,confirmed the position of intertubercular sulcus on the osteotomy plane,then saw the bone along intertubercular sulcus to the distal humerus, thedirection is perpendicular to the osteotomy plane,until to the base of the lesser tubercle level,cut the greater tuberosity from proximal humerusat the base of lesser tuberosity,the direction is perpendicular to the