舟状骨的生物力学特性及桡骨茎突切除对舟状骨生物力学的影响

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1、授予吊位代码10089学号或申请号20122266蚵处(£斜大tHebeiMedicalUniversityV硕士学位论文科学学位舟状骨的生物力学特性及桡骨茎突切除对舟状骨生物力学的影响研究生：马晨导师：张继春教授专业：外科学二级学院：第三医院2015年3月河北医科大学学位论文使用授权及知识产权归属承诺本学位论文在导师（或指导小组）的指导下，由本人独立完成。本学位论文研究所获得的研究成果，其知识产权归河北医科大学所有。河北医科大学有权对本学位论文进行交流、公幵和使用。'凡发表与学位论文主要内容相关的论文，第一署名单位为河北医科大学，试验材料、原始数据

2、、申报的专利等知识产权均归河北医科大学所有。否则，承担相应的法律责任。研究生签名：石Jf导师签章各二级学院签章：年

3、月j曰河北医科大学研究生学位论文独特性声明本论文是在导师指导下进行的研究工作及取得的研究成果，除了文中特别加以标注等内容外，文中不包括其他人己经发表或撰写的研究成果，指导教师对此进行了审定。本论文由本人独立撰写，文责自负。研究生签名：导师签珍抓年^^曰目录中文摘要·······································································1英文摘要············

4、····························································4英文缩写········································································7研究论文舟状骨的生物力学特性及桡骨茎突切除对舟状骨生物力学的影响前言········································································8材料与方法····························

5、·····································8结果··········································································11附图········································································12附表·········································································16讨论·······

6、··································································20结论·········································································24参考文献···································································25综述舟状骨骨折及桡骨远端骨折的研究及进展·······················27致谢·············

7、····································································35个人简历············································································37中文摘要舟状骨的生物力学特性及桡骨茎突切除对舟状骨生物力学的影响摘要目的：通过对舟状骨的生物力学特性和桡骨茎突切除对其生物力学影响的研究，为舟状骨骨折的治疗提供理论依据。在腕部骨折中，以舟状骨的骨折最为常见，占到了80%甚至更多。由于舟状骨的血供特点和

8、其在腕骨中的解剖位置都比较特殊，致使舟状骨的骨折愈合相对于其他腕骨来说比较困难，又由于目前舟状骨的诊断、治疗方法尚未有统一的标准和原则，故导致舟状骨骨折诊断不及时及骨折不愈合的情况时有发生，进而导致临床治疗的困难和治疗时间过长，增加患者的负担，常遗留腕关节的疼痛和不同程度的腕关节功能丧失，甚至发生创伤性关节[1]炎，影响患者的生活质量。对于在临床中遇到的陈旧性舟状骨骨折，经常用到的方法是将桡骨茎突切除，以减轻舟状骨在腕关节活动时所受的压力，以利于骨折的愈合，近年来改进的方法有将切除的桡骨茎突松质骨植入骨折断端、将舟状骨两断端以髓内钉加固等。该术式得到

9、了大家的普遍认可，但桡骨茎突切除后，舟状骨生物力学改变的量化研究，国内外目前鲜有报道。鉴于当前的研究进展，我