On the Biomechanical Reasons Why Children Are Liable to Have
Fracture in Supracondyle of Humerus
Zheng Xiang1 Chen Qi2
1 (Institute of Technology, Yangzhou University, Yangzhou 225009)
2 (Yangzhou Hosptial of Traditional Chinese Medicine, Yangzhou 225002)
Abstract With the viewpoint of biomechanics in theory, this paper analyses why children are liable to have fracture in supracondyle of humerus as a result of falling to the ground with the upper limbs propping up the body while adults usually have fracture in the middle or upper part of humerus under the same condition. The focus of discussion is the change of front-inclination in the lower end of humerus in the process of bone maturity from childhood to adulthood.
Key words Biomechanics Supracondyle fracture of humerus Front-inclination
1 前 言
在俯卧跌仆、上肢撑地为主要受伤姿态的一类肱骨骨折中，儿童多发生伸直型肱骨髁上骨折。对这一现象产生的原因，文献仅从肱骨髁上抗拉(压)强度比骨干低，肱骨髁上部位尺侧应力较集中来解释［1，2］。但是，同样情况，为什么成人肱骨骨折部位却很少发生在肱骨髁上，而一般位于肱骨中上部呢?
我们根据儿童到成人骨形态生长、发育过程中的变化，从生物力学角度进行了分析、论证，提出儿童俯卧跌仆上肢撑地易产生肱骨髁上骨折的原因，并非单纯骨强度问题，更重要的是与肱骨下端前倾角有关。这不仅在理论上澄清了既往的一些模糊概念和不准确结论，对肱骨髁上骨折、肱骨中上段骨折的临床诊断、治疗提供了生物力学角度上的有益思考，而且可能对未来有关诊疗器械设计的力学构思产生影响。
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