Research on human bone microhardness distribution characteristics of superior and inferior ramus of the pubis
Liu Guobin, Yin Bing, Wang Jianzhao, Li Sheng, Zhang Xiaojuan, Wu Weiwei, Hu Zusheng, Liu Yake, Zhang Yingze
Department of Orthopedic Surgery, the Third Hospital of Hebei Medical University, Key Laboratory of Orthopaedic Biomechanics of Hebei Province, Shijiazhuang 050000, China
Abstract:Objective To investigate the distribution characteristics of micro-vickers hardness (HV) in the pubic ramus.Methods Three fresh frozen adult cadavers were provided by the Department of Anatomy of Hebei Medical University. Specimen A, B, C were a 62-year-old male, a 45-year-old female and a 58-year-old male, respectively. Pubic ramus were taken out and soft tissue was removed. Micro-table saw and high-precision slow-speed saw were used to cut the specimens. Each one of the superior and inferior ramus of pubic were divided into 3 equal parts,each of which was equally cut. The bone was made into bone tissue sections 3 mm thick, which were fixed on slides and marked. The samples were sanded with silica carbide particles of 800, 1 000, 1 200, 2 000 and 4 000 mesh respectively. The hardness values of pubic ramus in different regions were tested by German KB-5 microhardness tester. In this series of studies, the standard operating method of 50 gf force loading 50 s and maintaining 12 s was used to determine the hardness values. Five effective microhardness values were selected for each region, and the average value of all effective values was used to be the hardness value of the region.Results The average bone hardness of superior and inferior ramus of pubic were (27.99±6.03)HV, (29.93±4.86) HV, (33.42±5.15)HV, and (33.99±3.10) HV, (37.95±5.39) HV, (36.19±3.87) HV, respectively. The One-way Anova analysis showed the significant difference of superior and inferior ramus of pubic among 3 groups(Fsr=9.540, Fir=12.890, all P values<0.01). The bone hardness of the inferior ramus of the pubis was higher than that of the superior ramus, and the difference was statistically significant (tA=3.432, tB=4.280, tC=3.874, all P values<0.01) for the three groups.Conclusions The microhardness of the inferior ramus of the pubis is higher than that of the superior ramus of the pubis. This is the first discovery of the distribution characteristics of microscopic bone hardness of the pubic bone,which can help to explain the injury mechanism of the pubic branch fracture, and provide data support for the development of internal fixation that conforms to the characteristics of bone hardness of the site and related biomechanical research. Trial Registation Chinese Clinical Trail Registry, ChiCTR-TNC-17010818.
刘国彬, 殷兵, 王建朝, 李升, 张晓娟, 吴卫卫, 胡祖圣, 刘雅克, 张英泽. 人体耻骨上、下支显微骨硬度分布特征研究[J]. 中华解剖与临床杂志, 2020, 25(2): 98-101.
Liu Guobin, Yin Bing, Wang Jianzhao, Li Sheng, Zhang Xiaojuan, Wu Weiwei, Hu Zusheng, Liu Yake, Zhang Yingze. Research on human bone microhardness distribution characteristics of superior and inferior ramus of the pubis. Chinese Journal of Anatomy and Clinics, 2020, 25(2): 98-101.
Hill RM, Robinson CM, Keating JF. Fractures of the pubic rami. Epidemiology and five-year survival[J]. J Bone Joint Surg Br, 2001, 83(8): 1141-1144. DOI:10.1302/0301-620x.83b8.11709.
殷兵, 王建朝, 李升, 等. 人体跖骨显微硬度的分布特征研究[J]. 中华解剖与临床杂志, 2018, 23(6): 465-468. DOI:10.3760/cma.j.issn.2095-7041.2018.06.002.Yin B, Wang JC, Li S, et al. The micro-hardness distribution in human metatarsal bones[J]. Chin J Anat Clin, 2018, 23(6): 465-468. DOI:10.3760/cma.j.issn.2095-7041.2018.06.002.
[5]
殷兵, 郭家良, 李升, 等. 人体距骨显微硬度的分布特征研究[J]. 中华解剖与临床杂志, 2018, 23(6): 461-464. DOI:10.3760/cma.j.issn.2095-7041.2018.06.001.Yin B, Guo JL, Li S, et al. The micro-hardness distribution in human talus bone[J]. Chin J Anat Clin, 2018, 23(6): 461-464. DOI:10.3760/cma.j.issn.2095-7041.2018.06.001.
[6]
李升, 张晓娟, 吴卫卫, 等. 人体脊柱胸腰段椎骨显微骨硬度分布特征研究[J]. 中华解剖与临床杂志, 2019, 24(4): 313-317. DOI:10.3760/cma.j.issn.2095-7041.2019.04.001.Li S, Zhang XJ, Wu WW, et al. The hardness variations and characteristics of the human thoracolumbar segments by Vickers microindentation[J]. Chin J Anat Clin, 2019, 24(4): 313-317. DOI:10.3760/cma.j.issn.2095-7041.2019.04.001.
[7]
张晓娟, 李升, 吴卫卫, 等. 人体肱骨干显微骨硬度分布特征的实验研究[J]. 中华解剖与临床杂志, 2019, 24(4): 318-321. DOI:10.3760/cma.j.issn.2095-7041.2019.04.002.Zhang XJ, Li S, Wu WW, et al. Micro-hardness distribution of humeral shaft in human skeleton[J]. Chin J Anat Clin, 2019, 24(4): 318-321. DOI:10.3760/cma.j.issn.2095-7041.2019.04.002.
[8]
Zwierzak I, Baleani M, Viceconti M. Microindentation on cortical human bone: effects of tissue condition and indentation location on hardness values[J]. Proc Inst Mech Eng H, 2009, 223(7): 913-918. DOI:10.1243/09544119JEIM634.
Matta JM. Indications for anterior fixation of pelvic fractures[J]. Clin Orthop Relat Res, 1996 (329): 88-96. DOI:10.1097/00003086-199608000-00011.
[16]
Steinitz D, Guy P, Passariello A, et al. All superior pubic ramus fractures are not created equal[J]. Can J Surg, 2004, 47(6): 422-425.
[17]
唐明杰, 周祖彬, 于晓巍, 等. 骨盆前环骨折的微创钢板固定有限元分析及临床研究[J]. 中华创伤杂志, 2013, 29(11): 1074-1078. DOI:10.3760/cma.j.issn.1001-8050.2013.11.012.Tang MJ, Zhou ZB, Yu XW, et al. Minimally invasive plate osteosynthesis for anterior pelvic ring fractures: a finite element analysis and clinical study[J]. Chinese Journal of Trauma , 2013, 29(11): 1074-1078. DOI:10.3760/cma.j.issn.1001-8050.2013.11.012.
[18]
Courtney PM, Taylor R, Scolaro J, et al. Displaced inferior ramus fractures as a marker of posterior pelvic injury[J]. Arch Orthop Trauma Surg, 2014, 134(7): 935-939. DOI:10.1007/s00402-014-1993-9.
[19]
Starr AJ, Nakatani T, Reinert CM, et al. Superior pubic ramus fractures fixed with percutaneous screws: what predicts fixation failure?[J]. J Orthop Trauma, 2008, 22(2): 81-87. DOI:10.1097/BOT.0b013e318162ab6e.
[20]
孟昊业, 汪爱媛, 许文静, 等. 逆行螺钉置入固定骨盆耻骨上支骨折的数字解剖学参数[J]. 解放军医学院学报, 2018, 39(6): 520-522,550. DOI:10.3969/j.issn.2095-5227.2018.06.016.Meng HY, Wang AY, Xu WJ, et al. Digital anatomical parameters of retrograde screw placement for superior pubic ramus fractures[J]. Acad J Chin PLA Med Sch, 2018, 39(6): 520-522, 550. DOI:10.3969/j.issn.2095-5227.2018.06.016.
[21]
Routt ML Jr, Simonian PT, Grujic L. The retrograde medullary superior pubic ramus screw for the treatment of anterior pelvic ring disruptions: a new technique[J]. J Orthop Trauma, 1995, 9(1): 35-44. DOI:10.1097/00005131-199502000-00006.