| Summary: | 碩士 === 國立成功大學 === 醫學工程研究所碩博士班 === 98 === Ipsilateral fractures of the hip and femoral shaft are relatively rare and mostly result of high-energy injuries. However, as the increasing of motor vehicle accidents, this issue becomes important. About 2.5-6% of femoral shaft fractures will combine with ipsilateral hip fracture. On these cases femoral neck fractures are often neglected initially and the rate of misdiagnosis varying from 19% to 31%. Although more than 60 methods are recommended for management of these concomitant fractures, none has been accepted as the gold standard. The most usd procedure can be divided to intra-medullary and extra-medullary. From Reviewing , the most used for the intra-medullary is the reconstruction nail while for extra-medullary device is the dynamic hip screw (DHS) combined with dynamic compression plate(DCP). In general, the reconstruction nail is better in load-sharing. However, neck varus deformity can be found in the reconstruction nail group. The purpose of this study was to compare the biomechanical behavior of these two different device by mechanical test. Digital Image Correlation (DIC) analysis was also used to identified the displacement on the femoral neck and intertrochanteric region. The result showed that there is no difference in these two device when the fracture site had good reduction. But the reconstruction nail group had better stiffness than DHS plus DCP group when the gap presented in fracture site. The displacement amount is bigger in the neck region then trochanter region after fracture reduction obtained from DIC. Besides, the direction of the displacedment seems to be related to the screw direction in both groups. However, due to the limited specimen number, further validation such as finite element analysis may be required.
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