CAJ | 학술논문

背景:很多临床报道认为"双钢板"方法治疗肱骨髁间骨折是较为理想的方法,但对于放置方式一直存在争议.目的:比较肱骨髁间骨折应用双钢板固定时,3种不同放置方式的生物力学特性.方法:18具防腐肱骨标本,制成肱骨远端"T"型髁间骨折模型,在髁间骨折线两侧各贴2个(共4个)应变片.随机予以背侧双钢板固定、垂直双钢板固定、平行双钢板固定,在压缩载荷下,对3种内固定方式进行应变、位移、刚度的测试.结果与结论:①从载荷-位移数据中可以看到:当载荷低于500 N时,3种内固定方式位移差异无显著性意义;在500 N时,平行双钢板压缩位移小于背侧双钢板固定、垂直双钢板固定(P < 0.05).②3种内固定应变较小的是平行双钢板固定,另两种钢板固定方式应变较大,前者与后两者差异有显著性意义(P < 0.05).内外髁的应变大于髁间应变,外髁的应变最大.当载荷低于300 N时,3种内固定方式的刚度差异无显著性意义.在300～500 N外力的载荷下轴向压缩刚度以平行双钢板内固定最高,背侧双钢板和垂直双钢板较低,前者与后两者比较差异有显著性意义(P < 0.05).由此可见,同等载荷下,平行钢板固定效果最佳,垂直钢板固定和背侧钢板固定之间无差异.
배경:흔다림상보도인위"쌍강판"방법치료굉골과간골절시교위이상적방법,단대우방치방식일직존재쟁의.목적:비교굉골과간골절응용쌍강판고정시,3충불동방치방식적생물역학특성.방법:18구방부굉골표본,제성굉골원단"T"형과간골절모형,재과간골절선량측각첩2개(공4개)응변편.수궤여이배측쌍강판고정、수직쌍강판고정、평행쌍강판고정,재압축재하하,대3충내고정방식진행응변、위이、강도적측시.결과여결론:①종재하-위이수거중가이간도:당재하저우500 N시,3충내고정방식위이차이무현저성의의;재500 N시,평행쌍강판압축위이소우배측쌍강판고정、수직쌍강판고정(P < 0.05).②3충내고정응변교소적시평행쌍강판고정,령량충강판고정방식응변교대,전자여후량자차이유현저성의의(P < 0.05).내외과적응변대우과간응변,외과적응변최대.당재하저우300 N시,3충내고정방식적강도차이무현저성의의.재300～500 N외력적재하하축향압축강도이평행쌍강판내고정최고,배측쌍강판화수직쌍강판교저,전자여후량자비교차이유현저성의의(P < 0.05).유차가견,동등재하하,평행강판고정효과최가,수직강판고정화배측강판고정지간무차이.
BACKGROUND: Dual-plate has been regarded as an ideal clinical therapy for intercondylar fracture of the humerus. However, the placement pattern remains controversial.OBJECTIVE: To compare biomechanical characteristics of three placement patterns of dual-plate internal fixation for intercondylar fracture of the humerus. METHODS: A total of 18 anticorrosive cadaveric adult humerus specimens were used to prepare "T" style intercondylar fracture of the humerus. Two strain gauges were stuck at each side of the fracture line. The fracture was treated by dorsal-plate, perpendicular-plate, and parallel-plate fixation. Biomechanical tests were performed on these specimens, including strain, displacement, and rigidity. RESULTS AND CONCLUSION: Data of the stress and displacement showed that there was no significant difference in displacement among three different internal fixation methods under stress bellow 500 N. The displacement of parallel-plate group was less than dorsal-plate and perpendicular-plate groups under stress of 500 N (P < 0.05). The strain was significantly less in parallel-plate group compared with dorsal-plate and perpendicular-plate groups (P < 0.05). The strain of internal and external condyle was greater than intercondylar strain, and the strain of external condyle was the largest. There were no significant differences in rigidity among three groups under stress less than 300 N. The axial compressive rigidity was largest in parallel-plate group under stress of 300-500 N compared with the other groups (P < 0.05). Under the same load condition, parallel-plate yielded the best results, and there was no obvious difference between dorsal-plate and perpendicular-plate.