CAJ | 학술논문

目的比较跟骨解剖接骨板加压螺栓与AO接骨板固定SandersⅢ型跟骨骨折的生物力学性能. 方法采集16具新鲜冰冻成人足标本,制作SandersⅢ型跟骨骨折模型,随机分为试验组和对照组,每组8具标本.试验组行跟骨解剖接骨板加压螺栓固定,对照组采用AO接骨板螺钉固定.对标本分别施以20～200 N、20～700 N循环负荷,重复1000次,最后进行屈服试验.记录并比较两组标本的不可逆位移、最大位移及最大负荷等,并计算弹性位移. 结果在20～200 N循环测试中,试验组和对照组不可逆位移差异无统计学意义(P＞0.05),但试验组最大位移[(2.84±0.05) mm]和弹性位移[(0.30±0.04) mm]明显小于对照组[(3.02±0.06)、(0.43±0.07) mm].差异有统计学意义(P＜0.05).在20～700 N循环测试中,试验组不可逆位移[(4.58±0.43) mm]及最大位移[(6.05±0.30) mm]较对照组[(7.31±0.28)、(8.38±0.30) mm]小,弹性位移[(1.49±0.16) mm]较对照组[1.06±0.15) mm]大,两组比较差异均有统计学意义(P＜0.05).在屈服试验中,试验组和对照组的最大负荷平均分别为(3873±476)、(3076±186)N,两组比较差异有统计学意义(P＜0.05)；两组最终位移差异无统计学意义(P＞0.05). 结论跟骨解剖接骨板加压螺栓的固定强度和稳定性均优于AO接骨板,可以更有效地固定Sanders Ⅲ型跟骨骨折.
목적 비교근골해부접골판가압라전여AO접골판고정SandersⅢ형근골골절적생물역학성능. 방법 채집16구신선빙동성인족표본,제작SandersⅢ형근골골절모형,수궤분위시험조화대조조,매조8구표본.시험조행근골해부접골판가압라전고정,대조조채용AO접골판라정고정.대표본분별시이20～200 N、20～700 N순배부하,중복1000차,최후진행굴복시험.기록병비교량조표본적불가역위이、최대위이급최대부하등,병계산탄성위이. 결과 재20～200 N순배측시중,시험조화대조조불가역위이차이무통계학의의(P＞0.05),단시험조최대위이[(2.84±0.05) mm]화탄성위이[(0.30±0.04) mm]명현소우대조조[(3.02±0.06)、(0.43±0.07) mm].차이유통계학의의(P＜0.05).재20～700 N순배측시중,시험조불가역위이[(4.58±0.43) mm]급최대위이[(6.05±0.30) mm]교대조조[(7.31±0.28)、(8.38±0.30) mm]소,탄성위이[(1.49±0.16) mm]교대조조[1.06±0.15) mm]대,량조비교차이균유통계학의의(P＜0.05).재굴복시험중,시험조화대조조적최대부하평균분별위(3873±476)、(3076±186)N,량조비교차이유통계학의의(P＜0.05)；량조최종위이차이무통계학의의(P＞0.05). 결론 근골해부접골판가압라전적고정강도화은정성균우우AO접골판,가이경유효지고정Sanders Ⅲ형근골골절.
Objective To compare the biomechanical properties of calcaneal anatomical plate and compression bolTs versus conventional AO plate in fixation of intraarticular calcaneal fractures. Methods In 16 fresh frozen cadaveric specimens of adult lower limb,Sanders type Ⅲ calcaneal fractures were created.The specimens were randomly divided into 2 equal groups.The experimental group was stabilized with the calcaneal anatomical plate and compression bolts while the control group with the conventional AO calcaneus plate.Next,each specimen in both groups was subjected to cyclic loading of 20N to 200N and 20N to 700N for 1000 times followed by loading to failure in the yield pressure test.Data regarding the irreversible deformation,maximum displacement,maximum load and elastic displacement were recorded and compared between the 2 groups. Results In the cyclic loading test of 20 N to 200 N,there was no significant difference between the 2 groups regarding the irreversible deformation (P ＞ 0.05),but the maximum displacement (2.84 ± 0.05 mm) and elastic displacement (0.30 ± 0.04 mm) in the experiment group were significantly lower than those (3.02 ± 0.06 mm and 0.43 ± 0.07 mm) in the contrnl group ( P ＜ 0.05).In the cyclic loading test of 20 N to 700 N,the irreversible deformation (4.58 ± 0.43 mm) and the maxinum displacement (6.05 ±0.30 mm) in the experiment group were significantly lower than those (7.31 ± 0.28 mm and 8.38 ±0.30 mm) in the control group ( P ＜0.05),but the elastic displacement (1.49 ±0.16 mm) in the experiment group was significantly greater than that (1.06 ±0.15 mm) in the control group ( P ＜ 0.05).In the yield pressure test,the maximum load in the experiment group (3873 ±476 N) was significantly larger than in the control group (3076 ± 186 N) ( P ＜ 0.05),but there was no significant difference between the 2 groups in the ultimate displacement ( P ＞ 0.05). Conclusion Compared with the conventional AO plate system,the calcaneal anatomical plate and compression bolts can stabilize Sanders Type Ⅲ calcaneus fractures more effectively because they can provide better stability and higher strength fixation.