CAJ | 학술논문

目的：对复杂胫骨平台骨折三种微创内固定方法进行生物力学比较研究。方法采集18具成人防腐尸体胫骨平台标本，制成复杂胫骨平台骨折模型（Schatzker分型Ⅵ型）。分别用外侧LISS锁定钢板+后内侧重建钢板（LISS+RP）、外侧LISS锁定钢板+内侧三枚空心加压螺钉（LISS+CS）、单独外侧锁定钢板（LISS）固定，进行位移、轴向刚度的研究。结果 LISS+RP组和LISS+CS组生物力学稳定性明显优于LISS组（P<0．05），而LISS+RP组和LISS+CS组之间比较，差异无统计学意义（P>0．05）。结论 LISS+RP与 LISS+CS是目前治疗复杂胫骨平台骨折较合适的内固定方式。但对于皮肤挫伤、软组织肿胀严重的胫骨平台骨折，LISS+CS注重软组织和血供的保护，更符合生物学固定的要求，是目前最理想的微创内固定方式。
목적：대복잡경골평태골절삼충미창내고정방법진행생물역학비교연구。방법채집18구성인방부시체경골평태표본，제성복잡경골평태골절모형（Schatzker분형Ⅵ형）。분별용외측LISS쇄정강판+후내측중건강판（LISS+RP）、외측LISS쇄정강판+내측삼매공심가압라정（LISS+CS）、단독외측쇄정강판（LISS）고정，진행위이、축향강도적연구。결과 LISS+RP조화LISS+CS조생물역학은정성명현우우LISS조（P<0．05），이LISS+RP조화LISS+CS조지간비교，차이무통계학의의（P>0．05）。결론 LISS+RP여 LISS+CS시목전치료복잡경골평태골절교합괄적내고정방식。단대우피부좌상、연조직종창엄중적경골평태골절，LISS+CS주중연조직화혈공적보호，경부합생물학고정적요구，시목전최이상적미창내고정방식。
Objective To compare the three kinds of minimally invasive internal fixations for complex tibial plateau fracture using biome-chanics. Methods 18 tibial plateau specimens of adult body were made out to the model of complicate Schatzker VI tibial plateau fractures. Fixa-tion with LISS plate in lateral + reconstruction plate in posteromedial (LISS+RP), LISS plate in lateral + three compressed hollow screws in medial (LISS+CS), LISS plate in lateral only respectively, test with displacement and axial stiffness. Results The LISS+RP group and LISS+CS group were better than the LISS group in stability (P<0.05), but there was no statistical significance between the LISS+RP group and LISS+CS group (P>0.05). Conclusions The LISS+RP and LISS+CS are fairly ideal internal fixators for treatment of complex tibial plateau fractures . In the meantime, the LISS+RP emphasizes conservation of soft tissues and blood supply, can better meet the requirement of the biological fixation of fracture and is the most ideal internal fixator at present.