CAJ | 학술논문

目的设计一种与胫骨平台后外髁解剖形态匹配的钢板,比较其与5孔T型有限接触动力加压钢板(LC-DCP)和7孔直型重建接骨板治疗胫骨平台后外侧骨折的生物力学性能.方法将18具经福尔马林溶液固定后的成人尸体膝关节标本,根据胫骨平台后外侧剪应力骨折的形态学特征建立后外侧骨折模型,随机分为3组(n=6):A组采用前外侧5孔T型LC-DCP固定,B组采用后外侧7孔直型重建接骨板固定,C组采用新设计的胫骨平台后外侧锁定钢板固定.测量三组骨折模型在轴向载荷为500、1000、1500 N下的垂直位移、失效载荷.结果 A、B、C三组骨折模型在500 N载荷下骨折块的相对位移平均分别为(0.898±0.073)、(0.418±0.092)、(0.203±0.027) mm,在1000 N载荷下骨折块的相对位移平均分别为(1.658±0.059)、(0.801±0.037)、(0.536±0.166) mm,在1500N载荷下骨折块相对位移平均分别为(2.271±0.073)、(1.518±0.109)、(0.780±0.058) mm.在同一载荷下,三组模型骨折块相对位移两两比较差异均有统计学意义(P＜0.05).A、B、C三组模型失效载荷平均分别为(1817.7±52.7)、(2399.2±162.6)、(2827.5±71.3)N,三组间两两比较差异均有统计学意义(P＜0.05).结论胫骨平台后外侧骨折使用新的胫骨平台后外侧锁定钢板治疗具有良好的解剖学形态,较5孔T型LC-DCP和7孔直型重建接骨板的生物力学设计均更合理.
목적 설계일충여경골평태후외과해부형태필배적강판,비교기여5공T형유한접촉동력가압강판(LC-DCP)화7공직형중건접골판치료경골평태후외측골절적생물역학성능.방법 장18구경복이마림용액고정후적성인시체슬관절표본,근거경골평태후외측전응력골절적형태학특정건립후외측골절모형,수궤분위3조(n=6):A조채용전외측5공T형LC-DCP고정,B조채용후외측7공직형중건접골판고정,C조채용신설계적경골평태후외측쇄정강판고정.측량삼조골절모형재축향재하위500、1000、1500 N하적수직위이、실효재하.결과 A、B、C삼조골절모형재500 N재하하골절괴적상대위이평균분별위(0.898±0.073)、(0.418±0.092)、(0.203±0.027) mm,재1000 N재하하골절괴적상대위이평균분별위(1.658±0.059)、(0.801±0.037)、(0.536±0.166) mm,재1500N재하하골절괴상대위이평균분별위(2.271±0.073)、(1.518±0.109)、(0.780±0.058) mm.재동일재하하,삼조모형골절괴상대위이량량비교차이균유통계학의의(P＜0.05).A、B、C삼조모형실효재하평균분별위(1817.7±52.7)、(2399.2±162.6)、(2827.5±71.3)N,삼조간량량비교차이균유통계학의의(P＜0.05).결론 경골평태후외측골절사용신적경골평태후외측쇄정강판치료구유량호적해부학형태,교5공T형LC-DCP화7공직형중건접골판적생물역학설계균경합리.
Objective To compare the biomechanical performances of a self-designed plate that matches the morphology of the lateral condyle of the tibial plateau,5-hole T-limited contact dynamic compression plate (LC-DCP) and 7-hole straight reconstruction plate (SRP) for the posterolateral fracture of the tibial plateau.Methods The posterolateral shearing fracture models were created from the specimens of the knee joint in 18 embalmed adult cadavers and assigned into 3 equal groups randomly (n =6).Group A were instrumented with LC-DCP,group B with SRP and group C with our self-designed posterolateral locking plate.Vertical displacements of the posterolateral fragments and failure loads were measured under axial loads of 500N,1000 N and 1500 N in the 3 groups.Results The vertical displacements in groups A,B and C were respectively 0.898 ±0.073 mm,0.418 ±0.092 mm and 0.203 ±0.027 mm under the axial load of 500 N; 1.658±0.059 mm,0.801 ±0.037 mm and 0.536±0.166 mm under 1000 N; 2.271 ±0.073 mm,1.518 ± 0.109 mm and 0.780 ± 0.058 mm under 1500 N.The differences under the same load between the 3 groups were statistically significant (P ＜ 0.05).The loads to failure in groups A,B and C were respectively 1817.7 ±52.7 N,2399.2 ± 162.6 N and 2827.5 ±71.3 N,with significant differences between groups (P ＜ 0.05).Conclusions The new type of posterolateral locking plate we designed can be applied for tibia1 plateau fractures with a splitting posterolateral condyle.It is superior to the 5-hole LC-DCP and 7-hole SRP because of its better anatomic profile and more rational biomechanical design.