CAJ | 학술논문

骨关节植入物%骨关节植入物学术探讨%锁定加压钢板%胫骨骨折%生物力学%内固定%钢板%螺钉%解剖复位%加压固定%解剖钢板%粉碎性骨折%拉出力%弯曲应力%成角稳定性%抗疲劳测试%感染%骨折延迟愈合骨關節植入物%骨關節植入物學術探討%鎖定加壓鋼闆%脛骨骨摺%生物力學%內固定%鋼闆%螺釘%解剖複位%加壓固定%解剖鋼闆%粉碎性骨摺%拉齣力%彎麯應力%成角穩定性%抗疲勞測試%感染%骨摺延遲愈閤
골관절식입물%골관절식입물학술탐토%쇄정가압강판%경골골절%생물역학%내고정%강판%라정%해부복위%가압고정%해부강판%분쇄성골절%랍출력%만곡응력%성각은정성%항피로측시%감염%골절연지유합

背景:锁定加压钢板结合了传统钢板和支架原理,即头部有锁定螺纹的螺钉和钢板锁钉孔构成的内固定支架锁定单元,又有传统螺钉和动力加压孔构成的内固定支架加压单元,在骨折的内固定治疗方面具有很多优势.目的:分析锁定加压钢板置入内固定治疗胫骨骨折的生物力学特点,以及在胫骨骨折治疗中的疗效.方法:锁定加压钢板是依靠钢板与螺钉的成角稳定性和螺钉与骨之间的把持力来实现骨折内固定的.骨髓腔细小时应避免螺钉尖端损伤近端皮质的骨螺纹,应更换为双皮质自攻螺钉至少在对侧骨皮质获得把持力.骨质疏松植入螺钉,由于单皮质骨螺钉产生的工作长度减少,在所有骨折块均使用双皮质自攻螺钉,以提高螺钉工作长度.当长骨轴线与钢板对线不良时,要么打入长自攻螺钉,要么改变角度打入标准螺钉.锁定加压钢板应选择适宜的长度,钢板的长度取决钢板跨越比和钢板螺钉密度,钢板与螺钉间的应力还受螺钉数量和位置的影响.结果与结论:锁定加压钢板置入内固定可应用于骨干或干骺端的简单骨折、粉碎性骨折、关节内及关节周围骨折、骨折延迟愈合、闭合或开放截骨术和不适合髓内钉固定的骨干骨折,对于骨质疏松骨折和假体周围骨折的内固定有很好的成角稳定性和把持力.锁定加压钢板置入内固定治疗胫骨骨干骨折均取得满意的疗效,符合生物力学固定原理.需要术者熟练掌握锁定加压钢板的内固定技术,避免由于失误导致内固定的失败.
배경:쇄정가압강판결합료전통강판화지가원리,즉두부유쇄정라문적라정화강판쇄정공구성적내고정지가쇄정단원,우유전통라정화동력가압공구성적내고정지가가압단원,재골절적내고정치료방면구유흔다우세.목적:분석쇄정가압강판치입내고정치료경골골절적생물역학특점,이급재경골골절치료중적료효.방법:쇄정가압강판시의고강판여라정적성각은정성화라정여골지간적파지력래실현골절내고정적.골수강세소시응피면라정첨단손상근단피질적골라문,응경환위쌍피질자공라정지소재대측골피질획득파지력.골질소송식입라정,유우단피질골라정산생적공작장도감소,재소유골절괴균사용쌍피질자공라정,이제고라정공작장도.당장골축선여강판대선불량시,요요타입장자공라정,요요개변각도타입표준라정.쇄정가압강판응선택괄의적장도,강판적장도취결강판과월비화강판라정밀도,강판여라정간적응력환수라정수량화위치적영향.결과여결론:쇄정가압강판치입내고정가응용우골간혹간후단적간단골절、분쇄성골절、관절내급관절주위골절、골절연지유합、폐합혹개방절골술화불괄합수내정고정적골간골절,대우골질소송골절화가체주위골절적내고정유흔호적성각은정성화파지력.쇄정가압강판치입내고정치료경골골간골절균취득만의적료효,부합생물역학고정원리.수요술자숙련장악쇄정가압강판적내고정기술,피면유우실오도치내고정적실패.
@@@@BACKGROUND: Locking compression plate combines with traditional steel plate and bracket principle, which has locking threaded screws on head and mounting bracket lock unit composed with steel locking nail holes, as wel as the internal fixation bracket pressurized unit composed with traditional screws and dynamic compression holes. So the locking compression plate has many advantages in the treatment of fracture fixation. OBJECTIVE: To analyze the biomechanical characteristics and effect of locking compression plate in the treatment of tibial fracture. METHODS: Locking compression plate could achieve the fracture fixation depended on the angular stability of steel plate and screws and the pul out strength between crews and bone. When the marrow cavitsy was smal , the top of the screw should be avoided to damage the proximal cortical bone threaded, and then the screws should be changed into the bicortical self-tapping screws at least in order to obtain the pul out strength from the contralateral cortical bone. Screw implantation for the treatment of osteoporosis, due to the reduced working length of unicortical screw fixation, the bicortical self-tapping screws were used in al the fracture fragments to improve the working length of the screws. When the alignment between the long bone axis and steel plate was not in order, implanting the long self-tapping screws or changing the angle to implant the standard screws were preferred. The locking compression plate should select a appropriate length. The length of the locking compression plate depended on the length and the density of the plate and screw. The stress between plate and screw was also affected by the number and the position of the screw. RESULTS AND CONCLUSION: Locking compression plate fixation can be used for the treatment of backbone or metaphyseal simple fracture, comminuted fracture, intra-articular and periarticular fractures, delayed fracture healing, closed or open osteotomy and the shaft fracture which is not suitable for intramedul ary nailing. And for the fixation of osteoporotic fractures and periprosthetic fractures, the locking compression plate has good angular stability and pul out strength. Locking compression plate fixation for the treatment of tibial shaft fractures has achieved satisfactory results, which in line with the biomechanics fixed principles. Surgeons need to be familiar with the fixation techniques of locking compression plate, in order to avoid mistakes-caused failure fixation.