摘要
目的研究胫骨中段骨折采用有限接触型动力加压接骨板(limited contact-dynamic compression plate,LC-DCP)内固定时钢板长度对骨折生物力学的影响。方法取自愿捐赠新鲜成人(20～40岁)尸体胫骨标本45根,长30～38cm,平均34cm。随机分成3组,每组15根。测定完整胫骨在扭转、三点弯曲及压缩状态下的应力-应变指标,确定垂直压缩应力为0～1000N,扭转角度为0～3°,三点弯应力为0～400N。然后制备中段斜行无缺损骨折模型,分别以6、10、14孔不锈钢AOLC-DCP固定,测定扭转、三点弯曲及压缩状态下应力-应变指标,行统计学分析。结果6、10、14孔钢板垂直压缩时竖直方向应变值分别为0.449±0.241、0.093±0.003、0.139±0.005,10、14孔钢板与6孔钢板比较差异有统计学意义(P<0.01),10孔钢板与14孔钢板间差异无统计学意义(P>0.05)。6、10、14孔钢板侧方应变值分别为0.1200±0.0004、0.1275±0.0100、0.2370±0.0006,6孔钢板和10孔钢板与14孔钢板比较差异有统计学意义(P<0.01),6孔钢板与10孔钢板间比较差异无统计学意义(P>0.05)。6、10、14孔钢板扭矩分别为(5.066±2.715)×10-3、(5.671±2.527)×10-3、(4.570±2.228)×10-3Nm,三点弯曲竖直方向应变值分别为0.049±0.009、0.124±0.017、0.062±0.009,各孔钢板间两两比较差异均有统计学意义(P<0.01)。结论当材质、厚度、宽度及螺钉使用数量相同时,采用长度不同的钢板固定胫骨中段斜形骨折,14孔钢板抗垂直压缩、抗扭转、抗弯曲的稳定性较好,6孔钢板较差。
Objective To research the biomechanical effect of different length bone plates on treatment of tibial shaft fracture. Methods Forty-five tibia specimens from fresh adult corpse （20-40 years old） were donated （30-38 cm in length, 34 cm on average） and were divided into 3 groups randomly （n=15）. Under the following three conditions, the experiment was made separately. Compression stress-strain indexes of whole tibia were determined under the reverse, three spots curving and compression. The vertical elastic strain was 0-1 000 N, the reverse angle was 0-3% and three bending stress was 0-400 N. Then the center-section squint non-damage bone fracture model was made, fracture was fixed by 6, 10, 14 stainless steel AO LC-DCP, respectively. The compression stress-strain indexes were determined under reverse angle, three spots curving and compression, statistical analysis was done. Results The vertical direction strain value of 6, 10 and 14 hole steel plate under vertical compressions, was 0.449±0.241, 0.093 ± 0.003, 0.139 ± 0.005, respectively ; showing significant difference between 10 and 14 hole steel plates and 6 steel plate （P 〈 0.01） and no significant difference between 10 and 14 hole steel plate （P 〉 0.05）. The lateral strain value of 6, 10 and 14 hole steel plate was 0.120 0 ± 0.000 4, 0.127 5 ± 0.010 0, 0.237 0 ± 0.000 6 respectively, indicating a significant difference between stell plates of 6 and 10 hole and 14 hole steel plate （P 〈 0.01） and no difference between 6 and 10 hole steel plate （P 〉 0.05）. The torque of 6, 10 and 14 hole steel plate was （5.066 ± 2.715）×10^-3, （5.671 ± 2.527）×10^-3 and （4.570 ± 2.228）×10^-3 Nm, respectively and three spot curving vertical direction strain value was 0.049 ± 0.009, 0.124 ± 0.017, 0.062 ± 0.009, respectively. There were significant differences between various steel plates （P 〈 0.01）. Conclusion For the fixation of tibial oblique fracture, 14 hole steel plate＇s stabilities of anti-vertical compress
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2008年第11期1323-1326,共4页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
胫骨骨折
钢板长度
生物力学
Tibial fracture Plate length Biomechanics
