摘要
目的:探讨双Endobutton钢板重建喙锁韧带手术中喙突骨隧道位置对术后喙锁韧带力学性能的影响。方法:选取新鲜冰冻尸体肩关节30个,年龄(65.5±8.3)岁。进行模拟双Endobutton钢板重建喙锁韧带手术,根据喙突隧道在喙突上表面和下表面的位置,将肩关节标本随机分为中心-中心组、内侧-中心组、外侧-中心组、中心-内侧组和中心-外侧组,每组6个肩关节。采用MTS858生物力学机对5组肩关节标本均施加方向与中心-中心组骨隧道方向一致的载荷,模拟肩胛骨和锁骨作用于喙锁韧带的拉力。持续施加载荷,直至Endobutton钢板拉出、断裂或喙突发生骨折。记录每个标本最终的破坏负荷和破坏方式。结果:5组标本力学测试中的破坏负荷比较,差异有统计学意义[(536.5±142.0)N,(534.2±130.2)N,(385.4±84.3)N,(382.0±131.0)N,(360.5±90.3)N,F=3.330,P=0.026];中心-中心组和内侧-中心组力学测试中的破坏负荷均高于中心-内侧组、中心-外侧组及外侧-中心组(P=0.036,P=0.032,P=0.016;P=0.038,P=0.035,P=0.017);其余各组间两两比较,组间差异均无统计学意义。中心-中心组和内侧-中心组破坏方式以Endobutton钢板从喙突骨隧道拉出或钢板断裂为主,其余3组破坏方式以钢板从喙突骨隧道拉出及喙突骨折为主。结论:在采用双Endobutton钢板重建喙锁韧带的手术中,选择中心-中心型及内侧-中心型喙突骨隧道可以明显降低术后喙突骨折和固定失败的风险。
Objective：To explore the effect of location of coracoid tunnel on the mechanical property of coracoclavicular ligament after reconstruction using double Endobutton.Methods：Thirty fresh frozen shoulder joints were fetched from the cadavers aged 65.5 ＋/-8.3 years for simulating coracoclavicular ligament reconstruction in which double Endobutton steel plates were used.The samples of shoulder joint were randomly divided into center -center group,medial -center group,lateral -center group,center -medial group and center -lat-eral group according to the location of bone tunnel on superior and inferior surface of coracoid process,6 cases in each group.The loads, which simulated the pullout forces on coracoclavicular ligament,were exert on shoulder joint samples in the 5 groups by using MTS858 bio-mechanical machine in the same direction as that of bone tunnel of center -center group.The loads increased continually until the Endobut-ton steel plates were pulled out or broken or the coracoids were fractured.The breakdown loads and breakdown mode of each sample were recorded.Results：There was statistical difference in the breakdown load between the 5 groups（536.5 ＋/-142.0,534.2 ＋/-130.2, 385.4 ＋/-84.3,382.0 ＋/-131.0,360.5 ＋/-90.3 N,F =3.330,P =0.026）.The breakdown loads of center -center group and medial -center group were higher than that of center -medial group,center -lateral group and lateral -center group（P =0.036,P =0.032,P =0.016;P =0.038,P =0.035,P =0.017）.There was no statistical difference in the breakdown load between the rest paired groups.The breakdown mode of center -center group and medial -center group presented mainly with Endobutton plates pulling out of coracoid tunnels or breaking,while it presented mainly with the plates pulling out of coracoid tunnels and coracoid fracture in the other 3 groups. Conclusion：In coracoclavicular ligament reconstruction using double Endobutton steel plates,selecting coracoid tunnel typed center -cen-ter or medial -center can significantly reduc
出处
《中医正骨》
2015年第5期1-4,共4页
The Journal of Traditional Chinese Orthopedics and Traumatology
基金
温州市科技计划项目(2012S018)
关键词
肩锁关节
脱位
喙锁韧带重建
喙突骨隧道
生物力学
acromioclavicular joint
dislocations
coracoclavicular ligament reconstruction
coracoid tunnel
biomechanics
