摘要
目的探讨联合术式手术治疗肩锁关节完全脱位的内固定有效性、稳定性以及疗效。方法采集18具成人肩锁关节标本进行生物力学实验应力分析,比较联合术式与传统的锁骨钩钢板、同种异体肌腱重建、Double Endo-button或缝合铆重建喙锁韧带等固定方式的差异,分析各种术式对肩关节固定的生物力学性能的影响。结果联合术式弯曲、扭转及压缩试验的强度和刚度均接近正常肩锁关节锁骨的强度和刚度,两者差异无统计学意义(P>0.05)。联合术式优于Double Endo-button固定或缝合铆加克氏针内固定,但差异无统计学意义(P>0.05),相较于同种异体肌腱、单缝合铆重建喙锁韧带和锁骨钩钢板固定具有明显优势(P<0.05)。几类人工韧带修复喙锁韧带生物力学性质结果表明,韧带的力学性质Double Endo-button修复、同种异体肌腱修复的单轴拉伸强度、弹性模量、轴向刚度和人工韧带的延展性均接近正常新鲜喙锁韧带,差异无统计学意义(P>0.05),而与缝合铆技术修复比较差异有统计学意义(P<0.05)。新鲜喙锁韧带、同种异体肌腱的延展性与弹性均较好,有利于韧带、锁骨损伤的力学愈合功能重建的充分发挥。结论联合术式具有优越的生物力学性能,符合人体正常生理功能要求,在有效性及稳定性上优于国内常用的各种术式,有利于提高肩锁关节脱位的治愈率及康复率。
Objective To evaluate the effectiveness,stability and efficacy of in ternal fixation in the treatment of complete dislocation of acromioclavicular joint by combined operation.Methods 18 adult acromioclavicular joint specimens were collected for biomechanical stress analysis.Combined operation method was used to compare the traditional clavicular hook plate,allograft tendon reconstruction,Double Endo-button or suture rivet reconstruction of coracoclavicular ligament and so on to analyze the effects on the biomechanical properties of shoulder joint fixation.Results The flexural,torsional and compression tests of combined operation were close to the strength and stiffness of the normal acromioclavicular joint,and there was no statistical significance(P>0.05).The combined method was superior to Double Endo-button fixation or suture riveting plus Kirschner wire internal fixation,but the difference was not statistically significant(P>0.05).Compared with allograft tendon,single suture riveting for coracoclavicular ligament reconstruction and clavicular hook plate fixation,the combined method had obvious advantages(P<0.05).The results of biomechanical properties of coracoclavicular ligaments repaired by several types of artificial ligaments showed that the mechanical properties of ligaments were similar to those of normal fresh coracoclavicular ligaments in terms of uniaxial tensile strength,elastic modulus,axial stiffness and extensibility of artificial ligaments repaired by Double Endo-button and tendon allograft,with no statistical significance(P>0.05),and the difference was statistically significant compared with suture riveting technique(P<0.05).The ductility and elasticity of fresh coracoclavicular ligament and allogeneic tendon were good,which were conducive to the full play of mechanical healing function reconstruction of ligament and clavicle injury.Conclusion The combined operation has superior biomechanical properties,meets the requirements of normal physiological functions of human body,and is superior to var
出处
《浙江临床医学》
2022年第4期478-481,共4页
Zhejiang Clinical Medical Journal
基金
杭州市医药卫生科技项目(B20200552)。
关键词
肩锁关节
完全脱位
不同术式内固定
生物力学
Acromioclavicular joint
Complete dislocation
Different surgical internal fixation
Biomechanics
