Neufeld Steven K, Parks Brent G, Naseef George S, Melamed Eyal A, Schon Lew C
Department of Orthopaedic Surgery, The Union Memorial Hospital, Baltimore, MD, USA.
Foot Ankle Int. 2002 Feb;23(2):97-101. doi: 10.1177/107110070202300203.
Arthrodesis of the first metatarsophalangeal joint of 21 matched pairs of cadaver toes was performed in order to compare the strength of three methods of internal fixation: 1. two crossed cannulated screws, 2. a dorsal plate with an oblique 0.062 K-wire, and 3. two compression staples with an oblique 0.062 K-wire. Biomechanical testing with plantar force was carried out, and gapping across the fusion site was measured. Stiffness, load to 1-mm displacement, and force to failure was determined for each specimen. Both the plate and screw constructs were statistically stronger in force to failure and initial stiffness than the compression construct. Compression staples have an advantage in their ease of insertion and theoretical continuous compressive force across an arthrodesis site, but should be supplemented with a cast or other external immobilization until union is achieved.
为比较三种内固定方法的强度，对21对匹配的尸体足趾的第一跖趾关节进行了关节融合术：1. 两枚交叉空心螺钉；2. 带一枚0.062英寸斜向克氏针的背侧板；3. 两枚带一枚0.062英寸斜向克氏针的加压钉。进行了足底力的生物力学测试，并测量了融合部位的间隙。确定了每个标本的刚度、1毫米位移时的载荷以及破坏时的力。钢板和螺钉结构在破坏时的力和初始刚度方面在统计学上均强于加压结构。加压钉在插入容易程度以及跨关节融合部位理论上的持续压缩力方面具有优势，但在达到骨愈合之前应辅以石膏或其他外部固定。
