Osada Denju, Viegas Steven F, Shah Munir A, Morris Randal P, Patterson Rita M
Division of Research, Department of Orthopaedic Surgery and Rehabilitation, University of Texas Medical Branch, Galveston, TX 77555, USA.
J Hand Surg Am. 2003 Jan;28(1):94-104. doi: 10.1053/jhsu.2003.50016.
To compare the biomechanical properties of 6 dorsal and volar fracture fixation plate designs in a cadaver model.
Six different plating techniques were used on surgically simulated, unstable, extra-articular distal radius fractures in fresh-frozen cadavers. Specimens were tested to failure in axial compression with the Materials Testing System machine, and were analyzed with a motion analysis system. The 6 different fixation systems studied included an AO stainless steel Pi plate (group 1), an AO titanium Pi plate (group 2), a Forte plate (group 3), a dorsally placed Symmetry plate (group 4), a volarly placed Symmetry plate (group 5), and a volarly placed SCS/V plate (group 6).
All dorsal plates (groups 1, 2, 3, 4) failed in apex dorsal angulation and all volar plates (groups 5, 6) failed in apex volar angulation. No group developed an average angular deformity greater than 5 degrees with a load of 100 N, which compares with the physiologic loads expected with active wrist motion. Only the volarly placed SCS/V plated specimens (group 6) resisted deformation of 5 degrees or more at loads up to 250 N, which compares with the physiologic loads expected with active finger motion, and was significantly stronger and more rigid than the other 5 plate groups.
The SCS/V plate fixation system is the most rigid of the systems tested and may offer adequate stability for the treatment of the distal radius fracture in which the anterior and/or posterior metaphyseal cortex is comminuted severely.
在尸体模型中比较6种背侧和掌侧骨折固定板设计的生物力学特性。
在新鲜冷冻尸体上对手术模拟的、不稳定的、关节外桡骨远端骨折采用6种不同的钢板固定技术。使用材料测试系统机器对标本进行轴向压缩直至破坏测试,并用运动分析系统进行分析。所研究的6种不同固定系统包括AO不锈钢Pi板(第1组)、AO钛Pi板(第2组)、Forte板(第3组)、背侧放置的Symmetry板(第4组)、掌侧放置的Symmetry板(第5组)和掌侧放置的SCS/V板(第6组)。
所有背侧板(第1、2、3、4组)均在背侧成角顶点处失效,所有掌侧板(第5、6组)均在掌侧成角顶点处失效。在100 N载荷下,没有一组出现平均角度畸形大于5度的情况,这与主动腕关节活动时预期的生理载荷相当。只有掌侧放置的SCS/V板标本(第6组)在高达250 N的载荷下能抵抗5度或更大的变形,这与主动手指活动时预期的生理载荷相当,并且比其他5个钢板组显著更强且更坚固。
SCS/V钢板固定系统是所测试系统中最坚固的,对于治疗前和/或后干骺端皮质严重粉碎的桡骨远端骨折可能提供足够的稳定性。