Miller Bruce S, Harper Wade P, Gillies R Mark, Sonnabend David H, Walsh William R
Orthopaedic Research Laboratories, The University of New South Wales, The Prince of Wales Hospital, Randwick, New South Wales, Australia.
ANZ J Surg. 2003 Dec;73(12):1015-7. doi: 10.1046/j.1445-2197.2003.t01-7-.x.
The purpose of the present study is to compare five fixation techniques in shoulder fusion. The most common complications resulting from shoulder fusion, non-union and unacceptable arm position, might reflect a failure to achieve rigid fixation during the surgical procedure.
Twenty-five shoulder fusions were carried out on human cadaveric specimens using the following techniques: screw fixation, external fixation, external fixation supplemented with screw fixation, single plate fixation and double plate fixation. Each specimen was tested on a servohydraulic machine to determine stiffness.
There was a statistically significant difference in bending and torsional stiffness between all five fixation techniques. Normalized bending (B) and torsional stiffness (T), in descending order, were: double plate (B = 1.00, T = 1.00), single plate (B = 0.77, T = 0.89), external fixation with screws (B = 0.68, T = 0.74), external fixation alone (B = 0.40, T = 0.53), and screws alone (B = 0.13, T = 0.26).
The risk of the most common complications resulting from shoulder fusion might be minimized if these biomechanical findings are applied to surgical decision making.
本研究旨在比较肩部融合术中的五种固定技术。肩部融合最常见的并发症，即不愈合和手臂位置不理想，可能反映出手术过程中未能实现牢固固定。
使用以下技术对25个尸体标本进行肩部融合：螺钉固定、外固定、螺钉辅助外固定、单板固定和双板固定。每个标本在伺服液压机上进行测试以确定刚度。
所有五种固定技术在弯曲和扭转刚度方面存在统计学显著差异。标准化弯曲（B）和扭转刚度（T），从高到低依次为：双板（B = 1.00，T = 1.00）、单板（B = 0.77，T = 0.89）、螺钉辅助外固定（B = 0.68，T = 0.74）、单纯外固定（B = 0.40，T = 0.53）和单纯螺钉固定（B = 0.13，T = 0.26）。
如果将这些生物力学研究结果应用于手术决策，肩部融合最常见并发症的风险可能会降至最低。
