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三种桡骨远端掌侧钢板单轴压缩的生物力学

Biomechanics in uniaxial compression of three distal radius volar plates.

作者信息

Osada Denju, Fujita Satoshi, Tamai Kazuya, Iwamoto Akira, Tomizawa Kazuo, Saotome Koichi

机构信息

Department of Orthopedics, Dokkyo University School of Medicine, Tochigi, Japan.

出版信息

J Hand Surg Am. 2004 May;29(3):446-51. doi: 10.1016/j.jhsa.2003.12.010.

Abstract

PURPOSE

A new fixed-angle volar plate for a dorsally displaced distal radius fracture was designed with the aim of avoiding soft tissue problems due to dorsal plating. The purpose of this study was to compare the biomechanical properties of this new plate with 2 existing volar plates in a cadaver model.

METHODS

Three different plates were applied on surgically simulated unstable extra-articular distal radius fractures in formalin-fixed cadaver radiuses. Group 1 (volarly placed AO titanium Distal Radius plates [Synthes Ltd, Paoli, PA]; n = 6), group 2 (volarly placed titanium Symmetry plates [DePuy ACE Co, El Segundo, CA]; n = 6), and group 3 (volarly placed newly designed titanium plates; n = 6) were tested to failure under axial compression with a materials testing machine. Specimens of all 3 groups had similar bone mineral density.

RESULTS

Group 3 specimens had significantly greater elastic limit and ultimate strength than the other 2 groups. Specimens of group 3 had the greatest rigidity, although this was statistically insignificant compared with the other 2 groups. All plates (groups 1, 2, 3) failed in apex volar angulation.

CONCLUSIONS

The newly designed plate fixation system is the strongest of the systems tested and may offer adequate stability for the treatment of a distal radius fracture in which the dorsal and/or volar metaphyseal cortex is comminuted severely.

摘要

目的

设计一种新型的用于治疗桡骨远端背侧移位骨折的固定角度掌侧板,旨在避免因背侧钢板固定导致的软组织问题。本研究的目的是在尸体模型中比较这种新型钢板与两种现有掌侧板的生物力学性能。

方法

将三种不同的钢板应用于福尔马林固定的尸体桡骨上手术模拟的不稳定关节外桡骨远端骨折。第1组(掌侧放置AO钛制桡骨远端钢板[Synthes有限公司,宾夕法尼亚州波利];n = 6),第2组(掌侧放置钛制Symmetry钢板[DePuy ACE公司,加利福尼亚州埃尔塞贡多];n = 6),第3组(掌侧放置新设计的钛制钢板;n = 6),使用材料试验机进行轴向压缩直至破坏测试。所有3组标本的骨矿物质密度相似。

结果

第3组标本的弹性极限和极限强度明显高于其他两组。第3组标本的刚度最大,尽管与其他两组相比在统计学上无显著差异。所有钢板(第1组、第2组、第3组)均在掌侧成角处失效。

结论

新设计的钢板固定系统是所测试系统中强度最强的,对于治疗背侧和/或掌侧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。

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