掌骨骨折的钢板固定：单皮质螺钉还是双皮质螺钉？
Plating of metacarpal fractures: unicortical or bicortical screws?
作者信息
Dona E, Gillies R M, Gianoutsos M P, Walsh W R
机构信息
Orthopaedic Research Laboratory, Prince of Wales Hospital, University of New South Wales, Sydney, Australia.
出版信息
J Hand Surg Br. 2004 Jun;29(3):218-21. doi: 10.1016/j.jhsb.2003.12.002.
Mid-shaft transverse osteotomies were performed in 18 cadaveric metacarpals and randomly divided into two groups. Using dorsally applied plates for repair, one group was secured using 6mm unicortical screws, while bicortical screws were used in the second group. The metacarpals were tested to failure with a four-point bending protocol using a servo-hydraulic testing machine and a 1kN load cell. The mean load to failure was 596N (SD=142) for the unicortical and 541N (SD=171) for the bicortical group. The stiffness was 333N/mm (SD=116) for the unicortical and 458N/mm (SD=158) for the bicortical group. Both load to failure and stiffness were not statistically significant between the two groups. Failure occurred by fracture at the screw-bone interface in all specimens: no screw pull-out was observed. No biomechanical advantage was found when using bicortical screws in metacarpal fracture plating.
对18根尸体掌骨进行中段横向截骨，并随机分为两组。使用背侧钢板进行修复，一组使用6毫米单皮质螺钉固定，而第二组使用双皮质螺钉。使用伺服液压试验机和1kN测力传感器，通过四点弯曲试验对掌骨进行破坏测试。单皮质组的平均破坏载荷为596N（标准差=142），双皮质组为541N（标准差=171）。单皮质组的刚度为333N/mm（标准差=116），双皮质组为458N/mm（标准差=158）。两组之间的破坏载荷和刚度均无统计学意义。所有标本均在螺钉-骨界面处发生骨折破坏：未观察到螺钉拔出。在掌骨骨折钢板固定中使用双皮质螺钉未发现生物力学优势。
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