Pooya Hooman A, Séguin Bernard, Mason David R, Walsh Peter J, Taylor Kenneth T, Kass Philip H, Stover Susan M
Department of Surgical & Radiological Sciences and the J.D. Wheat Veterinary Orthopedic Research Laboratory, School of Veterinary Medicine, University of California, Davis 95616, CA.
Vet Surg. 2004 Jul-Aug;33(4):301-8. doi: 10.1111/j.1532-950X.2004.04044.x.
To compare the biomechanical properties of radial graft (RG) versus ulnar transposition graft (UTG) limb-sparing techniques in the dog.
Cadaveric study.
Six pairs of normal canine thoracic limbs.
In each pair of limbs, 1 limb was subjected to the RG technique and the other to the UTG technique. Limbs were tested in axial loading until failure. Modes of failure and biomechanical properties were compared between the 2 groups. Percent coverage of the metacarpal bone by the plate was retrospectively compared between the limbs that failed by fracture of the metacarpal bones and those that did not.
RG limbs had significantly greater stiffness, yield load, maximum load, maximum energy, and post-yield energy. All UTG limbs failed by cranial bending of the plate. Half of the RG limbs failed by caudal bending of the plate and half by fracture of the third metacarpal bone at the distal end of the plate. Limbs with <80% plate coverage of the metacarpal bone were significantly more likely to fail by metacarpal fracture.
The RG technique was biomechanically superior to the UTG technique under the conditions studied. At least 80% plate coverage of the metacarpal bone should be achieved.
Exercise restriction and coaptation bandages should be considered for patients undergoing the UTG technique to minimize potential biomechanical complications.
比较犬桡骨移植(RG)与尺骨转位移植(UTG)保肢技术的生物力学特性。
尸体研究。
6对正常犬的胸肢。
在每对肢体中,1个肢体采用RG技术,另1个采用UTG技术。对肢体进行轴向加载直至失效。比较两组之间的失效模式和生物力学特性。回顾性比较掌骨骨折失效的肢体与未骨折失效的肢体中钢板对掌骨的覆盖百分比。
RG肢体的刚度、屈服载荷、最大载荷、最大能量和屈服后能量显著更高。所有UTG肢体均因钢板向前弯曲而失效。一半的RG肢体因钢板向后弯曲而失效,另一半因钢板远端的第三掌骨骨折而失效。掌骨钢板覆盖率<80%的肢体更易因掌骨骨折而失效。
在所研究的条件下,RG技术在生物力学上优于UTG技术。应使钢板对掌骨的覆盖率至少达到80%。
对于接受UTG技术的患者,应考虑限制活动和使用包扎绷带,以尽量减少潜在的生物力学并发症。