Cekin Tacettin, Tükenmez Mehmet, Tezeren Gündüz
Department of Orthopedics and Traumatology (Ortopedi ve Travmatoloji Anabilim Dali), Medicine Faculty of Cumhuriyet University, Sivas, Turkey.
Acta Orthop Traumatol Turc. 2006;40(3):248-51.
We evaluated the strength of three different fixation methods against distraction forces in a transverse fracture model of calf patellae.
Thirty calf patellae were randomly divided into three groups equal in number. Transverse fractures were induced at the same localization in all the samples. The fractures were fixed with a modified anterior tension band technique, Acutrak 4/5 screws, and a combination of Acutrak 4/5 screws and tension band technique in three groups, respectively. Following fixation, each patella was mounted in a compression-distraction testing machine from the quadriceps and patellar tendons on each side of the patella, and equal distraction forces were applied to each patella. The average load to failure at the fracture site was calculated and the results were compared with the Friedman test.
The mean failure loads were significantly different in three groups, being 288.8+/-40.1 newton (N), 878.5+/-68.6 N, and 938.6+/-38.8 N, respectively (p<0.001). The most efficient stabilization was obtained in the third group in which Acutrak 4/5 screws and the tension band application were used in combination, while the modified anterior tension band technique alone was found to be the weakest fixation technique.
Our results showed that Acutrak 4/5 screws enabled a rigid fixation in the surgical treatment of patellar fractures.
我们在小牛髌骨横向骨折模型中评估了三种不同固定方法抵抗牵张力的强度。
30个小牛髌骨随机分为数量相等的三组。所有样本在相同位置造成横向骨折。三组分别采用改良前张力带技术、Acutrak 4/5螺钉以及Acutrak 4/5螺钉与张力带技术联合的方法固定骨折。固定后，将每个髌骨通过髌骨两侧的股四头肌和髌腱安装在压缩-牵张试验机上，对每个髌骨施加相等的牵张力。计算骨折部位的平均破坏载荷，并将结果用Friedman检验进行比较。
三组的平均破坏载荷有显著差异，分别为288.8±40.1牛顿（N）、878.5±68.6 N和938.6±38.8 N（p<0.001）。第三组采用Acutrak 4/5螺钉与张力带联合应用获得了最有效的稳定效果，而单独的改良前张力带技术被发现是最弱的固定技术。
我们的结果表明，Acutrak 4/5螺钉在髌骨骨折手术治疗中能实现坚强固定。
