Liporace Frank Anthony, Kubiak Erik N, Jeong Gerard K, Iesaka Kazuho, Egol Kenneth A, Koval Kenneth J
Department of Orthopaedics, Trauma Division, New Jersey Medical School, University of Medicine & Dentistry, Newark, New Jersey, USA.
J Trauma. 2006 Sep;61(3):668-72. doi: 10.1097/01.ta.0000234727.51894.7d.
This study compares the biomechanical stability of two volar locked plate systems for fixation of unstable, extra-articular distal radius fractures.
In six matched pairs of fresh frozen cadaveric specimens, a simulated unstable, extra-articular distal radius fracture was created. The fractures were stabilized with one of two types of volar locked plates. Specimens were axially loaded at five different positions: central, volar, dorsal, radial, and ulnar. Initial (precyclic loading) stiffness of each locked plate system was calculated. Each specimen was then loaded for 5,000 cycles with an 80 N central load. Finally, specimens were axially loaded at the same five positions to calculate the postcyclic loading stiffness of each volar locked plate system. Main outcome measurements were precyclic loading stiffness, postcyclic loading stiffness, maintenance of stiffness after cyclic loading, and amount of fracture displacement between the two volar locked plate systems.
There were no differences in maintenance of stiffness and fracture displacement following cyclical loading between the two volar plate systems. After cyclic loading, the distal volar radius (DVR) locked plate was significantly stiffer than the Synthes volar locked plate in volar loading only (p < 0.01).
Materials properties and design differences between these systems did not provide enough biomechanical difference to support use of either implant over the other. With this in vitro model, both implants provided adequate stability to resist physiologic loads expected during therapy in the initial postoperative period.
本研究比较了两种掌侧锁定钢板系统用于固定不稳定的关节外桡骨远端骨折的生物力学稳定性。
在六对匹配的新鲜冷冻尸体标本中,制造模拟的不稳定关节外桡骨远端骨折。骨折用两种掌侧锁定钢板中的一种进行固定。标本在五个不同位置进行轴向加载:中央、掌侧、背侧、桡侧和尺侧。计算每个锁定钢板系统的初始(预循环加载)刚度。然后每个标本以80 N的中央载荷加载5000次循环。最后,在相同的五个位置对标本进行轴向加载,以计算每个掌侧锁定钢板系统的循环后加载刚度。主要观察指标为预循环加载刚度、循环后加载刚度、循环加载后刚度的维持情况以及两种掌侧锁定钢板系统之间的骨折移位量。
两种掌侧钢板系统在循环加载后刚度维持和骨折移位方面没有差异。循环加载后,仅在掌侧加载时,桡骨远端掌侧(DVR)锁定钢板比Synthes掌侧锁定钢板明显更硬(p < 0.01)。
这些系统之间的材料特性和设计差异没有提供足够的生物力学差异来支持使用其中一种植入物而非另一种。在这个体外模型中,两种植入物都提供了足够的稳定性来抵抗术后初期治疗期间预期的生理负荷。