Meyer Christophe, Martin Emilie, Kahn Jean-Luc, Zink Simone
Department of Maxillofacial Surgery, University Hospital of Besançon, France.
J Craniomaxillofac Surg. 2007 Mar;35(2):84-90. doi: 10.1016/j.jcms.2006.11.006. Epub 2007 Apr 19.
In this paper, the different steps of development and experimental validation of a new type of three-dimensional (3-D) trapezoidal osteosynthesis plate (Modus TCP 2.0, Medartis, Basel, Switzerland) is described. These plates have been designed to stabilize sub-condylar and condylar neck fractures of the mandible.
In order to apply the principles of functionally stable osteosynthesis to the mandibular condyle, i.e. to put the plate as close as possible to the tensile strain lines occurring during function, two new 4- and 9-hole 3-D trapezoidal plates were designed. Tests were conducted on fresh human mandibles before and after osteosynthesis of a standardised unilateral sub-condylar 'fracture', and a static biting exercise between the ipsilateral first molars was reproduced on a test bench. The resulting condylar fragment displacement in the sagittal plane was measured and the alterations of the condylar tensile strain lines induced by the osteosynthesis were investigated by using photoelastic strain tests.
None of the plates broke. No macroscopic condylar displacement was noted when assessing the quality of the primary stabilization. Strain analysis showed the ability of these 3-D plates to transmit physiological strains across the fracture line and the absence of potentially damaging strains around the plate.
These results were accredited to the 3-D and trapezoidal features of the plates.
The Modus TCP plates experimentally fulfil the principles of functionally stable osteosynthesis in the condylar region and are able to resist physiological strains.
本文描述了一种新型三维(3-D)梯形接骨板(Modus TCP 2.0,Medartis,瑞士巴塞尔)研发与实验验证的不同步骤。这些接骨板旨在稳定下颌骨髁突下和髁突颈部骨折。
为了将功能稳定接骨术的原理应用于下颌髁突,即尽可能将接骨板置于功能过程中出现拉伸应变线的位置,设计了两种新型的4孔和9孔三维梯形接骨板。在标准化单侧髁突下“骨折”接骨术前和术后对新鲜人下颌骨进行测试,并在试验台上重现同侧第一磨牙之间的静态咬合动作。测量髁突碎片在矢状面的位移,并通过光弹性应变测试研究接骨术引起的髁突拉伸应变线的变化。
接骨板均未断裂。评估初次稳定质量时未发现明显的髁突移位。应变分析表明,这些三维接骨板能够将生理应变传递至骨折线,且接骨板周围不存在潜在的损伤性应变。
这些结果归因于接骨板的三维和梯形特征。
Modus TCP接骨板在实验上符合髁突区域功能稳定接骨术的原理,并且能够抵抗生理应变。