Chodos Marc D, Parks Brent G, Schon Lew C, Guyton Gregory P, Campbell John T
Department of Orthopaedics, Union Memorial Hospital, Baltimore, MD 21218, USA.
Foot Ankle Int. 2008 Feb;29(2):219-24. doi: 10.3113/FAI.2008.0219.
We hypothesized that a locking plate would be stronger than a blade plate for tibiotalocalcaneal arthrodesis under dorsiflexion and torsional loading.
Nine pairs of matched cadaveric lower extremities were used. BMD was obtained for each specimen. Each received a retrograde augmentation screw and a stainless steel LC-angled blade plate (Synthes, Paoli, PA) or a stainless steel LCP proximal humerus locking plate (Synthes, Paoli, PA). Specimens were cyclically loaded in dorsiflexion to simulate 6 weeks of partial weightbearing and then monotonically loaded to failure. Specimens were removed from the load frame and remounted to simulate fusion. The specimen received an axial load of 720 N and was externally rotated proximal to the construct at 5 degrees/sec to fracture. Data were compared with a Student's t-test. Pearson correlation analysis was used to determine whether bone mineral density was significantly related to measured parameters. Significance was set at p < or = 0.05.
The locking plate group had higher initial stiffness, higher dorsiflexion and torsional load to failure, and lower construct deformation than the blade plate group. Bone mineral density was positively correlated with dorsiflexion failure load and torsional failure load in the locking plate construct.
Fixation with the locking plate was superior to that with the blade plate.
Use of a locking plate may be an effective fixation technique in tibiotalocalcaneal arthrodesis, especially in complex hindfoot reconstructions with bone loss or deformity.
我们假设在背屈和扭转负荷下，锁定钢板用于胫距跟关节融合术时比刀片钢板更坚固。
使用九对匹配的尸体下肢。获取每个标本的骨密度。每个标本均植入一枚逆行加压螺钉以及一块不锈钢LC角刀片钢板（辛迪斯公司，宾夕法尼亚州波利）或一块不锈钢肱骨近端锁定钢板（辛迪斯公司，宾夕法尼亚州波利）。标本进行背屈循环加载以模拟6周部分负重，然后进行单调加载直至失效。将标本从加载框架上取下并重新安装以模拟融合。标本承受720 N的轴向负荷，并以5度/秒的速度在构建物近端进行外旋直至骨折。数据采用Student t检验进行比较。采用Pearson相关分析确定骨密度是否与测量参数显著相关。显著性设定为p≤0.05。
与刀片钢板组相比，锁定钢板组具有更高的初始刚度、更高的背屈和扭转失效负荷以及更低的构建物变形。在锁定钢板构建物中，骨密度与背屈失效负荷和扭转失效负荷呈正相关。
锁定钢板固定优于刀片钢板固定。
锁定钢板的应用可能是胫距跟关节融合术中一种有效的固定技术，尤其适用于伴有骨质丢失或畸形的复杂后足重建。
