第一跖楔关节融合术：固定方法的比较研究
Arthrodesis of the first metatarsocuneiform joint: a comparative study of fixation methods.
作者信息
Scranton Pierce E, Coetzee J Chris, Carreira Dominic
机构信息
Orthopedics International, 12333 NE 130th Lane Suite 400, Kirkland, WA 98034, USA.
出版信息
Foot Ankle Int. 2009 Apr;30(4):341-5. doi: 10.3113/FAI.2009.0341.
BACKGROUND
The Lapidus bunionectomy is a popular procedure for severe bunion deformity where metatarsus primus varus is equal to or exceeds 15 degrees. We evaluated a new locking compression plate which may improve outcomes with the Lapidus procedure.
METHODS
Ten matched pairs of cadaver feet were used to compare the standard crossed 4.0-mm compression screw method of fixation to the LPS Lapidus plate. After performing the matched operations the cadaver constructs were stressed to failure using the INSTRON and Wavemaker software.
RESULTS
The LPS Lapidus plate load to failure was 108 Nm with a bending moment of 6.0 Nm. The crossed screw technique was inferior at 78 Nm with a bending moment of 4.4 Nm (p = 0.02)
CONCLUSION
Unlike other H-plates or locking plates, load to failure was higher with the Lapidus plate constructs.
CLINICAL RELEVANCE
The increased rigidity provided by these plates may help to minimize the risk of nonunion or malunion.
背景
拉皮德斯拇外翻切除术是治疗严重拇外翻畸形（第一跖骨内翻等于或超过15度）的常用手术方法。我们评估了一种新型锁定加压钢板，它可能会改善拉皮德斯手术的效果。
方法
使用十对匹配的尸体足，将标准的4.0毫米交叉加压螺钉固定方法与LPS拉皮德斯钢板进行比较。在进行匹配操作后，使用英斯特朗材料试验机和波形发生器软件对尸体结构施加应力直至破坏。
结果
LPS拉皮德斯钢板的破坏载荷为108牛米，弯矩为6.0牛米。交叉螺钉技术较差，破坏载荷为78牛米，弯矩为4.4牛米（p = 0.02）。
结论
与其他H型钢板或锁定钢板不同，拉皮德斯钢板结构的破坏载荷更高。
临床意义
这些钢板提供的更高刚度可能有助于将不愈合或畸形愈合的风险降至最低。
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