Krukhaug Yngvar, Gjerdet Nils R, Lundberg Odd J, Lilleng Peer K, Hove Leiv M
Department of Orthopaedic Surgery, Haukeland University Hospital, Helse-Bergen HF, Bergen, Norway.
Acta Orthop. 2009 Apr;80(2):239-44. doi: 10.3109/17453670902947440.
In recent years several different plate designs for internal fixation of fractures of the distal radius have been developed. However, few biomechanical studies have been performed to compare these new implants. The purpose of this study was to compare the mechanical properties of 5 different commercially available plates (3 volar and 2 dorsal) with standard K-wire fixation using a distal radial cadaver model.
42 human radial bones from 26 cadavers were included. The bone mineral density (BMD) was measured by DEXA in all bones, and the radial bones were assigned to 6 equiv alent groups based on bone density and total amount of mineral. A distal radial osteotomy was done and a dorsal 30-degree wedge of bone was removed. 1 K-wire fixation group and 5 plate groups were tested for rigidity, yield load, and maximum load.
When data from dorsally and volarly applied plates were pooled, we did not find any statistically significant differences between them regarding stiffness, yield load, and maximum load. The K-wire group showed significantly lower yield load than 3 of the plate groups. There were no statistically significant differences in yield load between the 5 plate groups. The K-wire group showed lower rigidity than the plate groups. The K-wire group and 1 plate group failed at a statistically significant lower maximum load than the 4 other plate groups.
The volar plates had the same mechanical stability as the dorsally applied plates, and they are therefore a good alternative to dorsally applied plates. K-wire osteosynthesis was inferior to plate osteosyntheses regarding all mechanical properties.
近年来,已研发出几种用于桡骨远端骨折内固定的不同钢板设计。然而,很少有生物力学研究对这些新型植入物进行比较。本研究的目的是使用桡骨远端尸体模型,比较5种不同市售钢板(3种掌侧钢板和2种背侧钢板)与标准克氏针固定的力学性能。
纳入来自26具尸体的42根人桡骨。用双能X线吸收法(DEXA)测量所有骨骼的骨密度(BMD),并根据骨密度和矿物质总量将桡骨分为6个等效组。进行桡骨远端截骨术,切除一块30度背侧楔形骨块。对1个克氏针固定组和5个钢板组进行刚度、屈服载荷和最大载荷测试。
当汇总掌侧和背侧应用钢板的数据时,我们发现它们在刚度、屈服载荷和最大载荷方面没有任何统计学上的显著差异。克氏针组的屈服载荷明显低于3个钢板组。5个钢板组之间的屈服载荷没有统计学上的显著差异。克氏针组的刚度低于钢板组。克氏针组和1个钢板组的最大载荷在统计学上显著低于其他4个钢板组。
掌侧钢板与背侧应用钢板具有相同的机械稳定性,因此是背侧应用钢板的良好替代品。在所有力学性能方面,克氏针内固定均不如钢板内固定。