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两种用于舟骨固定的无头加压螺钉的生物力学比较

Biomechanical comparison of two headless compression screws for scaphoid fixation.

作者信息

Pensy Raymond A, Richards Andrew M, Belkoff Stephen M, Mentzer Kurt, Andrew Eglseder W

机构信息

The Curtis National Hand Center, Union Memorial Hospital, 3333 North Calvert Street, Baltimore, MD 21218, USA.

出版信息

J Surg Orthop Adv. 2009 Winter;18(4):182-8.

Abstract

This study compared compression generation between two headless compression screws: the Synthes 3.0-mm and the Acutrak standard. Twenty scaphoids were harvested from 10 pairs of fresh cadaveric forearms. A washer-shaped load cell was inserted between the halves of each scaphoid created by a simulated fracture via osteotomy. One scaphoid of each pair was tested with the Synthes and the other with the Acutrak. Parameters of interest were peak screw torque and fracture site compression. Differences in parameters of interest were checked for significance (p < .05) with paired t tests. No significant differences were shown in mean (+/- standard deviation) peak torque (57 +/- 28 Ncm vs. 55 +/- 32 Ncm; p < .84), compression immediately after insertion (119 +/- 54 N vs. 91 +/- 37 N; p < .15), or compression 5 min after insertion (32 +/- 30 N vs. 38 +/- 24 N; p < .61) between the Synthes and Acutrak screw fixations, respectively. The choice between these two screws to stabilize scaphoid waist fractures should be based on parameters other than compression generation, such as size, availability, cost, and ease of use of the implant.

摘要

本研究比较了两种无头加压螺钉(Synthes 3.0毫米螺钉和Acutrak标准螺钉)之间的加压效果。从10对新鲜尸体前臂上获取了20块舟骨。通过截骨模拟骨折,在每块舟骨的两半之间插入一个垫圈形测力传感器。每对舟骨中的一块用Synthes螺钉进行测试,另一块用Acutrak螺钉进行测试。感兴趣的参数是峰值螺钉扭矩和骨折部位的压力。使用配对t检验检查感兴趣参数的差异是否具有显著性(p < 0.05)。结果显示,Synthes螺钉固定和Acutrak螺钉固定之间在平均(±标准差)峰值扭矩(57±28 Ncm对55±32 Ncm;p < 0.84)、插入后立即的压力(119±54 N对91±37 N;p < 0.15)或插入5分钟后的压力(32±30 N对38±24 N;p < 0.61)方面均无显著差异。在这两种螺钉之间选择用于稳定舟骨腰部骨折时,应基于除加压效果之外的其他参数,如植入物的尺寸、可获得性、成本和易用性。

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