Morrison K M, Ebraheim N A, Southworth S R, Sabin J J, Jackson W T
Department of Orthopaedics, Medical College of Ohio, Toledo 43699.
Clin Orthop Relat Res. 1991 May(266):209-13.
There is added stability when plate fixation of the fibula supplements the external fixator used in treating tibial fractures associated with a segmental defect. An anatomic specimen model of a Grade III open fracture of the tibia with an associated fibular fracture was used in this study. Fibular internal fixation using an AO standard plate was performed on one of each of five matched pairs of legs. These were then subjected to identical loads in compression and torsion. The numeric values obtained during loading in all modes were converted to ratios between each of the tested pair to directly compare the effect of stabilization of the fibula. The final results showed that in each case, the preparation with fibular plating had improved resistance to deformation in axial loading. On average, the plated specimens were 2.2 times stiffer. In torsion, plating the fibula did not appear to affect the resistance of the construct to the applied load. Supplemental plate fixation of the fibula in fractures of the tibia with segmental defects may improve subsequent morbidity. The increased rigidity of the system may be sufficient to allow partial to full weight bearing immediately after surgery. This may have significant value in the management of the polytraumatized patient.
当使用钢板固定腓骨辅助治疗伴有节段性骨缺损的胫骨骨折时，稳定性会增强。本研究使用了一个伴有腓骨骨折的III级胫骨开放性骨折的解剖标本模型。在五对匹配的腿部中，每对中的一条腿采用AO标准钢板进行腓骨内固定。然后对其施加相同的压缩和扭转载荷。将所有加载模式下获得的数值转换为各测试对之间的比率，以直接比较腓骨稳定的效果。最终结果表明，在每种情况下，采用腓骨钢板固定的标本在轴向加载时的抗变形能力有所提高。平均而言，钢板固定的标本刚度提高了2.2倍。在扭转试验中，腓骨钢板固定似乎并未影响结构对所施加载荷的抵抗力。对于伴有节段性骨缺损的胫骨骨折，采用腓骨钢板辅助固定可能会改善后续的病情。系统刚度的增加可能足以允许术后立即部分或完全负重。这对于多发伤患者的治疗可能具有重要价值。
