Haim Dominik, Müller Annett, Leonhardt Henry, Nowak Alexander, Richter Gerd, Lauer Günter
Department of Oral and Maxillofacial Surgery, University Hospital Carl Gustav Carus, Dresden Technical University, Dresden, Germany.
J Oral Maxillofac Surg. 2011 Oct;69(10):2619-25. doi: 10.1016/j.joms.2011.01.002. Epub 2011 Apr 7.
The aim of this study was to evaluate in mandibular condylar process fractures the biomechanical stability of osteosynthesis using the Delta plate and the TriLock Delta condyle trauma plate and to compare these with 2 4-hole miniplates.
The condyles of 120 porcine mandibles were fractured at a defined location. After anatomic reduction, the fractures were fixed with a Delta plate, a TriLock Delta condyle trauma plate, or 2 4-hole miniplates (40 per group). Each group was subjected to linear loadings in 4 different directions with a universal mechanical testing machine (TIRA Test 2720). Yield load and yield displacement were measured for the 2 Delta plates and the 2 miniplates. Means were derived and compared for statistical significance using the Kruskal-Wallis test with a confidence level of 95% (P < .05).
None of the plates broke. In 4 cases using the double miniplate and in 2 cases using the Delta plate, osteosynthesis screw loosening was registered. In lateral-to-medial and anterior-to-posterior directions, the 2 miniplates tolerated the highest loads. From medial to lateral and from posterior to anterior, the TriLock Delta condyle trauma plate resisted the highest loads. However, there was a statistically significant difference among all osteosynthesis systems only for medial-to-lateral loads. Statistical analysis for displacement showed significant differences among all plates in the 4 directions.
This biomechanical study indicates that for rigid internal fixation of condylar fractures of the mandible, similar to 2 miniplates, the 2 Delta plates (Delta plate with gliding holes and TriLock Delta plate) fulfill the principles of a functional and stable osteosynthesis. Both are able to resist physiologic strains. The locking plate (TriLock Delta condyle trauma plate) has the advantages of greater primary stability and decreased likelihood of screw loosening.
本研究旨在评估下颌髁突骨折中使用Delta钢板和TriLock Delta髁突创伤钢板进行骨合成的生物力学稳定性，并将其与两块4孔微型钢板进行比较。
120个猪下颌骨的髁突在特定位置骨折。解剖复位后，骨折分别用Delta钢板、TriLock Delta髁突创伤钢板或两块4孔微型钢板固定（每组40个）。每组通过万能机械试验机（TIRA Test 2720）在4个不同方向施加线性载荷。测量两块Delta钢板和两块微型钢板的屈服载荷和屈服位移。采用Kruskal-Wallis检验得出平均值并比较其统计学意义，置信水平为95%（P < 0.05）。
所有钢板均未断裂。在使用双微型钢板的4例和使用Delta钢板的2例中，记录到骨合成螺钉松动。在从外侧到内侧和从前到后的方向上，两块微型钢板承受的载荷最高。从内侧到外侧和从后到前，TriLock Delta髁突创伤钢板抵抗的载荷最高。然而，仅在从内侧到外侧的载荷方面，所有骨合成系统之间存在统计学显著差异。位移的统计分析表明，所有钢板在4个方向上均存在显著差异。
这项生物力学研究表明，对于下颌髁突骨折的坚固内固定，与两块微型钢板类似，两块Delta钢板（带滑动孔的Delta钢板和TriLock Delta钢板）符合功能性和稳定骨合成的原则。两者都能够抵抗生理应变。锁定钢板（TriLock Delta髁突创伤钢板）具有更高的初始稳定性和更低的螺钉松动可能性的优点。
