Jakubietz Michael G, Zahn Robert, Gruenert Joerg G, Waschke Jens, Meffert Rainer H, Jakubietz Rafael G
Department of Trauma, Hand, Plastic and Reconstructive Surgery, Julius Maximilian University Wuerzburg, Wuerzburg, Germany.
J Orthop Surg (Hong Kong). 2012 Aug;20(2):224-9. doi: 10.1177/230949901202000218.
To compare 5 different Kirschner wire fixation techniques in terms of the failure loads seen as scapholunate (SL) dissociation in a cadaveric, biomechanical study.
10 fresh-frozen, finger-amputated wrists with sectioned SL ligaments from 3 male and 2 female cadavers were tested. The change of SL angle, SL dissociation, and the load to failure of the 5 different Kirschner wire fixation techniques (using 1.4-mm Kirschner wires) were compared using an axial loading testing machine. The techniques were: (1) SL fixation (using one wire), (2) SL fixation (using 2 wires), (3) SL and scaphocapitate (SC) fixation, (4) SL, SC, and capitolunate (CL) fixation, and (5) CL fixation alone.
There was no significant difference between SL fixations using one or 2 wires. The force for SL dissociation was significantly greater in the SL-SC fixation than the SL fixation using one wire (p=0.003). The SL-SC-CL fixation was not significantly stronger than the SL-SC fixation.
The SL-SC fixation achieved adequate stabilisation of both carpal rows with minimal biological impairment.
在一项尸体生物力学研究中，比较5种不同的克氏针固定技术在舟月骨（SL）分离方面的失效载荷。
对来自3具男性和2具女性尸体的10个新鲜冷冻、手指截肢且切断SL韧带的腕关节进行测试。使用轴向加载试验机比较5种不同克氏针固定技术（使用1.4毫米克氏针）的SL角变化、SL分离情况以及失效载荷。这些技术分别为：（1）SL固定（使用1根针），（2）SL固定（使用2根针），（3）SL和舟头状骨（SC）固定，（4）SL、SC和头月骨（CL）固定，以及（5）单独CL固定。
使用1根或2根针进行SL固定之间无显著差异。SL - SC固定时SL分离的力显著大于使用1根针进行SL固定时的力（p = 0.003）。SL - SC - CL固定并不比SL - SC固定显著更强。
SL - SC固定以最小的生物损伤实现了腕骨两排的充分稳定。
