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本文引用的文献

1
Does plugging unused combination screw holes improve the fatigue life of fixation with locking plates in comminuted supracondylar fractures of the femur?封堵未使用的组合螺钉孔是否能提高股骨髁上粉碎性骨折锁定钢板固定的疲劳寿命？
J Bone Joint Surg Br. 2012 Feb;94(2):241-8. doi: 10.1302/0301-620X.94B2.27440.
2
Biomechanical testing of fracture fixation constructs: variability, validity, and clinical applicability.骨折固定结构的生物力学测试：变异性、有效性和临床适用性。
J Am Acad Orthop Surg. 2012 Feb;20(2):86-93. doi: 10.5435/JAAOS-20-02-086.
3
Biomechanical analysis of a synthetic femur spiral fracture model: Influence of different materials on the stiffness in flexible intramedullary nailing.合成股骨螺旋骨折模型的生物力学分析：不同材料对弹性髓内钉固定中刚度的影响
Clin Biomech (Bristol). 2011 Jul;26(6):592-7. doi: 10.1016/j.clinbiomech.2011.01.012. Epub 2011 Feb 22.
4
Threaded screw head inserts improve locking plate biomechanical properties.螺纹螺钉头植入物可改善接骨板的生物力学性能。
J Orthop Trauma. 2011 Feb;25(2):65-71. doi: 10.1097/BOT.0b013e3181dc56b1.
5
Choosing a proper working length can improve the lifespan of locked plates. A biomechanical study.选择合适的工作长度可提高锁定钢板的使用寿命。一项生物力学研究。
Clin Biomech (Bristol). 2011 May;26(4):405-9. doi: 10.1016/j.clinbiomech.2010.11.020. Epub 2010 Dec 24.
6
Distal femoral osteoarticular allografts: long-term survival, but frequent complications.股骨远端骨关节同种异体移植物：长期存活率高，但并发症频发。
Clin Orthop Relat Res. 2010 Nov;468(11):2914-23. doi: 10.1007/s11999-010-1470-x.
7
Stiffness and endurance of a locking compression plate fixed on fractured femur.
J Appl Biomech. 2010 Feb;26(1):10-6. doi: 10.1123/jab.26.1.10.
8
Long-term results for limb salvage with osteoarticular allograft reconstruction.同种异体骨关节移植重建肢体挽救的长期结果。
Clin Orthop Relat Res. 2009 Oct;467(10):2685-90. doi: 10.1007/s11999-009-0726-9. Epub 2009 Feb 13.
9
Locking plates: tips and tricks.锁定钢板：技巧与窍门。
J Bone Joint Surg Am. 2007 Oct;89(10):2298-307. doi: 10.2106/00004623-200710000-00028.
10
Fracture toughness and fatigue crack propagation rate of short fiber reinforced epoxy composites for analogue cortical bone.用于模拟皮质骨的短纤维增强环氧树脂复合材料的断裂韧性和疲劳裂纹扩展速率
J Biomech Eng. 2007 Aug;129(4):487-93. doi: 10.1115/1.2746369.

锁定按钮可提高节段性骨缺损模型中锁定板的疲劳寿命。

Locking buttons increase fatigue life of locking plates in a segmental bone defect model.

机构信息

Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA.

出版信息

Clin Orthop Relat Res. 2013 Mar;471(3):1039-44. doi: 10.1007/s11999-012-2664-1. Epub 2012 Oct 27.

DOI:10.1007/s11999-012-2664-1
PMID:23104045
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3563789/
Abstract

BACKGROUND

Durability of plate fixation is important in delayed union. Although locking plates result in stronger constructs, it is not known if locking affects the fatigue life of a plate. Two locking screws on either side of the nonunion could decrease working length and increase strain in the plate. However, the reinforcing effect of the locking head on the plate may compensate, so that it is unclear whether locking reduces fatigue life.

QUESTIONS/PURPOSES: We determined whether locking screws, compression screws, and locking buttons reduce or increase the fatigue life of a plate.

METHODS

We tested fatigue life of four constructs using an eight-hole locking plate in a segmental defect model: (1) all locking screws (Locked; n = 5); (2) all compression screws (Unlocked; n = 5); (3) six compression screws with two locking buttons in the central holes (Button; n = 6); and (4) six compression screws with two open central holes (Open; n = 6).

RESULTS

The Button group had the longest fatigue life (1.3 million cycles). There was no difference between the Locked and Unlocked groups. All of the constructs failed by fracture of the plates through a screw hole adjacent to the defect.

CONCLUSIONS

Locking screws did not improve fatigue life, however a locking button increased the fatigue life of a locking plate in a segmental bone defect model.

CLINICAL RELEVANCE

Locking buttons in holes adjacent to a defect may improve durability, which is important when delayed union is a possibility.

摘要

背景

延迟愈合时，板固定的耐久性很重要。锁定钢板虽然能产生更强的结构，但尚不清楚锁定是否会影响钢板的疲劳寿命。在非愈合部位两侧的两个锁定螺钉可能会减小工作长度并增加钢板的应变。然而，锁定头对钢板的增强作用可能会补偿，因此尚不清楚锁定是否会降低疲劳寿命。

问题/目的：我们确定锁定螺钉、加压螺钉和锁定按钮是否会减少或增加钢板的疲劳寿命。

方法

我们使用八孔锁定钢板在节段性缺损模型中测试了四种结构的疲劳寿命：（1）所有锁定螺钉（锁定组；n = 5）；（2）所有加压螺钉（未锁定组；n = 5）；（3）中央孔中的 6 个加压螺钉和 2 个锁定按钮（按钮组；n = 6）；（4）中央孔中的 6 个加压螺钉和 2 个开口中央孔（开放组；n = 6）。

结果

按钮组的疲劳寿命最长（130 万次循环）。锁定组和未锁定组之间没有差异。所有的结构都因紧邻缺损处的螺钉孔的钢板断裂而失效。

结论

锁定螺钉并没有提高疲劳寿命，但是在节段性骨缺损模型中，锁定按钮增加了锁定钢板的疲劳寿命。

临床相关性

在缺损附近的孔中使用锁定按钮可能会提高耐用性，这在延迟愈合的情况下很重要。