Wang Yan-xiang, Zhang Yun-tong, Tang Yang, Zhao Xue, Fu Qing-ge, Zhang Xin, Zhang Chun-cai
Department of Orthopaedics, the Affiliated Changhai Hospital of the Second Military Medical University, Shanghai 200433, China.
Zhongguo Gu Shang. 2013 Jul;26(7):601-4.
To assess the clinical effects of Ni-Ti shape memory alloy bow-teeth screws combined with locking plate internal fixation in treating comminuted fracture of tibial plateau.
From January 2003 to December 2008, 17 patients with comminuted fracture of tibial plateau were treated with Ni-Ti shape memory alloy bow-teeth screws and locking plate internal fixation. There were 9 males and 8 females with an average age of 33.7 years old (ranged, 23 to 48 years). All fractures were fresh and injured time less 3 weeks and 2 patients with common peroneal nerve injury. According to Schatzker typing, type V was in 1 case and type VI was in 16 cases.
All patients were followed up from 10 to 22 months with an average of 18 months and all incisions healed in one stage. At 3 to 12 weeks after operation, knee joint function of 16 cases arrived to the level of uninjured side and 1 case was poor in flexed function. All fractures obtained union at 3 to 5 months after operation, and internal fixtures were removed at 1 year after operation and no reduction lossing or refracture occurred. At final follow-up, no bone block shifting, internal fixture loosening and breakage was found. According to the standard of Xushanding's knee joint function, 9 cases got excellent results, 4 good, 4 fair.
The design of Ni-Ti shape memory alloy bow-teeth screws is adapt to irregular anatomic structure of comminuted fractures of tibial plateau,it can continuously pressurize and promote bone healing. Multi drop lockedup may avoid wide-ranging stripping local soft tissue, and form three-dimension fixation after combined with locking plate internal fixation, can effective recover anatomic structure of fracture. So Ni-Ti shape memory alloy bow-teeth screws combined with locking plate internal fixation is an effective method in treating comminuted fracture of tibial plateau.
评估镍钛形状记忆合金齿弓钉联合锁定钢板内固定治疗胫骨平台粉碎性骨折的临床疗效。
2003年1月至2008年12月,对17例胫骨平台粉碎性骨折患者采用镍钛形状记忆合金齿弓钉联合锁定钢板内固定治疗。男9例,女8例,平均年龄33.7岁(23~48岁)。所有骨折均为新鲜骨折,受伤时间小于3周,2例伴有腓总神经损伤。按Schatzker分型,Ⅴ型1例,Ⅵ型16例。
所有患者随访10~22个月,平均18个月,切口均一期愈合。术后3~12周,16例膝关节功能恢复至健侧水平,1例屈曲功能差。所有骨折术后3~5个月均获得愈合,术后1年取出内固定物,无复位丢失及再骨折发生。末次随访时,未发现骨块移位、内固定松动及断裂。按胥少汀膝关节功能标准评定,优9例,良4例,可4例。
镍钛形状记忆合金齿弓钉的设计适应胫骨平台粉碎性骨折的不规则解剖结构,能持续加压促进骨折愈合。多点锁定可避免广泛剥离局部软组织,与锁定钢板内固定联合后形成三维固定,能有效恢复骨折解剖结构。因此,镍钛形状记忆合金齿弓钉联合锁定钢板内固定是治疗胫骨平台粉碎性骨折的有效方法。