Wang Da-xing, Xiong Ying, Deng Hong, Jia Fu, Gu Shao, Liu Bai-lian, Li Qun-hui, Pu Qi, Zhang Zhong-Zi
Department of Orthopedics, Yan'an Hospital, Kunming, China.
Department of Orthopedics, Yan'an Hospital, Kunming, China
Proc Inst Mech Eng H. 2014 Sep;228(9):899-907. doi: 10.1177/0954411914548866. Epub 2014 Sep 8.
This work aimed to compare the stress distribution and mechanical properties of our bridge combined fixation system and commonly used metal locking plate screw system by finite element analysis and by using the Zwick/Z100 testing machine. In addition, we also investigated the clinical outcome of our bridge combined fixation system for femoral fractures in 59 patients from June 2005 to January 2013. As a result, the stress distribution in the bone plate and screws of metal locking plate screw system during walking and climbing stairs was significantly lower than that of metal locking plate screw system. No significant difference in the displacement was observed between two systems. The equivalent bending stiffness of bridge combined fixation system was significantly lower than that of metal locking plate screw system. There were no significant differences in the bending strength, yield load, and maximum force between two systems. All the cases were followed up for 12-24 months (average 18 months). The X-ray showed bone callus was formed in most patients after 3 months, and the fracture line was faint and disappeared at 6-9 months postoperatively. No serious complications, such as implant breakage and wound infection, occurred postoperatively. According to self-developed standard for bone healing, clinical outcomes were rated as excellent or good in 55 out of 59 patients (success rate: 93.2%). Therefore, our findings suggest that our bridge combined fixation system may be a promising approach for treatment of long-bone fractures.
本研究旨在通过有限元分析以及使用Zwick/Z100试验机，比较我们的桥式联合固定系统与常用的金属锁定钢板螺钉系统的应力分布和力学性能。此外，我们还调查了2005年6月至2013年1月期间59例股骨干骨折患者使用我们的桥式联合固定系统的临床疗效。结果显示，在行走和爬楼梯过程中，金属锁定钢板螺钉系统的骨板和螺钉中的应力分布明显低于桥式联合固定系统。两个系统之间在位移方面未观察到显著差异。桥式联合固定系统的等效弯曲刚度明显低于金属锁定钢板螺钉系统。两个系统在弯曲强度、屈服载荷和最大力方面没有显著差异。所有病例均随访12 - 24个月（平均18个月）。X线显示大多数患者在3个月后形成骨痂，术后6 - 9个月骨折线模糊并消失。术后未发生严重并发症，如植入物断裂和伤口感染。根据自行制定的骨愈合标准，59例患者中有55例临床疗效评定为优或良（成功率：93.2%）。因此，我们的研究结果表明，我们的桥式联合固定系统可能是治疗长骨骨折的一种有前景的方法。
