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四边形区域髋臼骨折四种内固定方式的生物力学对比研究

[BIOMECHANICAL COMPARATIVE STUDY ON FOUR INTERNAL FIXATIONS FOR ACETABULAR FRACTURES IN QUADRILATERAL AREA].

作者信息

Wang Lei, Wu Xiaobo, Qi Wei, Wang Yongbin, He Quanjie, Xu Fengsong, Liu Hongyang

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2015 Oct;29(10):1235-9.

Abstract

OBJECTIVE

To compare the biomechanical difference of 4 kinds of internal fixations for acetabular fracture in quadrilateral area.

METHODS

The transverse fracture models were created in 16 hemipelves specimens from 8 adult males, and were randomly divided into 4 groups according to different internal fixation methods (n = 4): infrapectineal buttress reconstruction plate (group A), infrapectineal buttress locking reconstruction plate (group B), reconstruction plate combined with trans-plate quadrilateral screws (group C), and anterior reconstruction plate-lag screw (group D). Then the horizontal displacement, longitudinal displacement of fractures, and axial stiffness were measured and counted to compare the stability after continuous vertical loading.

RESULTS

Under the same loading, the horizontal and longitudinal displacements of groups A, B, C, and D were decreased gradually; when the loading reached 1 800 N, the longitudinal displacement of group A was more than 3.00 mm, indicating the failure criterion, while the axial stiffness increased gradually. Under 200 N loading, there was no significant difference (P > 0.05) in horizontal displacement, longitudinal displacement, and axial stiffness among 4 groups. When the loading reached 600-1 800 N, significant differences were found in horizontal displacement, longitudinal displacement, and axial stiffness among 4 groups (P < 0.05) except the horizontal displacement between groups C and D (P > 0.05).

CONCLUSION

For acetabular fracture in the quadrilateral area, anterior reconstruction plate-lag screw for internal fixation has highest stability, followed by reconstruction plate combined with trans-plate quadrilateral screws, and they are better than infrapectineal buttress reconstruction plate and infrapectineal buttress locking reconstruction plate.

摘要

目的

比较四边形区域髋臼骨折4种内固定方式的生物力学差异。

方法

取8具成年男性半骨盆标本制作横行骨折模型,根据不同内固定方式随机分为4组(n = 4):耻骨下支持重建钢板组(A组)、耻骨下支持锁定重建钢板组(B组)、重建钢板联合经钢板四边形螺钉组(C组)、前路重建钢板拉力螺钉组(D组)。然后测量并计算骨折的水平位移、纵向位移及轴向刚度,比较持续垂直加载后的稳定性。

结果

相同载荷下,A、B、C、D组骨折的水平和纵向位移逐渐减小;当载荷达到1 800 N时,A组纵向位移超过3.00 mm,提示达到失效标准,而轴向刚度逐渐增加。在200 N载荷下,4组的水平位移、纵向位移及轴向刚度差异无统计学意义(P > 0.05)。当载荷达到600~1 800 N时,4组的水平位移、纵向位移及轴向刚度差异有统计学意义(P < 0.05),C组与D组水平位移差异无统计学意义(P > 0.05)。

结论

对于四边形区域髋臼骨折,前路重建钢板拉力螺钉内固定稳定性最高,其次是重建钢板联合经钢板四边形螺钉,二者均优于耻骨下支持重建钢板和耻骨下支持锁定重建钢板。

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