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[胫骨髁间隆起撕脱骨折的颈围结环结扎缝合生物力学研究]

[BIOMECHANICAL STUDY ON SUTURE WITH NECKWEAR-KNOT-LOOP-LIGATURE FOR TIBIAL EMINENCE AVULSION FRACTURES].

作者信息

Wang Jiangtao, Shen Xuezhen, Liu Chang, Qi Wei, Qu Feng, Yuan Bangtuo, Zhao Gang, Guo Qi, Li Hongliang, Lu Xi, Zhu Juanli, Liu Yang, Liu Yujie

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2015 Sep;29(9):1080-3.

Abstract

OBJECTIVE

To study the biomechanical stability of neckwear-knot-loop-ligature fixation for tibial eminence avulsion fractures by comparing with cannulated screw fixation and suture anchor fixation.

METHODS

Twenty-four fresh porcine knee joints were selected. After the model of tibial eminence avulsion fracture (type III) was made, 24 samples were randomly divided into 3 groups: neckwear-knot-loop-ligature group (group A), cannulated screw group (group B), and suture anchor group (group C), 8 samples in each group. The Universal electromagnetic and mechanical testing machines were used for the biomechanical tests. After 200 cyclic tests, pull-out test was done until fixation failure. The maximum failure load, yield load, stiffness, and displacement were measured.

RESULTS

Failure mode: the displacement was beyond limit in 8 samples of group A; screws extraction (5 samples) and bone fragment re-fracture (3 samples) were observed in group B; and suture anchor extraction (4 samples), suture rupture (3 samples), and suture thread cutting (1 sample) were found in group C. Biomechanical test: From groups A to C, the maximum failure load and yield load showed significant decreasing tendency (P<0.05), but the displacements showed significant increasing tendency (P<0.05). The stiffness also gradually decreased, but differences was not significant (P>0.05).

CONCLUSION

Compared with cannulated screw and suture anchor, neckwear-knot-loop-ligature fixation for tibial eminence avulsion fracture has good biomechanical performance and the advantages of firm fixation and simple operation.

摘要

目的

通过与空心螺钉固定和缝线锚钉固定相比较,研究颈带结环绑扎固定治疗胫骨髁间棘撕脱骨折的生物力学稳定性。

方法

选取24个新鲜猪膝关节。制作胫骨髁间棘撕脱骨折(III型)模型后,将24个样本随机分为3组:颈带结环绑扎组(A组)、空心螺钉组(B组)和缝线锚钉组(C组),每组8个样本。使用万能电磁和力学试验机进行生物力学测试。经过200次循环测试后,进行拔出试验直至固定失效。测量最大失效载荷、屈服载荷、刚度和位移。

结果

失效模式:A组8个样本位移超出极限;B组观察到螺钉拔出(5个样本)和骨块再骨折(3个样本);C组发现缝线锚钉拔出(4个样本)、缝线断裂(3个样本)和缝线切割(1个样本)。生物力学测试:从A组到C组,最大失效载荷和屈服载荷呈显著下降趋势(P<0.05),但位移呈显著上升趋势(P<0.05)。刚度也逐渐降低,但差异不显著(P>0.05)。

结论

与空心螺钉和缝线锚钉相比,颈带结环绑扎固定治疗胫骨髁间棘撕脱骨折具有良好的生物力学性能,固定牢固且操作简单。

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