锁定加压钢板与有限接触动力加压钢板联合髓内钉在犬股骨干骨折间隙模型中的生物力学比较

Biomechanical Comparison of Locking Compression Plate and Limited Contact Dynamic Compression Plate Combined with an Intramedullary Rod in a Canine Femoral Fracture-Gap Model.

作者信息

Matres-Lorenzo Luis, Diop Amadou, Maurel Nathalie, Boucton Marie-Charlotte, Bernard Fabrice, Bernardé Antoine

机构信息

Centre Hospitalier Vétérinaire Saint-Martin, Saint Martin Bellevue, France.

Equipe Biomécanique et Remodelage Osseux (EPBRO), École Nationale Supérieure d'Arts et Métiers, Paris, France.

出版信息

Vet Surg. 2016 Apr;45(3):319-26. doi: 10.1111/vsu.12451. Epub 2016 Feb 22.

DOI:10.1111/vsu.12451

PMID:26909507

Abstract

OBJECTIVE

To compare the biomechanical properties of locking compression plate (LCP) and a limited contact dynamic compression plate combined with an intramedullary rod (LC-DCP-R) in a cadaveric, canine, femoral fracture-gap model.

STUDY DESIGN

In vitro biomechanical study; nonrandomized, complete block (dog).

SAMPLE POPULATION

Paired cadaveric canine femora (n = 10 dogs).

METHODS

Paired femurs with a mid-diaphyseal 20 mm gap were stabilized with either LCP or LC-DCP-R. Nondestructive testing up to 60% of body weight (BW) was followed by a continuous destructive test. Comparative structural properties, 3-dimensional (3D) interfragmentary motion, and plate linear strain were evaluated. Paired comparisons were made between LCP and LC-DCP-R.

RESULTS

Stiffness after nondestructive testing was significantly lower for LCP with a mean (95% confidence interval [CI]) of 61 N/mm (46-76) versus 89 N/mm (67-110) for LC-DCP-R (P = .0072). Ultimate load to failure was significantly lower for LCP with a median (interquartile range [IQR]) of 270 N (247-286) versus 371.5 (353-385) for LC-DCP-R (P = .002). Axial motion at 60% BW was significantly higher for LCP with a median (IQR) of 1.01 mm (0.71-1.26) versus 0.36 mm (0.20-0.49) for LC-DCP-R (P = .002). Shear motion was significantly higher for LCP with a median (IQR) of 1.18 (0.78-1.58) versus 0.72 mm (0.45-1.00) for LC-DCP-R (P = .018). Strain was significantly higher for mid-LCP surface with a mean (95%CI) at 60% BW of 979 μdef (579-1378) versus 583 μdef (365-801) at mid-LC-DCP-R surface (P = .0153). The elastic limit strain of the plates was not different and was reached at a mean (95%CI) load of 241 N (190-292) for LCP versus 290 N (245-336) for LC-DCP-R (P = .12).

CONCLUSION

The LC-DCP-R showed higher stiffness and resistance to failure, lower interfragmentary motion, and lower plate strain and stress compared to LCP.

摘要

目的

在尸体犬股骨干骨折间隙模型中比较锁定加压钢板（LCP）和有限接触动力加压钢板联合髓内钉（LC-DCP-R）的生物力学性能。

研究设计

体外生物力学研究；非随机、完全区组（犬）。

样本群体

配对的尸体犬股骨（n = 10只犬）。

方法

将股骨干中段有20 mm间隙的配对股骨分别用LCP或LC-DCP-R固定。先进行高达体重（BW）60%的无损测试，随后进行连续的破坏测试。评估比较结构性能、三维（3D）骨折块间运动和钢板线性应变。对LCP和LC-DCP-R进行配对比较。

结果

无损测试后的刚度，LCP显著较低，平均值（95%置信区间[CI]）为61 N/mm（46 - 76），而LC-DCP-R为89 N/mm（67 - 110）（P = 0.0072）。LCP的极限破坏载荷显著较低，中位数（四分位数间距[IQR]）为270 N（247 - 286），而LC-DCP-R为371.5（353 - 385）（P = 0.002）。在60% BW时，LCP的轴向运动显著更高，中位数（IQR）为1.01 mm（0.71 - 1.26），而LC-DCP-R为0.36 mm（0.20 - （此处原文有误，应为0.49））（P = 0.002）。LCP的剪切运动显著更高，中位数（IQR）为1.18（0.78 - 1.58），而LC-DCP-R为0.72 mm（0.45 - 1.00）（P = 0.018）。在60% BW时，LCP钢板中部表面的应变显著更高，平均值（95%CI）为979 μdef（579 - （此处原文有误，应为1378）），而LC-DCP-R钢板中部表面为583 μdef（365 - 801）（P = 0.0153）。钢板的弹性极限应变无差异，LCP在平均（95%CI）载荷241 N（190 - 292）时达到，LC-DCP-R在290 N（245 - 336）时达到（P = 0.12）。