Uher J
Acta Chir Orthop Traumatol Cech. 1989 Feb;56(1):66-77.
Morphological and biomechanical changes of the course of healing of cavities after screws in compression AO plates applied for 8 weeks and simple drilling revealed that in the long-term reduction of mechanical properties of these sites as a rule a major influence is played by transverse drillingholes of 3.4 mm and holes after 4.0 mm screws rather than by plates. The healing of cavities after simple drillingholes and after removal of screws is similar. In both instances a transversally oriented trabecular bony tissue is formed, i.e. transversally oriented to the original direction of osteones. This transverse orientation of trabecular bone matrix than causes poor distribution and spread of forces acting at these sites with a different vascular supply nutrition and biochemical changes. This reduces on a long-term basis biomechanical and other properties of these sites. Tranverse drillingholes and holes after screws are more important than plates in the subsequent reconstruction of osseous tissue after their removal. Therefore it is important when treating fractures using compression plates to keep in mind this adverse late effect of transverse cavities after screws and use them as little as possible.
在应用AO加压钢板8周后以及单纯钻孔后，对螺钉置入部位空洞愈合过程中的形态学和生物力学变化进行研究，结果显示，通常情况下，这些部位力学性能的长期降低主要受3.4mm的横向钻孔以及4.0mm螺钉置入后的孔洞影响，而非钢板。单纯钻孔后及取出螺钉后空洞的愈合情况相似。在这两种情况下，均会形成横向排列的小梁骨组织，即与骨单位的原始方向呈横向排列。小梁骨基质的这种横向排列进而导致作用于这些部位的力分布和传导不佳，同时伴有不同的血管供应、营养及生化变化。这会长期降低这些部位的生物力学及其他性能。横向钻孔和螺钉置入后的孔洞在去除钢板后骨组织的后续重建中比钢板更为重要。因此，在使用加压钢板治疗骨折时，务必牢记螺钉置入后横向空洞的这种不良后期影响，并尽可能减少其使用。
