Karakasli Ahmet, Basci Onur, Ertem Fatih, Sekik Eyad, Havitcioglu Hasan
Dokuz Eylul University, Faculty of Medicine, Dept. Orthopaedics and Traumatology, Izmir, Turkey.
Dokuz Eylul University, Institute of Health Sciences, Dept. Biomechanics, Izmir, Turkey.
Acta Orthop Traumatol Turc. 2016 Aug;50(4):432-6. doi: 10.1016/j.aott.2016.07.002. Epub 2016 Jul 29.
The role of plate configuration was found inconclusive on the biomechanical effects of the plate size and hole number for dual plate constructions in humeral shaft fractures. The purpose of this study was to test the biomechanical stability of various dual plate constructions.
Twenty-four left humeri (4th Generation Composite Humerus, Sawbones, Malmö, Sweden) with comminuted midshaft humeral fracture were used. Four groups of plate constructs were tested: laterally fixed 8-hole locking plate and screws were combined with anteriorly locking plates containing 0, 4, 6, or 8 holes in groups I, II, III, and IV, respectively. The alterations in axial, bending, and torsional angles were recorded.
There were no fixation failures during axial, bending, or torsional stiffness testing within the elastic behavior limits. Axial stiffness was highest in Group IV. Torsional stiffness, posterior-to-anterior bending stiffness, lateral-to-medial bending stiffness, and medial-to-lateral bending stiffness were lowest in Group I.
The similar stiffness values for the 8-to-4 hole and 8-to-6 hole plate constructions indicate that the 8-to-4 hole construction is an option in young adults, while the stiffest 8-to-8 hole combination may be an option for osteoporotic patients.
对于肱骨干骨折的双钢板固定结构，钢板构型对钢板尺寸和孔数的生物力学影响尚无定论。本研究的目的是测试各种双钢板固定结构的生物力学稳定性。
使用24根左侧肱骨（第4代复合肱骨，Sawbones公司，瑞典马尔默），均为肱骨干中段粉碎性骨折。测试四组钢板固定结构：在I、II、III和IV组中，分别将外侧固定的8孔锁定钢板及螺钉与前方含0、4、6或8孔的锁定钢板组合。记录轴向、弯曲和扭转角度的变化。
在弹性行为限度内进行轴向、弯曲或扭转刚度测试期间，均未出现固定失败情况。IV组的轴向刚度最高。I组的扭转刚度、后前向弯曲刚度、内外侧弯曲刚度和外内侧弯曲刚度最低。
8孔与4孔及8孔与6孔钢板固定结构的刚度值相似，表明8孔与4孔结构可作为年轻成人的一种选择，而刚度最大的8孔与8孔组合可能是骨质疏松患者的一种选择。
