Karakasli Ahmet, Acar Nihat, Karaarslan Ahmet, Ertem Fatih, Havitcioglu Hasan
Dokuz Eylul University, Faculty of Medicine, Department of Orthopaedics and Traumatology, 35340 Balcova, Izmir, Turkey.
Gazikent Medical Center, Department of Orthopaedics and Traumatology, 35340 Gazi Emir, Izmir, Turkey.
J Clin Orthop Trauma. 2016 Oct-Dec;7(Suppl 2):177-183. doi: 10.1016/j.jcot.2016.08.006. Epub 2016 Aug 28.
Locking compression plate (LCP) system was designed to provide bone stability and to enhance bone healing. However, implant failure, nonunion and instability are still frequently encountered complications. The purpose of this study was to assess and compare the biomechanical characteristics of a novel adjustable dynamic plate (ADP) with the commonly used LCP.
Twelve 4th generation composite artificial femoral bones were used. Transverse fracture was created in all bones, 6 femurs were fixated using the novel ADP, whereas the other 6 femurs were fixated using the traditional LCP. All samples had undergone a non-destructive repetitive different forces (axial compression, bending and torsion), to evaluate the biomechanical differences between the two plating systems.
Under axial load the mean stiffness value was 439.0 N/mm for the ADP and 158.9 N/mm for the LCP, ADP showed a statistically significant stiffness value than LCP with a value of 0.004. There was no significant difference in flexion/extension bending strain values between ADP and LCP. However LCP provided significantly stiffer fixation in medial and lateral bending tests than ADP ( = 0.037) and ( = 0.016) respectively. But no significant difference was detected between the two plating system in the applied torsional stress.
These results do not show any significant biomechanical difference in the applied torsional and bending stresses between LCP and ADP. However the remarkably increased persistent compression effect of the ADP created a considerable stress on fracture edges which may accelerate bone healing.
锁定加压接骨板(LCP)系统旨在提供骨骼稳定性并促进骨愈合。然而,植入物失败、骨不连和不稳定仍是常见的并发症。本研究的目的是评估并比较新型可调动力接骨板(ADP)与常用LCP的生物力学特性。
使用12根第4代复合人工股骨。所有股骨均制造横向骨折,6根股骨用新型ADP固定,另外6根股骨用传统LCP固定。所有样本均承受非破坏性重复不同力(轴向压缩、弯曲和扭转),以评估两种接骨板系统之间的生物力学差异。
在轴向载荷下,ADP的平均刚度值为439.0N/mm,LCP为158.9N/mm,ADP的刚度值比LCP具有统计学显著差异,P值为0.004。ADP和LCP在屈伸弯曲应变值方面无显著差异。然而,在内外侧弯曲试验中,LCP分别比ADP提供了显著更硬的固定(P = 0.037)和(P = 0.016)。但在施加的扭转应力方面,两种接骨板系统之间未检测到显著差异。
这些结果表明,LCP和ADP在施加的扭转和弯曲应力方面没有任何显著的生物力学差异。然而,ADP显著增强的持续压缩效应在骨折边缘产生了相当大的应力,这可能会加速骨愈合。