Orhan Suleyman Nazif, Ozyazicioglu Mehmet Hamit, Colak Abdurrahim
Department of Civil Engineering, Erzurum Technical University, Engineering and Architecture Faculty, Erzurum, Turkey.
Department of Civil Engineering, Atatürk University, Engineering Faculty, Erzurum, Turkey.
Interact Cardiovasc Thorac Surg. 2017 Nov 1;25(5):750-756. doi: 10.1093/icvts/ivx175.
This study experimentally compares the efficiency of the 4 most preferred sternal closure tehniques, in 3 different deformation modes of the chest.
Polyurethane sternum models fixed by conventional wiring, steel band, ZipFix band and figure-8 wiring are tested statically under lateral distraction, longitudinal shear and torsional deformation modes. As a result, load-deformation curves are obtained. The closure efficiency of the techniques is then compared with respect to allowable load (corresponding to 2 mm displacement), rigidity, rupture load and rupture displacement. A comparison in terms of cost and ease of application has also been presented.
The highest allowable load and rigidity values in simple tension and longitudinal shear are obtained by the steel and ZipFix band techniques, respectively. In torsion mode, the highest allowable load is provided by the ZipFix band and the highest rigidty is attained by the steel band technique. The highest rupture loads under simple tension, longitudinal shear and torsion modes are observed in ZipFix, steel band and conventional wiring, respectively. Steel band closure provides the least rupture displacement in simple tension as well as torsion, whereas ZipFix bands give the smallest rupture displacements in longitudinal shear. However, in every loading mode there were no statistically significant differences in allowable load, rigidity and rupture load values between the closure methods, and only rupture displacement values were statistically different for each method.
Our results showed that conventional wiring is the most advantageous closing method when compared to the others.
本研究通过实验比较了4种最常用的胸骨闭合技术在胸部3种不同变形模式下的效率。
对采用传统钢丝、钢带、ZipFix带和8字钢丝固定的聚氨酯胸骨模型，在侧向牵张、纵向剪切和扭转变形模式下进行静态测试。结果得到了载荷-变形曲线。然后根据允许载荷（对应2毫米位移）、刚度、断裂载荷和断裂位移比较这些技术的闭合效率。还给出了成本和应用难易程度方面的比较。
在简单拉伸和纵向剪切中，分别采用钢带和ZipFix带技术可获得最高的允许载荷和刚度值。在扭转变形模式下，ZipFix带提供了最高的允许载荷，钢带技术获得了最高的刚度。在简单拉伸、纵向剪切和扭转变形模式下，分别在ZipFix带、钢带和传统钢丝固定方式中观察到最高的断裂载荷。在简单拉伸和扭转时，钢带闭合提供的断裂位移最小，而在纵向剪切时，ZipFix带的断裂位移最小。然而，在每种加载模式下，闭合方法之间的允许载荷、刚度和断裂载荷值没有统计学上的显著差异，只有每种方法的断裂位移值在统计学上有所不同。
我们的结果表明，与其他方法相比，传统钢丝固定是最具优势的闭合方法。
