Gutbrod Andreas, Vincenti Simona, Kühn Karolin, Knell Sebastian Christoph, Schmierer Philipp Alexander, Pozzi Antonio
Department for Small Animal Surgery, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
Department for Diagnostic Imaging, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
Vet Surg. 2017 Oct;46(7):909-914. doi: 10.1111/vsu.12678. Epub 2017 Jun 22.
To investigate the feasibility of placing bi-cortical cortex (B-cort) or mono-cortical locking screws (M-lock) in a plate-rod construct applied to the feline tibia in combination with different intramedullary (IM) pins.
Twenty-four feline tibiae of cats were divided into 4 groups, corresponding to IM pin sizes filling approximately 30% (1.0 mm), 40% (1.4 mm), 45% (1.6 mm), and 50% (1.8 mm) of the medullary canal. Computed tomography (CT) was performed to trace potential screw trajectories in each group. A 12-hole, 2.4 mm locking compression plate was then applied on the medial aspect of the tibia. M-lock and B-cort screws were inserted subsequently in each plate hole. Success rates of screw insertion based on CT analysis and cadaveric simulation were compared with screw type, IM pin diameter, and anatomic location as variables.
Screw insertion rates were underestimated on CT compared to cadaveric specimens. During cadaveric simulation, B-cort screws could be inserted in all specimens in the 3 most proximal plate holes and in at least 1 of the 3 distal plate holes. The smallest pin size (30%) allowed placement of a greater number of B-cort screws (P < .05) compared to other pins. Fewer B-cort screws could be inserted in the distal diaphyseal region (P < .05) compared to other regions. A total of 99.3% of M-lock screws could be inserted regardless of IMP size.
Plate rod constructs can include bicortical screws in the proximal and distal metaphysis, and monocortical screws in the diaphysis, combined with an IM pin filling up to 50% of the medullary canal.
研究在应用于猫胫骨的钢板-髓内钉结构中，联合不同髓内钉使用双皮质骨皮质螺钉（B-cort）或单皮质锁定螺钉（M-lock）的可行性。
将24只猫的胫骨分为4组，分别对应髓内钉尺寸约为髓腔的30%（1.0毫米）、40%（1.4毫米）、45%（1.6毫米）和50%（1.8毫米）。进行计算机断层扫描（CT）以追踪每组中潜在的螺钉轨迹。然后在胫骨内侧应用一块12孔、2.4毫米的锁定加压钢板。随后在每个钢板孔中插入M-lock和B-cort螺钉。以螺钉类型、髓内钉直径和解剖位置为变量，比较基于CT分析和尸体模拟的螺钉插入成功率。
与尸体标本相比，CT上螺钉插入率被低估。在尸体模拟过程中，B-cort螺钉可插入最近端3个钢板孔中的所有标本以及最远端3个钢板孔中的至少1个。与其他髓内钉相比，最小尺寸的髓内钉（30%）允许插入更多的B-cort螺钉（P < 0.05）。与其他区域相比，在骨干远端区域可插入的B-cort螺钉较少（P < 0.05）。无论髓内钉尺寸如何，总共99.3%的M-lock螺钉可插入。
钢板-髓内钉结构可在近端和远端干骺端包括双皮质螺钉，在骨干包括单皮质螺钉，并联合填充髓腔达50%的髓内钉。
