采用克氏针或钢板辅助固定以稳定肱骨外侧髁单髁骨折。

Adjunct fixation with a Kirschner wire or a plate for lateral unicondylar humeral fracture stabilization.

作者信息

Coggeshall Jason D, Lewis Daniel D, Iorgulescu Alex, Kim Stanley E, Palm Lindsey S, Pozzi Antonio

机构信息

Comparative Orthopaedic and Biomechanics Laboratory, University of Florida, Gainesville, Florida.

Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida.

出版信息

Vet Surg. 2017 Oct;46(7):933-941. doi: 10.1111/vsu.12677. Epub 2017 Jun 22.

DOI:10.1111/vsu.12677

PMID:28640455

Abstract

OBJECTIVE

To compare the biomechanical properties of using an interfragmentary 1.6 mm Kirschner wire or a 2.7 mm reconstruction plate as adjunctive epicondylar stabilization in simulated comminuted lateral unicondylar humeral fractures stabilized with a transcondylar 4.5 mm cortical screw.

STUDY DESIGN

Cadaveric biomechanical assessment.

SAMPLE POPULATION

Paired humeri harvested from 9 young, skeletally mature dogs.

METHODS

Simulated comminuted lateral unicondylar humeral fractures were stabilized with a transcondylar 4.5 mm cortical screw placed in lag fashion. Adjunct fixations consisting of a 1.6 mm Kirschner wire on one side, and a 2.7 mm reconstruction plate on the contralateral side, were tested within paired humeri. Repaired humeri were axially loaded to failure and construct stiffness, yield load, and load to failure were obtained from the load-deformation curves.

RESULTS

Stiffness (mean ± SD: 577 ± 245 vs 310 ± 71 N/mm; P = .01), yield load (mean ± SD: 2389 ± 572 vs 1017 N ± 292; P = .0002), and load at failure (mean ± SD: 3351 ± 358 vs 1693 ± 363 N; P = .009) were greater in constructs incorporating a reconstruction plate rather than a Kirschner wire.

CONCLUSION

Our results support the recommendation for adjunct fixation of comminuted lateral unicondylar humeral fractures with an epicondylar plate.

摘要

目的

比较在模拟的经髁4.5 mm皮质骨螺钉固定的粉碎性外侧单髁肱骨骨折中，使用1.6 mm骨间克氏针或2.7 mm重建钢板作为辅助髁上稳定的生物力学特性。

研究设计

尸体生物力学评估。

样本群体

从9只骨骼成熟的年轻犬身上获取的配对肱骨。

方法

模拟的粉碎性外侧单髁肱骨骨折采用经髁4.5 mm皮质骨螺钉以拉力方式固定。在配对的肱骨中测试辅助固定，一侧为1.6 mm克氏针，对侧为2.7 mm重建钢板。对修复后的肱骨进行轴向加载直至破坏，并从载荷-变形曲线中获得结构刚度、屈服载荷和破坏载荷。

结果

采用重建钢板而非克氏针的结构，其刚度（平均值±标准差：577±245 vs 310±71 N/mm；P = 0.01）、屈服载荷（平均值±标准差：2389±572 vs 1017±292 N；P = 0.0002）和破坏载荷（平均值±标准差：3351±358 vs 1693±363 N；P = 0.009）更大。