Kim Sung-Jae, Jo Young-Hoon, Choi Wan-Sun, Lee Chang-Hun, Lee Bong-Gun, Kim Joo-Hak, Lee Kwang-Hyun
Department of Orthopaedic Surgery, Dongtan Sacred Hospital, Hallym University College of Medicine, Hwasung, Korea.
Department of Orthopaedic Surgery, Hanyang University College of Medicine, Seoul, Korea.
J Hand Surg Am. 2017 Sep;42(9):747.e1-747.e6. doi: 10.1016/j.jhsa.2017.05.009. Epub 2017 Jun 23.
This study evaluated the biomechanical properties of a new volar locking plate made by 3-dimensional printing using titanium alloy powder and 2 conventional volar locking plates under static and dynamic loading conditions that were designed to replicate those seen during fracture healing and early postoperative rehabilitation.
For all plate designs, 12 fourth-generation synthetic composite radii were fitted with volar locking plates according to the manufacturers' technique after segmental osteotomy. Each specimen was first preloaded 10 N and then was loaded to 100 N, 200 N, and 300 N in phases at a rate of 2 N/s. Each construct was then dynamically loaded for 2,000 cycles of fatigue loading in each phase for a total 10,000 cycles. Finally, the constructs were loaded to a failure at a rate of 5 mm/min.
All 3 plates showed increasing stiffness at higher loads. The 3-dimensional printed volar locking plate showed significantly higher stiffness at all dynamic loading tests compared with the 2 conventional volar locking plates. The 3-dimensional printed volar locking plate had the highest yield strength, which was significantly higher than those of 2 conventional volar locking plates.
A 3-dimensional printed volar locking plate has similar stiffness to conventional plates in an experimental model of a severely comminuted distal radius fracture in which the anterior and posterior metaphyseal cortex are involved.
These results support the potential clinical utility of 3-dimensional printed volar locking plates in which design can be modified according the fracture configuration and the anatomy of the radius.
本研究评估了一种使用钛合金粉末通过三维打印制成的新型掌侧锁定钢板以及两种传统掌侧锁定钢板在静态和动态加载条件下的生物力学性能，这些加载条件旨在模拟骨折愈合和术后早期康复过程中所见到的情况。
对于所有钢板设计，在进行节段性截骨后，按照制造商的技术为12个第四代合成复合桡骨安装掌侧锁定钢板。每个标本首先预加载10 N，然后以2 N/s的速率分阶段加载至100 N、200 N和300 N。然后，每个结构在每个阶段进行2000次疲劳加载循环，总共进行10000次循环。最后，以5 mm/min的速率对结构加载直至破坏。
所有三种钢板在较高载荷下均表现出刚度增加。与两种传统掌侧锁定钢板相比，三维打印掌侧锁定钢板在所有动态加载测试中均表现出明显更高的刚度。三维打印掌侧锁定钢板具有最高的屈服强度，显著高于两种传统掌侧锁定钢板。
在涉及前后干骺端皮质的严重粉碎性桡骨远端骨折的实验模型中，三维打印掌侧锁定钢板具有与传统钢板相似的刚度。
这些结果支持三维打印掌侧锁定钢板的潜在临床应用，其设计可根据骨折形态和桡骨解剖结构进行修改。
