Rahm S, Ebneter L, Schultz B, Spross C, Kulling F, Erhardt J B
Acta Orthop Belg. 2016 Sep;82(3):586-592.
The extent of interfragmentary compression in intra-articular fractures treated with various fixation methods have not yet been reported. Lateral split fractures were created in six pairs of cadaver tibiae treated -using buttress plating with lag screws (group C) or locked buttress plating after clamp compression (group L). Interfragmentary compression and fracture displacement were continuously measured using pressure sensors and a stereoscopic 3-D image correlation system. Significantly larger interfragmentary compression was found initially after clamping the fragment (p < 0.05) in group C (median ± SD ; 45.1 ± 5.0 N/mm2) compared with group L (33.6 ± 3.4 N/mm2), and a statistical trend towards larger compression was also found after cyclic loading (p = 0.05) in group C (45.3 ± 8.6 N/mm2) compared with group L (28.7 ± 5.8 N/mm2). These data indicate that conventional plating with lag screws achieves higher interfragmentary compression in this model compared with external clamp compression and locked plating.
采用各种固定方法治疗的关节内骨折的骨折块间压缩程度尚未见报道。在六对尸体胫骨上制造外侧劈裂骨折，分别采用带拉力螺钉的支撑钢板固定（C组）或夹钳加压后锁定支撑钢板固定（L组）。使用压力传感器和立体三维图像相关系统连续测量骨折块间压缩和骨折移位情况。与L组（33.6±3.4N/mm²）相比，C组在夹钳固定骨折块后最初发现骨折块间压缩明显更大（p＜0.05）（中位数±标准差；45.1±5.0N/mm²），并且在循环加载后C组（45.3±8.6N/mm²）与L组（28.7±5.8N/mm²）相比也发现有更大压缩的统计学趋势（p = 0.05）。这些数据表明，在该模型中，与外部夹钳加压和锁定钢板固定相比，传统的拉力螺钉钢板固定可实现更高的骨折块间压缩。
