3.5毫米锁定加压钢板（LCP）扭转的体外生物力学测试：靠近骨折间隙处单皮质锁定螺钉与双皮质非锁定螺钉的比较。
In vitro biomechanical testing of the 3.5 mm LCP in torsion: a comparison of unicortical locking to bicortical nonlocking screws placed nearest the fracture gap.
作者信息
Padron Alex A, Owen John R, Wayne Jennifer S, Aktay Sevima A, Barnes Roy F
机构信息
Virginia Veterinary Surgical Associates a BluePearl® Partner, 5918 W. Broad Street, Richmond, VA, 23230, USA.
Departments of Orthopaedic Surgery and Biomedical Engineering, Orthopaedic Research Laboratory, 325 McGuire Annex 1112 E. Clay Street, Virginia Commonwealth University, Richmond, VA, 23298-0694, USA.
出版信息
BMC Res Notes. 2017 Dec 27;10(1):768. doi: 10.1186/s13104-017-3102-y.
OBJECTIVE
This biomechanical study compared the torsional strength and stiffness of a locking compression plate with all locking versus nonlocking screws and examined the effect of placing a locking unicortical or nonlocking bicortical screw nearest the fracture gap in a synthetic bone model.
RESULTS
Synthetic bone models simulating a diaphyseal fracture without anatomic reduction were tested using four screw configurations: all bicortical locking (ABL), all bicortical nonlocking (ABN), a hybrid construct with a bicortical nonlocking screw nearest the fracture gap (BN), and a unicortical locking screw placed nearest the fracture gap (UL). Torsional stiffness, rotation and torque at failure were compared via ANOVA and post hoc pairwise comparisons (p < 0.05). ABN and BN had the highest stiffness (p < 0.01) with ABL greater than UL (p < 0.01). Rotation at failure was greatest for ABL (p < 0.01) with UL greater than ABN (p < 0.05). Unicortical locking screws nearest the fracture gap decreased stiffness, without significantly affecting torque or rotation at failure. Construct stiffness was found to exist in a very narrow range of 0.9-1.2 N m/deg with standard deviations of 0.1 N m/deg in all cases. The results of this study support the use of nonlocking screws in a hybrid construct to increase torsional stiffness.
目的
本生物力学研究比较了全锁定与非锁定螺钉的锁定加压钢板的抗扭强度和刚度，并在合成骨模型中研究了在骨折间隙附近置入锁定单皮质或非锁定双皮质螺钉的效果。
结果
使用四种螺钉配置对模拟未解剖复位骨干骨折的合成骨模型进行测试：全双皮质锁定（ABL）、全双皮质非锁定（ABN）、在骨折间隙附近使用双皮质非锁定螺钉的混合结构（BN）以及在骨折间隙附近置入单皮质锁定螺钉（UL）。通过方差分析和事后成对比较（p < 0.05）比较了失效时的扭转刚度、旋转和扭矩。ABN和BN的刚度最高（p < 0.01），ABL大于UL（p < 0.01）。ABL失效时的旋转最大（p < 0.01），UL大于ABN（p < 0.05）。靠近骨折间隙的单皮质锁定螺钉降低了刚度，但对失效时的扭矩或旋转没有显著影响。发现所有情况下结构刚度都存在于0.9 - 1.2 N·m/deg的非常窄的范围内，标准差为0.1 N·m/deg。本研究结果支持在混合结构中使用非锁定螺钉以增加扭转刚度。
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