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[经关节骰骨钢板的设计与生物力学研究]

[DESIGN AND BIOMECHANICAL STUDY OF TRANSARTICULAR CUBOID BONE PLATE].

作者信息

Chen Dan, Chen Zhiwei, Yang Haiqing, Wu Wente

机构信息

Department of Orthopedics, First Affiliated Hospital, University of South China, Hengyang Hunan, 421001, P. R. China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2016 Oct 8;30(10):1215-1219. doi: 10.7507/1002-1892.20160249.

Abstract

OBJECTIVE

To design a new type of transarticular cuboid bone plate by measuring and collecting the anatomic data of the articular surface around cuboid, and to carry out comparative biomechanical study.

METHODS

The angle α (between the fifth metatarsocuboid joint and the fifth metatarsal bone) and the angle β (between the fifth metatarsocuboid joint and the calcaneocuboid joint) were measured in 100 adults on medial oblique X-ray film and 30 adult foot specimens. Based on literature data, the transarticular cuboid bone plate was designed with an angle α of 70° and an angle β of 30°. Six adult cadaver feet were chosen and were transected approximately 15 cm proximal to the ankle. Five strain gauges were placed at the calcaneus, cuboid, and the fourth and fifth metatarsal bones. The vertical pressure was loaded on the foot at 0-600 N, the strain value was measured. Then the cuboid fracture model was established and 600 N load was given on foot to measure the strain value and compare with the strain value before fracture. The specimens were randomly divided into groups A and B (=3). Fracture was fixed with transarticular cuboid bone plate and 9 screws in group A and with double plate and 8 screws in group B, then the 600 N load was given to measure the strain value and vertical displacement of the fracture fragments.

RESULTS

After loads of 0-600 N on the foot, the strain value of the 5 points showed an increased trend. No significant difference was found in the strain value between pre- and post-fracture at a, d, and e points >0.05), but it was significantly larger at post-fracture than pre-fracture at b and c points (<0.05). After fracture fixation, no significant difference was shown in the strain value at 5 points between groups A and B when loads of 0-600 N was given >0.05). The experimental data showed that the strain value change mainly focused on the fracture site under the same load, so the strain value after fracture fixation was similar to that before fracture at b and c points >0.05). The vertical displacement values of medial and lateral fracture fragments in group A[(0.804±0.011) mm and (0.672±0.036) mm] were significantly less than those in group B[(1.126±0.083) mm and (1.007±1.103) mm] (=-6.711, =0.003; =-5.307, =0.006).

CONCLUSIONS

Through biomechanical study, a new type of transarticular cuboid bone plate has better fixation effect.

摘要

目的

通过测量和收集骰骨周围关节面的解剖数据,设计一种新型的经关节骰骨钢板,并进行比较性生物力学研究。

方法

在100例成人的内侧斜位X线片及30例成人足部标本上测量第五跖骰关节与第五跖骨之间的夹角α以及第五跖骰关节与跟骰关节之间的夹角β。根据文献资料,设计角度α为70°、角度β为30°的经关节骰骨钢板。选取6例成年尸体足,在距踝关节近端约15 cm处截断。在跟骨、骰骨以及第四、五跖骨处放置5个应变片。在足部施加0 - 600 N的垂直压力,测量应变值。然后建立骰骨骨折模型,在足部施加600 N负荷,测量应变值并与骨折前的应变值进行比较。将标本随机分为A组和B组(每组n = 3)。A组采用经关节骰骨钢板及9枚螺钉固定骨折,B组采用双钢板及8枚螺钉固定骨折,然后施加600 N负荷,测量骨折块的应变值和垂直位移。

结果

足部施加0 - 600 N负荷后,5个点的应变值呈上升趋势。a、d、e点骨折前后应变值差异无统计学意义(P>0.05),但b、c点骨折后应变值显著大于骨折前(P<0.05)。骨折固定后,A、B两组在施加0 - 600 N负荷时5个点的应变值差异无统计学意义(P>0.05)。实验数据表明,在相同负荷下应变值变化主要集中在骨折部位,因此b、c点骨折固定后的应变值与骨折前相似(P>0.05)。A组内侧和外侧骨折块的垂直位移值[(0.804±0.011)mm和(0.672±0.036)mm]显著小于B组[(1.126±0.083)mm和(1.007±1.103)mm](t=-6.711,P = 0.003;t=-5.307,P = 0.006)。

结论

通过生物力学研究,新型经关节骰骨钢板具有更好的固定效果。

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