MacLeod Alisdair R, Pankaj Pankaj
School of Engineering, The University of Edinburgh, UK.
School of Engineering, The University of Edinburgh, UK.
Injury. 2018 Jun;49 Suppl 1:S12-S18. doi: 10.1016/S0020-1383(18)30296-1.
Most locked plating failures are due to inappropriate device configuration for the fracture pattern. Several studies cite screw positioning variables such as the number and spacing of screws as responsible for occurrences of locking plate breakage, screw loosening, and peri-prosthetic re-fracture. It is also widely accepted that inappropriate device stiffness can inhibit or delay healing. Careful preoperative planning is therefore critical if these failures are to be prevented. This study examines several variables which need to be considered when optimising a locking plate fixation device for fracture treatment including: material selection; screw placement; the effect of the fracture pattern; and the bone-plate offset. We demonstrate that device selection is not straight-forward as many of the variables influence one-another and an identically configured device can perform very differently depending upon the fracture pattern. Finally, we summarise the influence of some of the key parameters and the influence this can have on the fracture healing environment and the stresses within the plate in a flowchart.
大多数锁定钢板失效是由于针对骨折类型的器械配置不当。多项研究指出，诸如螺钉数量和间距等螺钉定位变量是导致锁定钢板断裂、螺钉松动和假体周围再骨折的原因。同样被广泛认可的是，器械刚度不当会抑制或延迟愈合。因此，如果要预防这些失效情况，仔细的术前规划至关重要。本研究考察了在优化用于骨折治疗的锁定钢板固定器械时需要考虑的几个变量，包括：材料选择；螺钉放置；骨折类型的影响；以及骨板偏移。我们证明，器械选择并非简单直接，因为许多变量相互影响，并且相同配置的器械根据骨折类型的不同其性能可能差异很大。最后，我们在流程图中总结了一些关键参数的影响以及这对骨折愈合环境和钢板内应力的影响。
