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下颌骨高髁突骨折接骨钛板的力学评估

Mechanical Evaluation of Titanium Plates for Osteoesynthesis High Neck Condylar Fracture of Mandible.

作者信息

Zieliński Rafał, Kozakiewicz Marcin, Konieczny Bartłomiej, Krasowski Michał, Okulski Jakub

机构信息

Department of Maxillofacial Surgery, Medical University of Lodz, 1stGen. J. Hallera Pl., 90-647 Lodz, Poland.

Material Science Laboratory, Medical University of Lodz, 251st Pomorska, 92-213 Lodz, Poland.

出版信息

Materials (Basel). 2020 Jan 27;13(3):592. doi: 10.3390/ma13030592.

Abstract

BACKGROUND

In the literature no information about plates for the high-neck mandibular condylar osteosynthesis could be found despite that 30 plate designs have been published. The main course consider the basal condylar or diacapitular fractures. The aim of the study was to test mechanically all available designs (only 4 of 30 was proper) on polyurethane mandibles using an individually designed clamping system.

METHODS

Forces required for a 1 mm displacement of fixed fracture fragments and incidents of screw loosening were recorded.

RESULTS

It has occured that dedicated plates for fixation are much weaker than set of two straight plates (p<0.0001). General observation is the bigger plate and more screws, the better rigid stable osteosynthesis of mandibular condyle, however, there are limitations in plates design for high-neck fractures resulted in restricted operation field.

CONCLUSION

Double straight plates occured to be the best mechanical fixation for high-neck fractures of the mandibular condyle. Maybe other existing plates could be used but only after prebending or that fracture required novel dedicated plates design.

摘要

背景

尽管已发表了30种钢板设计,但在文献中未找到有关高颈下颌髁突骨固定钢板的信息。主要研究对象为髁突基部或双髁骨折。本研究的目的是使用单独设计的夹紧系统,对聚氨酯下颌骨上所有可用的设计(30种中只有4种合适)进行力学测试。

方法

记录使固定骨折碎片产生1毫米位移所需的力以及螺钉松动的情况。

结果

已发现专用固定钢板比两块直板的组合要弱得多(p<0.0001)。一般观察结果是,钢板越大、螺钉越多,下颌髁突的刚性稳定骨固定效果越好,然而,高颈骨折的钢板设计存在局限性,导致手术视野受限。

结论

双直板是下颌髁突高颈骨折的最佳力学固定方式。也许可以使用其他现有的钢板,但前提是要预先弯曲,或者该骨折需要新颖的专用钢板设计。

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