关节缝合纽扣、可吸收螺钉和金属螺钉修复踝关节联合修复的生物力学比较：荟萃分析。
Biomechanical comparison of suture-button, bioabsorbable screw, and metal screw for ankle syndesmotic repair: A meta-analysis.
机构信息
Department of Orthopaedic Surgery, University of Toledo Medical Center, Toledo, OH 43614, USA.
Department of Orthopaedic Surgery, University of Toledo Medical Center, Toledo, OH 43614, USA.
出版信息
Foot Ankle Surg. 2021 Feb;27(2):117-122. doi: 10.1016/j.fas.2020.03.008. Epub 2020 Apr 27.
BACKGROUND
To compare biomechanically metal screw fixation to suture-button or bioabsorbable screw fixation for ankle syndesmotic injuries.
METHODS
A literature search of the comparison studies in Pubmed and Google Scholar was conducted. The biomechanical outcomes of interest were syndesmotic stability in the coronal, sagittal, and axial planes as well as torque and rotation at failure.
RESULTS
A total of 11 cadaveric studies were included. In the suture-button group, coronal displacement (MD 1.72mm, p = 0.02) and sagittal displacement (MD 2.65mm, p = 0.0003) were increased relative to the metal screw group. In contrast, no difference was found with axial rotation (MD 0.35 degrees, p = 0.57). Bioabsorbable screws exhibited equivalent failure torque (MD -3.04Nm, p = 0.53) and rotation at failure (MD 3.77 degrees, p = 0.48) in comparison to metal screws.
CONCLUSIONS
Suture-button provide less rigidity when compared to metal screw fixation. They afford flexible syndesmotic micromotion which may more closely resemble a physiological state and be helpful for ligament healing. Bioabsorbable screws demonstrate similar mechanical strength properties to metal screws.
背景
比较金属螺钉固定与缝线纽扣或可吸收螺钉固定治疗踝关节联合损伤的生物力学效果。
方法
在 Pubmed 和 Google Scholar 中对比较研究进行文献检索。关注的生物力学结果包括冠状面、矢状面和轴面的联合稳定性，以及失效时的扭矩和旋转。
结果
共纳入 11 项尸体研究。与金属螺钉组相比，缝线纽扣组的冠状面位移（MD 1.72mm，p = 0.02）和矢状面位移（MD 2.65mm，p = 0.0003）增加。而轴向旋转无差异（MD 0.35 度，p = 0.57）。与金属螺钉相比，可吸收螺钉在失效扭矩（MD -3.04Nm，p = 0.53）和失效时的旋转（MD 3.77 度，p = 0.48）方面表现出相当的机械强度。
结论
与金属螺钉固定相比，缝线纽扣固定的刚度较低。它们提供了灵活的联合微动，更接近生理状态，有助于韧带愈合。可吸收螺钉的机械强度特性与金属螺钉相似。
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