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比较 3 孔 4.5mm 动态加压钢板和 7 孔 5.5mm Y 型锁定加压钢板治疗马近节指关节融合术的体外生物力学研究。

Comparison of a 3-hole 4.5-mm Dynamic Compression Plate and a 7-hole 5.5-mm Y Locking Compression Plate for Arthrodesis of the Proximal Interphalangeal Joint in Horses-an Ex Vivo Biomechanical Study.

机构信息

Department of Surgery, School of Veterinary Medicine and Animal Science, University of São Paulo (USP), São Paulo, SP, Brazil.

Department of Surgery, School of Veterinary Medicine and Animal Science, University of São Paulo (USP), São Paulo, SP, Brazil.

出版信息

J Equine Vet Sci. 2020 Nov;94:103252. doi: 10.1016/j.jevs.2020.103252. Epub 2020 Sep 12.

DOI:10.1016/j.jevs.2020.103252
PMID:33077103
Abstract

The objective of this study was to compare the biomechanical properties in a single cycle axial loading test and the types of failures in two constructs (a 3-hole 4.5-mm dynamic compression plate (DCP) and 7-hole 5.5-mm Y locking compression plate (Y-LCP)) in equine proximal interphalangeal joint (PIJ) arthrodesis. One limb in each pair was randomly assigned to PIJ arthrodesis using a 3-hole 4.5-mm DCP combined with two transarticular 5.5-mm cortical screws, whereas the contralateral limb was submitted to PIJ arthrodesis using a 7-hole Y-shaped 5.0-mm LCP in conjunction with one transarticular 4.5-mm cortical screw inserted through the central plate hole. Cortical screws were inserted in lag fashion. Constructs were submitted to a single axial load cycle to failure. Construct stiffness, load, and deformation were analyzed. Dynamic compression plate and Y-LCP arthrodesis constructs did not differ significantly and were equally resistant to axial loading under the conditions studied (DCP and Y-LCP group stiffness, 5685.22 N/mm and 6591.10 N/mm, respectively). Arthrodesis of the PIJ using a DCP and two transarticular 5.5-mm cortical screws or a Y-LCP yielded biomechanically equivalent outcomes under the test conditions considered. However, Y-LCP provides less impact in the palmar/plantar bone. Application of Y-LCP with unicortical screws has equivalent biomechanical characteristics of DCP and may be a safe option for PIJ arthrodesis, where potential trauma secondary to applying bicortical screws in the palmar/plantar aspect of the pastern can be avoided.

摘要

本研究旨在比较单次循环轴向加载试验中的生物力学性能和两种构建物(3 孔 4.5mm 动力加压接骨板(DCP)和 7 孔 5.5mm Y 型锁定加压接骨板(Y-LCP))在马的近侧趾间关节(PIJ)融合中的失效类型。每对肢体的一条随机分配进行 PIJ 融合,使用 3 孔 4.5mm DCP 结合两个经关节 5.5mm 皮质螺钉,而对侧肢体则使用 7 孔 Y 形 5.0mm LCP 结合一个经关节 4.5mm 皮质螺钉通过中央板孔进行 PIJ 融合。皮质螺钉以滞后方式插入。构建物在单个轴向加载循环下失效。分析了构建物的刚度、载荷和变形。动态加压板和 Y 型加压板融合构建物在研究条件下对轴向加载的抵抗力没有显著差异(DCP 和 Y-LCP 组的刚度分别为 5685.22 N/mm 和 6591.10 N/mm)。在考虑的试验条件下,使用 DCP 和两个经关节 5.5mm 皮质螺钉或 Y-LCP 对 PIJ 进行融合,产生了生物力学等效的结果。然而,Y-LCP 在掌/跖骨上的影响较小。使用单皮质螺钉的 Y-LCP 具有与 DCP 等效的生物力学特性,可能是 PIJ 融合的安全选择,其中可以避免在掌/跖侧应用双皮质螺钉可能造成的潜在创伤。

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