Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan.
Department of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
BMC Musculoskelet Disord. 2021 May 14;22(1):440. doi: 10.1186/s12891-021-04302-9.
The posterior plating technique could be used as a clinical alternative to parallel plating for treating comminuted distal humerus fractures (DHFs) successfully with good clinical results. However, the biomechanical characteristics for posterior fixation are still unclear. The purpose of this study is to evaluate the biomechanical properties of the posterior fixation and to make comparisons between the parallel and the posterior fixation systems.
We performed a cadaveric biomechanical testing with two posterior plating systems (a posterior two plating and a single posterior pre-contoured Y plating system) and one parallel two plating system to treat AO/OTA type-C2.3 DHFs. Among three groups, we compared construct stiffness, failure strength, and intercondylar width changes after 5000-cycle fatigue loading and failure loads and failure modes after destructive tests in both the axial compression and (sagittal) posterior bending directions. The correlations between construct failure loads and bone marrow density (BMD) were also compared.
In axial direction, there were no significant differences in the stiffness and failure load between the posterior and the parallel constructs. However, in sagittal direction, the two-plate groups (posterior two plating and parallel plating group) had significant higher stiffness and failure loads than the one-plate group (single posterior Y plating). There was no fixation failure after 5000-cyclic loading in both directions for all groups. Positive correlation was noted between BMD and failure loads on parallel fixation.
We found that when using two plates for treating comminuted DHFs, there were no significant differences in terms of most biomechanical measurements between posterior and parallel fixation. However, the single pre-contoured posterior Y plate construct was biomechanically weaker in the sagittal plane than the parallel and the posterior two-plate constructs, although there was no fixation failure after the fatigue test for all groups regardless of the fixation methods.
Biomechanical study.
对于粉碎性肱骨远端骨折（DHF），后钢板技术可作为平行钢板的临床替代方法，可获得良好的临床效果。然而，后固定的生物力学特性仍不清楚。本研究旨在评估后固定的生物力学特性，并对平行固定系统和后固定系统进行比较。
我们对两种后钢板系统（后双钢板和单后预弯 Y 钢板系统）和一种平行双钢板系统进行了尸体生物力学测试，以治疗 AO/OTA 型 C2.3 DHF。在三组中，我们比较了在 5000 次循环疲劳加载后和在轴向压缩和（矢状）后弯方向的破坏性试验后的结构刚度、失效强度和髁间宽度变化，以及在轴向和（矢状）后弯方向的结构失效载荷和骨髓密度（BMD）之间的相关性。
在轴向方向，后钢板和平行钢板的结构刚度和失效载荷无显著差异。然而，在矢状方向，双钢板组（后双钢板和平行钢板组）的刚度和失效载荷明显高于单钢板组（单后 Y 钢板）。在两个方向上，所有组在 5000 次循环加载后均无固定失败。平行固定的 BMD 与失效载荷呈正相关。
我们发现，当使用两块钢板治疗粉碎性 DHF 时，后钢板和平行钢板在大多数生物力学测量方面没有显著差异。然而，单预弯后 Y 钢板在矢状面上的结构强度弱于平行和后双钢板，尽管在疲劳试验后所有组均无固定失败，无论固定方法如何。
生物力学研究。
