Hopf T, Osthege S
Orthopädische Universitätsklinik Homburg/Saar.
Z Orthop Ihre Grenzgeb. 1987 Sep-Oct;125(5):546-52. doi: 10.1055/s-2008-1044753.
Apart from the advantages of plate osteosynthesis, like primary bone healing and immediate post-operative mobilisation treatment, the disadvantages of this method must be mentioned. First of all these are the high pressure on the surface of the bone by the plate and the high tension stress on the bone by the thread of the screws, which can lead to bone atrophy. Besides the splinting by the plate is accompanied by a functional lack of the bone. The bone reacts on this "stress protection" by reduction of material, especially under the plate. These disadvantages shall be avoided by a new osteosynthesis system, called ZESPOL, which has been developed in Poland. Here the plate does not contact directly the bone, but is fixed above the periost by special screw bolts. Although this method is used in Poland clinically with success, until now no experimental examinations concerning the stability of this osteosynthesis have been published. In the following biomechanical tests we examined, whether the new method achieves a comparable interfragmental compression like common selfcompressing plate systems. We measured the maximal interfragmental compression with an interposed piezo-electric element on human cadaver tibiae. Because the original ZESPOL plates have greater dimensions than common plates, we did not use these original plates. In order to get a comparability between the two systems, we modified small Autocompression plates (ACP) by milling a slot in the underside, so that they could be used with the original ZESPOL screw bolts. These modified ZESPOL plates we compared with common 6-hole Autocompression plates and cortical screws.(ABSTRACT TRUNCATED AT 250 WORDS)
除了钢板接骨术的优点,如一期骨愈合和术后立即进行活动治疗外,还必须提及这种方法的缺点。首先,钢板对骨表面产生的高压以及螺钉螺纹对骨产生的高拉应力,可能导致骨萎缩。此外,钢板的固定会伴随骨的功能缺失。骨会对这种“应力保护”作出反应,减少物质,尤其是在钢板下方。一种名为ZESPOL的新型接骨术系统已在波兰研发出来,旨在避免这些缺点。在此系统中,钢板不直接接触骨,而是通过特殊螺栓固定在骨膜上方。尽管这种方法在波兰临床应用取得了成功,但到目前为止,尚未发表关于这种接骨术稳定性的实验研究。在接下来的生物力学测试中,我们研究了这种新方法是否能实现与普通自加压钢板系统相当的骨折块间加压。我们在人体尸体胫骨上使用插入的压电元件测量最大骨折块间压力。由于原始的ZESPOL钢板尺寸比普通钢板大,我们没有使用这些原始钢板。为了使两个系统具有可比性,我们通过在小型自动加压钢板(ACP)底面铣出一个槽来对其进行改造,使其能够与原始的ZESPOL螺栓配合使用。我们将这些改造后的ZESPOL钢板与普通的6孔自动加压钢板及皮质骨螺钉进行了比较。(摘要截选至250词)