Liang Cheng, Li Chun-Yan, Qin Xiao-Shuai, Wang Guan, Duan Ke, Lu Xiao-Bo
Department of Orthopedics, The Affiliated Hospital of Southwest Medical University, LuZhou, China; Sichuan Provincial Laboratory of Orthopaedic Engineering, LuZhou, China; The Clinical Medicine Research Center, The Affiliated Hospital of Southwest Medical University, LuZhou, China.
General Pediatrics, LuZhou People's Hospital, LuZhou, China.
Injury. 2023 Apr;54 Suppl 2:S95-S100. doi: 10.1016/j.injury.2022.07.010. Epub 2022 Jul 8.
In the treatment of transverse olecranon fractures, complicated tension band wiring (TBW) has high rates of re-operations. Besides, plate fixation (PF) and TBW both have large surgical incisions and soft-tissue irritation. Therefore, the new cross-locking intramedullary nail (CIN) with easy handling and minimally invasive features is significantly advantageous. The goal of this study was to biomechanically compare CIN with TBW for fixing transverse olecranon fracture.
The transverse olecranon fracture models were created with 15 fresh-frozen cadaveric ulnae which were randomly divided into 3 groups: one group for TBW fixation, another for CIN fixation with 1 conical locking screw (CIN-1), and the last for CIN fixation with 3 conical locking screws (CIN-3). The stiffness, cyclic stability, and failure strength of the fixed fracture models were compared after the corresponding experimental tests.
The failure strength of TBW, CIN-1 and CIN-3 were (313.38±27.68) N, (528.56±53.58) N and (871.04±94.95) N. There was a significant difference between them. However, as for dynamic stability and stiffness, CIN-3 was higher and TBW was lower, with no significant differences between the groups.
The biomechanical properties of CIN were superior to those of TBW, and CIN was more stable and solid for fixing transverse olecranon fracture, of which CIN-3 was the strongest.
在治疗尺骨鹰嘴横行骨折时，复杂张力带钢丝固定术（TBW）的再次手术率较高。此外，钢板固定（PF）和TBW都有较大的手术切口和软组织刺激。因此，具有操作简便和微创特点的新型交锁髓内钉（CIN）具有显著优势。本研究的目的是对CIN和TBW固定尺骨鹰嘴横行骨折进行生物力学比较。
用15具新鲜冷冻尸体尺骨建立尺骨鹰嘴横行骨折模型，随机分为3组：一组采用TBW固定，另一组采用1枚锥形锁定螺钉的CIN固定（CIN-1），最后一组采用3枚锥形锁定螺钉的CIN固定（CIN-3）。在进行相应实验测试后，比较固定骨折模型的刚度、循环稳定性和破坏强度。
TBW、CIN-1和CIN-3的破坏强度分别为（313.38±27.68）N、（528.56±53.58）N和（871.04±94.95）N。它们之间存在显著差异。然而，在动态稳定性和刚度方面，CIN-3较高，TBW较低，各组之间无显著差异。
CIN的生物力学性能优于TBW，在固定尺骨鹰嘴横行骨折时CIN更稳定、牢固，其中CIN-3最强。
