Second Department of Orthopedics, Fifth Affiliated Hospital of Zunyi Medical University, No. 1439, Zhufeng Avenue, Doumen District, Zhuhai, 519100, China.
Zunyi Medical University Zhuhai Campus, No. 368, Jinwan Road, Jinwan District, Zhuhai, 519041, China.
BMC Musculoskelet Disord. 2023 Jan 18;24(1):39. doi: 10.1186/s12891-023-06150-1.
A locking compression plate (LCP) of the distal femur is used as an external fixator for lower tibial fractures. However, in clinical practice, the technique lacks a standardized approach and a strong biomechanical basis for its stability.
In this paper, internal tibial LCP fixator (Group IT-44), external tibial LCP fixator (Group ET-44), external distal femoral LCP fixator (Group EF-44, group EF-33, group EF-22), and conventional external fixator (Group CEF-22) frames were used to fix unstable fracture models of the lower tibial segment, and anatomical studies were performed to standardize the operation as well as to assess the biomechanical stability and adjustability of the distal femoral LCP external fixator by biomechanical experiments.
It was found that the torsional and flexural stiffnesses of group EF-44 and group EF-33 were higher than those of group IT-44 and group ET-44 (p < 0.05); the flexural stiffness of group EF-22 was similar to that of group IT-44 (p > 0.05); and the compressive stiffness of all three EF groups was higher than that of group ET-44 (p < 0.05). In addition, the flexural and compressive stiffnesses of the three EF groups decreased with the decrease in the number of screws (p < 0.05), while the torsional stiffness of the three groups did not differ significantly between the two adjacent groups (p > 0.05). Group CEF-22 showed the highest stiffnesses, while group ET-44 had the lowest stiffnesses (P < 0.05).
The study shows that the distal femoral LCP has good biomechanical stability and adjustability and is superior to the tibial LCP as an external fixator for distal tibial fractures, as long as the technique is used in a standardized manner according to the anatomical studies in this article.
股骨远端锁定加压钢板（LCP）可用作胫骨下段骨折的外固定器。然而，在临床实践中，该技术缺乏标准化方法和稳定的强大生物力学基础。
本文使用胫骨内置 LCP 固定器（组 IT-44）、胫骨外置 LCP 固定器（组 ET-44）、股骨外置 LCP 固定器（组 EF-44、组 EF-33、组 EF-22）和常规外固定器（组 CEF-22）固定胫骨下段不稳定性骨折模型，进行解剖学研究以规范操作，并通过生物力学实验评估股骨远端 LCP 外固定器的生物力学稳定性和可调节性。
发现组 EF-44 和组 EF-33 的扭转和弯曲刚度均高于组 IT-44 和组 ET-44（p<0.05）；组 EF-22 的弯曲刚度与组 IT-44 相似（p>0.05）；而所有三组 EF 组的抗压刚度均高于组 ET-44（p<0.05）。此外，随着螺钉数量的减少，三组 EF 的弯曲和压缩刚度均降低（p<0.05），而三组的扭转刚度在两组相邻组之间无显著差异（p>0.05）。组 CEF-22 表现出最高的刚度，而组 ET-44 的刚度最低（P<0.05）。
本研究表明，股骨远端 LCP 具有良好的生物力学稳定性和可调节性，只要根据本文的解剖学研究采用标准化技术，作为胫骨下段骨折的外固定器，其性能优于胫骨 LCP。
