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51种接骨板设计中哪种能最稳定地固定下颌髁突基部骨折的骨折块?

Which of 51 Plate Designs Can Most Stably Fixate the Fragments in a Fracture of the Mandibular Condyle Base?

作者信息

Kozakiewicz Marcin, Okulski Jakub, Krasowski Michał, Konieczny Bartłomiej, Zieliński Rafał

机构信息

Department of Maxillofacial Surgery, Medical University of Lodz, 113 Żeromskiego Str., 90-549 Lodz, Poland.

Material Science Laboratory, Medical University of Lodz, 251 Pomorska Str., 92-213 Lodz, Poland.

出版信息

J Clin Med. 2023 Jul 5;12(13):4508. doi: 10.3390/jcm12134508.

Abstract

In the surgical treatment of the most common fracture of the mandible, which is a fracture of the condylar base, a great choice of different plate shapes is observed. The aim of this study was to determine which shape gives the greatest fixation stiffness. To ensure homogeneity in comparison, tests were performed on polyurethane models divided at the level of the condylar base fracture and each were fixed with 51 plates. The plates were cut from a 1 mm thick grade 23 titanium sheet. The models were then loaded and the force required for 1 mm of fracture displacement was recorded. It was noted that in addition to osteosynthesis from two simple plates, there were also two dedicated single plates with similar rigidity. Among the large number of described designs of plates, there is considerable variation in terms of the stability of the fixation performed with them. The proposed Mechanical Excellence Factor allows a pre-evaluation of the expected rigidity of fixation with a given plate shape without the need for a loading experiment. The authors expect this to be helpful for surgeons in the application of relevant plates, as well for inventors of new plates for the osteosynthesis of basal fractures in mandibular condyle.

摘要

在下颌骨最常见的骨折即髁突基部骨折的外科治疗中,可以看到有多种不同形状的钢板可供选择。本研究的目的是确定哪种形状能提供最大的固定刚度。为确保比较的同质性,对在髁突基部骨折水平处切开的聚氨酯模型进行测试,每个模型用51块钢板固定。钢板由1毫米厚的23级钛板切割而成。然后对模型加载,并记录骨折位移1毫米所需的力。值得注意的是,除了用两块简单钢板进行骨接合外,还有两块具有相似刚度的专用单块钢板。在大量已描述的钢板设计中,它们所实现的固定稳定性存在相当大的差异。所提出的机械卓越因子允许在无需加载实验的情况下,对给定钢板形状的预期固定刚度进行预评估。作者期望这对外科医生在应用相关钢板时有所帮助,同时也对用于下颌髁突基部骨折骨接合的新型钢板的发明者有所帮助。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee29/10343011/6657892b46be/jcm-12-04508-g001.jpg

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