Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN, United States of America.
Department of Mechanical and Aerospace Engineering, College of Engineering, University of Florida, Gainesville, FL United States of America.
PLoS One. 2023 Oct 13;18(10):e0286937. doi: 10.1371/journal.pone.0286937. eCollection 2023.
The objective of this study was to determine compressive loads that could be generated using a tibial plateau leveling osteotomy (TPLO) jig with a tensioned strand of 18-gauge stainless steel orthopedic wire in a simulated transverse fracture model. The wire was sequentially tensioned using heavy needle holders or an AO wire tightener. Recorded loads were subsequently compared to loads generated by applying a 3.5 mm limited contact-dynamic compression plate (LC-DCP) as a compression plate. Two segments of 2 cm diameter Delrin rod were placed in a testing apparatus and used to simulate a transverse fracture. A load cell was interposed between the two segments to measure the compressive loads generated during the application of the TPLO jig or the LC-DCP. Compression was generated by sequential tensioning a strand of 18-gauge wire secured through the base of the arms of the TPLO jig or by placing one or two load screws in the LC-DCP. Wires were tensioned using heavy needle holders or an AO wire tightener. Eight replicates of each construct were tested. Recorded loads were compared using a one-way repeated measures ANOVA and Tukey Honestly Significant Difference test. The wire being tensioned broke while attempting a second quarter rotation of the needle holders and when the crank handle of the AO wire tightener was advanced beyond two rotations. The mean + SD peak compressive loads recorded when tensioning the wire using the heavy needle holders and AO wire tightener was 148 ± 7 N and 217 ± 16 N, respectfully. The mean ± SD load recorded after placement of the first and second load screw in the LC-DCP was 131 ± 39 N and 296 ± 49 N, respectively. The compression generated by placing two load screws in the LC-DCP was superior to the compression generated using the jig. The maximum load recorded by tensioning the wire secured through the TPLO jig using the AO wire tightener was superior to the compression generated by placing a single load screw and tensioning the wire using needle holders. Our results demonstrate that the TPLO jig allows surgeons to compress transverse fractures or osteotomies effectively. Tensioning the AO wire tightener allows for sequential tensioning and generates superior compressive loads than tensioning wires with heavy needle holders.
本研究旨在确定使用胫骨平台水平截骨术(TPLO)夹具和 18 号不锈钢骨科线材拉紧线在模拟横向骨折模型中产生的压缩载荷。使用重型针持或 AO 线材紧固器逐步拉紧线材。随后将记录的载荷与施加 3.5 毫米有限接触动力加压接骨板(LC-DCP)作为加压板产生的载荷进行比较。将两段直径为 2 厘米的 Delrin 棒放置在测试装置中,用于模拟横向骨折。在两段之间插入一个负载单元,以测量在应用 TPLO 夹具或 LC-DCP 时产生的压缩载荷。通过逐步拉紧穿过 TPLO 夹具臂底部固定的 18 号线或通过在 LC-DCP 中放置一个或两个负载螺钉来产生压缩。使用重型针持或 AO 线材紧固器拉紧线材。每种结构重复测试 8 次。使用单向重复测量方差分析和 Tukey Honestly Significant Difference 检验比较记录的载荷。在尝试第二次旋转针持器的四分之一旋转和 AO 线材紧固器的曲柄手柄前进超过两圈时,拉紧线材的线断裂。使用重型针持器和 AO 线材紧固器拉紧线材时记录的平均峰值压缩载荷分别为 148±7N 和 217±16N。在 LC-DCP 中放置第一个和第二个负载螺钉后的平均 ±SD 负载分别为 131±39N 和 296±49N。在 LC-DCP 中放置两个负载螺钉产生的压缩优于使用夹具产生的压缩。使用 AO 线材紧固器拉紧通过 TPLO 夹具固定的线材时记录的最大载荷优于放置单个负载螺钉和使用针持器拉紧线材时产生的压缩。我们的结果表明,TPLO 夹具可让外科医生有效地压缩横向骨折或截骨术。使用 AO 线材紧固器拉紧线材可进行顺序拉紧,并产生比使用重型针持器拉紧线材更高的压缩载荷。