Liu Xiao, Gao Jianpeng, Wu Xiaoyong, Deng Junhao, Li Zijian, Li Ran, Zhang Licheng, Liu Jianheng, Li Ming
Department of Orthopaedics, The First Medical Center of the Chinese PLA General Hospital, No. 28 Fuxin Road, Beijing 100853, China.
National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, No. 28 Fuxin Road, Beijing 100853, China.
Life (Basel). 2023 Oct 24;13(11):2108. doi: 10.3390/life13112108.
The treatment of complex acetabular fractures remains a complicated clinical challenge. Our self-designed novel anatomical locking guide plate (NALGP) has previously shown promising potential in T-shaped acetabular fractures (TAF), but a direct comparison with conventional fixations is yet to be made. The TAF model was established based on a volunteer's computer tomography data and then fixed with double column locking plates (DLP), a posterior column locking plate with anterior column screws (LPACS), and our NALGP. Forces of 200 N, 400 N, and 600 N were then loaded on the model vertically downward, respectively. The stress distribution and peaks and maximum displacements at three sites were assessed. We found that the stress area of all three plates was mainly concentrated around the fracture line, while only the matching screws of the NALGP showed no obvious stress concentration points. In addition, the NALGP and DLP showed significantly less fracture fragment displacement than the LPACS at the three main fracture sites. The NALGP was found to have less displacement than DLP at the posterior column and ischiopubic branch sites, especially under the higher loading forces of 400 N and 600 N. The fixation stability of the NALGP for TAF was similar to that of DLP but better than that of LPACS. Moreover, the NALGP and its matching screws have a more reasonable stress distribution under different loads of force and the same strength as the LPACS.
复杂髋臼骨折的治疗仍然是一项复杂的临床挑战。我们自行设计的新型解剖锁定导向钢板（NALGP）此前在T形髋臼骨折（TAF）中已显示出有前景的潜力，但尚未与传统固定方法进行直接比较。基于一名志愿者的计算机断层扫描数据建立TAF模型，然后分别用双柱锁定钢板（DLP）、带前柱螺钉的后柱锁定钢板（LPACS）和我们的NALGP进行固定。然后分别在模型上垂直向下施加200 N、400 N和600 N的力。评估三个部位的应力分布、应力峰值和最大位移。我们发现，所有三种钢板的应力区域主要集中在骨折线周围，而只有NALGP的匹配螺钉未显示明显的应力集中点。此外，在三个主要骨折部位，NALGP和DLP的骨折碎片位移明显小于LPACS。发现在后柱和耻骨坐骨支部位，NALGP的位移小于DLP，尤其是在400 N和600 N的较高加载力下。NALGP对TAF的固定稳定性与DLP相似，但优于LPACS。此外，NALGP及其匹配螺钉在不同载荷力下具有更合理的应力分布，且强度与LPACS相同。
