Halbauer Christian, Capanni Felix, Paech Andreas, Knop Christian, Merkle Tobias, Da Silva Tomas
Department of Mechatronics and Medical Engineering, 138717 Biomechatronics Research Group, Ulm University of Applied Sciences , Ulm, Germany.
Department for Orthopedic and Trauma Surgery, University Medical Center Schleswig-Holstein, Lübeck, Germany.
Biomed Tech (Berl). 2024 Dec 13;70(2):125-133. doi: 10.1515/bmt-2024-0347. Print 2025 Apr 28.
Helical plating is an established method for treating proximal humeral shaft fractures, mitigating the risk of iatrogenic radial nerve damage. However, biomechanical test data on helical plates under physiological load condition is limited. Hence, the aim of this study was to compare the biomechanical performance of helical and straight PHILOS Long plates in AO12C2 fractures using static and cyclic implant system testing.
Helical and straight PHILOS Long plates on artificial bone substitutes were tested under physiological axial static (n=6) and cyclic loading (n=12). The axial construct stiffness was the main parameter for comparing the biomechanical performance of the two groups. Mimicking a clinical scenario, the helical deformation was performed consecutively by an experienced surgeon using iron bending tools. The torsional angle was determined computationally from 3D-scanning models afterwards.
Helical plating resulted in a significantly reduced axial construct stiffness in all test scenarios compared to conventional straight plating (static testing: p=0.012; cyclic testing: p≤0.010). No failure occurred within the range of physiological loading in both groups.
Helical plating favors multidimensional deformation of the test sample in lateral-ventral direction under axial loading, resulting in a reduced axial construct stiffness and in an increased interfragmentary movement. No biomechanical failure is to be expected within physiological load boundaries.
螺旋钢板是治疗肱骨干近端骨折的一种既定方法，可降低医源性桡神经损伤的风险。然而，关于螺旋钢板在生理负荷条件下的生物力学测试数据有限。因此，本研究的目的是通过静态和循环植入系统测试，比较螺旋型和直型PHILOS长钢板在AO12C2骨折中的生物力学性能。
在人工骨替代物上对螺旋型和直型PHILOS长钢板进行生理轴向静态（n = 6）和循环加载（n = 12）测试。轴向结构刚度是比较两组生物力学性能的主要参数。模拟临床场景，由一名经验丰富的外科医生使用弯铁工具连续进行螺旋变形。随后从3D扫描模型计算得出扭转角度。
与传统直型钢板相比，在所有测试场景中，螺旋钢板导致轴向结构刚度显著降低（静态测试：p = 0.012；循环测试：p≤0.010）。两组在生理负荷范围内均未发生失效。
螺旋钢板有利于测试样本在轴向负荷下向外侧-腹侧方向进行多维变形，导致轴向结构刚度降低和骨折块间运动增加。在生理负荷范围内预计不会出现生物力学失效。
