Tanaka K
Nihon Seikeigeka Gakkai Zasshi. 1979 Nov;53(11):1561-78.
In the operative treatment of a long bone fracture, the most important point is to secure the bone healing and to strengthen the bone after removal of internal fixation materials. In this regards, the author has analyzed the mechanical strength of various internal fixation methods (a plate, a medullary nail, screws and encircling wires) on the bone by using acrylics models. Experimental studies of their influences on the bone have also been performed especially investigating the decrease in the bone strength in rabbits. All of internal fixation materials are made of 316L stainless steel. Recently, there has been a tendency to use larger materials for internal fixations such as an AO compression plate or a Küntscher type medullary nail. However, it was found that the rigid plate fixation greatly affects the bone strength. A medullary nail produced less impairment to the bone. But this method is restricted in its application because of the weak fixability of the torsional load. On the other hand, the internal fixations with screws or encircling wires are weaker than the other methods especially against the bending load. Therefore the commencement of postoperative treatment will be delayed. But, these two methods have little influence on the bone during fixation.
在长骨骨折的手术治疗中，最重要的一点是确保骨折愈合，并在取出内固定材料后增强骨骼强度。在这方面，作者通过使用丙烯酸模型分析了各种内固定方法（钢板、髓内钉、螺钉和环形钢丝）对骨骼的机械强度。还对它们对骨骼的影响进行了实验研究，特别是研究了兔子骨骼强度的降低情况。所有内固定材料均由316L不锈钢制成。最近，有一种使用更大尺寸材料进行内固定的趋势，如AO加压钢板或Küntscher型髓内钉。然而，发现刚性钢板固定对骨骼强度有很大影响。髓内钉对骨骼的损伤较小。但由于其对扭转载荷的固定能力较弱，这种方法的应用受到限制。另一方面，螺钉或环形钢丝内固定比其他方法更弱，尤其是抵抗弯曲载荷。因此，术后治疗的开始将被推迟。但是，这两种方法在固定过程中对骨骼的影响很小。
