Carter D R, Shimaoka E E, Harris W H, Gates E I, Caler W E, McCarthy J C
J Orthop Res. 1984;2(1):80-9. doi: 10.1002/jor.1100020113.
The midplate structural rigidities of metal- and plastic-plated intact canine femora were experimentally determined after initial plate application and 8 weeks after in vivo implantation. Composite beam theory significantly overestimated the bending rigidities of the metal-plated bones. The rigidities of the plastic-plated bones were nearly identical to that of the isolated bone, as composite beam theory predicted. Plating with either plate increased the intracortical porosity and caused the deposition of periosteal new bone, which was greater with plastic than with metal plates. The increased rigidities provided by the attachment of the metal plates and, hence, the degree of bone strain shielding were variable. Platings for 8 weeks which provided little strain shielding with either metal or plastic plates caused an increase in bone flexural rigidity (measured after plate removal) with respect to the contralateral control. Platings that provided increasing amounts of strain shielding caused a decreasing midplate bone rigidity (measured after plate removal) and increasing bone deposition at the outer screws. These findings suggest that the surgical implantation of any plate (metal or plastic) will provide a net stimulus to bone formation and consequently increased bone structural rigidity, even though intracortical porosity is increased. If the plate significantly reduces the normal loads borne by the bone, however, there is a net stimulus to remove bone, resulting in a loss of midplate structural rigidity within 8 weeks of implantation.
在最初应用接骨板以及体内植入8周后,通过实验测定了金属接骨板和塑料接骨板固定的完整犬股骨的中板结构刚度。复合梁理论显著高估了金属接骨板固定骨的弯曲刚度。正如复合梁理论所预测的,塑料接骨板固定骨的刚度与孤立骨的刚度几乎相同。两种接骨板固定均增加了皮质内孔隙率,并导致骨膜新骨沉积,塑料接骨板引起的沉积比金属接骨板更多。金属接骨板固定所提供的刚度增加以及因此产生的骨应变屏蔽程度是可变的。使用金属或塑料接骨板进行8周固定,若提供的应变屏蔽较少,则相对于对侧对照,会导致骨弯曲刚度增加(在移除接骨板后测量)。提供的应变屏蔽量增加的固定方式会导致中板骨刚度降低(在移除接骨板后测量),并使外螺钉处的骨沉积增加。这些发现表明,任何接骨板(金属或塑料)的手术植入都会对骨形成产生净刺激,从而增加骨结构刚度,即使皮质内孔隙率增加。然而,如果接骨板显著降低了骨所承受的正常负荷,则会有净刺激导致骨吸收,从而在植入后8周内导致中板结构刚度丧失。