Liu J, Lai K A, Chou Y L
Department of Orthopedics, National Cheng Kung University, Tainan, Taiwan, the Republic of China.
Clin Orthop Relat Res. 1995 Jan(310):237-44.
The iliac crest is a frequent insertion site for external fixation pins in treating unstable pelvic or acetabular fractures and in iliofemoral distraction for superiorly dislocated hips. The pin-bone interface is critical for the success of treatment, but studies of the iliac crest are lacking. The purpose of this study was to investigate the strength of the pin-bone interface of different pins and different insertion methods. Four types of commercial pins, Wagner pins, Orthofix cortical and cancellous screws, and AO pins, were driven into sheep iliac crests by 2 methods: the intercortical and the transcortical. Specimens were tested for pullout and bending with an Instron testing machine (Model 1343) at a extension rate of 0.02 mm/sec to failure. The results revealed that the intercortical method had a stronger pullout force than the transcortical in all types of screws (p < 0.05), probably caused by longer insertion in the bone. In the pullout tests, the Wagner pins were the strongest and the Orthofix cancellous screws were the weakest. There were no differences in bending. In the iliac crest, the intercortical method was the better way of driving pins, and the new Orthofix screws were not proven to be stronger than the Wagner pins, nor were the cancellous screws more suitable than the cortical ones.
在治疗不稳定骨盆或髋臼骨折以及对高位脱位髋关节进行髂股牵引时，髂嵴是外固定针常用的插入部位。针 - 骨界面对于治疗成功至关重要，但目前缺乏对髂嵴的相关研究。本研究的目的是探究不同类型的针和不同插入方法下针 - 骨界面的强度。将四种市售针，即瓦格纳针、奥托菲克斯皮质骨和松质骨螺钉以及AO针，通过两种方法插入绵羊髂嵴：皮质内插入法和穿皮质插入法。使用英斯特朗试验机（型号1343）以0.02毫米/秒的拉伸速率对标本进行拔出和弯曲测试，直至失效。结果显示，在所有类型的螺钉中，皮质内插入法的拔出力均强于穿皮质插入法（p < 0.05），这可能是由于在骨内插入深度更长所致。在拔出测试中，瓦格纳针最强，奥托菲克斯松质骨螺钉最弱。弯曲测试结果无差异。在髂嵴部位，皮质内插入法是更好的插针方式，新型奥托菲克斯螺钉并未被证明比瓦格纳针更强，松质骨螺钉也并不比皮质骨螺钉更合适。
