Bouvy B M, Markel M D, Chelikani S, Egger E L, Piermattei D L, Vanderby R
Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison 53706.
Vet Surg. 1993 May-Jun;22(3):194-207. doi: 10.1111/j.1532-950x.1993.tb00382.x.
The purpose of this study was to determine the respective contribution of each of the following parameters to the compressive, bending, and torsional rigidity of the Kirschner-Ehmer (KE) external fixation splint as applied to canine tibiae with an osteotomy gap: bilateral versus unilateral splints; increasing the number of fixation pins; altering the diameter of fixation pins and side bars; decreasing side bar distances from the bone; increasing pin separation distances in each pin group; decreasing distances between pin groups; altering pin clamp orientation; and altering side bar conformation. Bilateral splints were 100% (mean) stiffer than unilateral splints, with stiffness enhanced to the greatest extent in mediolateral bending and torsion. Increasing pin numbers stiffened both bilateral (mean, 41%; 8 versus 4) and unilateral splints (mean, 14%; 8 versus 4). Medium KE splints were 85% (mean) stiffer than small KE splints. Decreasing side bar distances to the bone from 1.5 cm to 1.0 cm to 0.5 cm increased stiffness of both bilateral and unilateral splints by a mean of 13% to 35%. Widening pin spacing from 1.67 cm to 2.5 cm increased stiffness in craniocaudal bending only (56% increase, bilateral splints; 73% increase, unilateral splints). Decreasing the distance between pin groups from 5.84 cm to 2.5 cm increased stiffness in torsion between 23% (unilateral splints) and 45% (bilateral splints) and decreased stiffness of unilateral splints by 29% in craniocaudal bending. Altering pin clamp configuration so that the bolts of the clamp were inside the side bar rather than outside the side bar increased stiffness in axial compression only (73% increase, bilateral splints; 54% increase, unilateral splints). Conforming the lateral side bar to the tibiae increased only axial compressive stiffness by 77% but was no different than placing the clamps inside the side bars of an unconformed bilateral splint. These results quantify the relative importance of specific parameters affecting KE splint rigidity as applied to unstable fractures in the dog.
本研究的目的是确定以下各参数对应用于有截骨间隙的犬胫骨的克氏-埃默尔（KE）外固定夹板的压缩、弯曲和扭转刚度的各自贡献：双侧夹板与单侧夹板；增加固定针数量；改变固定针和侧杆的直径；减小侧杆与骨的距离；增加每组固定针的针间距；减小组间针距；改变针夹方向；以及改变侧杆形态。双侧夹板比单侧夹板平均硬100%，在外侧弯曲和扭转时刚度增加幅度最大。增加针的数量使双侧夹板（平均增加41%；8根针与4根针相比）和单侧夹板（平均增加14%；8根针与4根针相比）都变硬。中型KE夹板比小型KE夹板平均硬85%。将侧杆与骨的距离从1.5厘米减小到1.0厘米再减小到0.5厘米，使双侧和单侧夹板的刚度平均增加13%至35%。将针间距从1.67厘米扩大到2.5厘米仅增加了前后弯曲的刚度（双侧夹板增加56%；单侧夹板增加73%）。将组间针距从5.84厘米减小到2.5厘米，使扭转刚度增加23%（单侧夹板）至45%（双侧夹板），并使单侧夹板在前后弯曲时的刚度降低29%。改变针夹配置，使夹的螺栓位于侧杆内部而非侧杆外部，仅增加了轴向压缩的刚度（双侧夹板增加73%；单侧夹板增加54%）。使外侧侧杆贴合胫骨仅使轴向压缩刚度增加77%，但与将夹置于未贴合的双侧夹板的侧杆内部没有差异。这些结果量化了影响应用于犬不稳定骨折的KE夹板刚度的特定参数的相对重要性。
