Curtis M J, Myerson M, Jinnah R H, Cox Q G, Alexander I
Department of Orthopaedic Surgery, St George's Hospital, London, England.
Foot Ankle. 1993 Sep;14(7):395-9. doi: 10.1177/107110079301400705.
This study compares the strength and rigidity of four methods of internal fixation for arthrodesis of the first metatarsophalangeal joint. Ten matched pairs of cadaveric first rays were harvested and arthrodesis performed by one of four techniques: (1) planar excision of joint surfaces and fixation with crossed Kirschner wires, (2) planar excision of joint surfaces and internal fixation with a dorsal plate and screws, (3) planar excision of joint surfaces and internal fixation with an interfragmentary screw, or (4) excision of the joint surfaces using powered conical reamers and fixation with an interfragmentary lag screw. Biomechanical testing with a Bionix 858 materials testing machine was carried out, applying a plantar force utilizing principles of cantilever loading. Force applied and displacement of the arthrodesis were recorded. Of the four methods tested, bony preparation with power conical reamers and supplementary interfragmentary screw fixation was the most stable.
本研究比较了四种用于第一跖趾关节融合术的内固定方法的强度和刚度。采集了十对匹配的尸体第一跖骨，并用以下四种技术之一进行关节融合术：（1）关节面平面切除并用交叉克氏针固定，（2）关节面平面切除并用背侧板和螺钉进行内固定，（3）关节面平面切除并用一枚加压螺钉进行内固定，或（4）使用动力锥形铰刀切除关节面并用一枚加压拉力螺钉固定。使用Bionix 858材料试验机进行生物力学测试，根据悬臂加载原理施加足底力。记录施加的力和关节融合术的位移。在测试的四种方法中，使用动力锥形铰刀进行骨准备并辅以加压拉力螺钉固定是最稳定的。
