White A A, Panjabi M M, Southwick W O
J Bone Joint Surg Am. 1977 Mar;59(2):188-92.
Based on analysis of the torque-angle curves and roentgenographic findings in fifty-three healing tibial fractures in rabbits tested in torsion to failure, four biomechanical stages of fracture healing were defined, as follows: Stage I--failure through original fracture site, with low stiffness; Stage II--failure through original fracture site, with high stiffness; Stage III--failure partially through original fracture site and partially through intact bone, with high stiffness; and Stage IV--failure entirely through intact bone, with high stiffness. These stages correlated with the progressive increases in the average torque and energy absorption to failure as healing progressed and also with the average times since the original experimental fracture. It is hoped that this system of staging will provide both a standard by which important variables related to ultimate strength of healing fractures can be correlated and an objective way to predict delayed unions and non-unions and to determine the level of activity that is safe for patients with a healing fracture.
基于对53只经扭转至骨折失败测试的兔愈合胫骨骨折的扭矩-角度曲线和X线检查结果的分析，定义了骨折愈合的四个生物力学阶段，如下：第一阶段——通过原始骨折部位发生骨折失败，刚度低；第二阶段——通过原始骨折部位发生骨折失败，刚度高；第三阶段——部分通过原始骨折部位且部分通过完整骨发生骨折失败，刚度高；第四阶段——完全通过完整骨发生骨折失败，刚度高。这些阶段与随着愈合进展平均扭矩和吸收至骨折失败的能量的逐渐增加相关，也与自原始实验性骨折后的平均时间相关。希望这个分期系统既能提供一个标准，通过该标准可以关联与愈合骨折最终强度相关的重要变量，又能提供一种客观方法来预测延迟愈合和不愈合，并确定对愈合骨折患者安全的活动水平。
