Stubbs W P, Lewis D D, Miller G J, Quarterman C, Hosgood G
Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, USA.
Vet Surg. 1998 Sep-Oct;27(5):429-37. doi: 10.1111/j.1532-950x.1998.tb00152.x.
To compare the accuracy of reduction, biomechanical characteristics, and mode of failure of two methods of acetabular osteotomy repair.
Acetabular osteotomies were created in 16 paired hemipelves and stabilized with a screw/wire/polymethylmethacrylate composite fixation technique (SWP) or a 2-mm veterinary acetabular plate (VAP). Eight intact hemipelves were used as controls.
Twelve canine cadavers.
Accuracy of osteotomy reduction was evaluated grossly and by measurement of articular incongruencies formed in polyvinylsiloxane impression casts. Acetabula were loaded in modified bending until failure using a universal testing machine. Data from load-deformation curves were used to determine the biomechanical characteristics of the repaired and intact acetabula. Mode of failure was evaluated grossly and radiographically.
Osteotomy reduction was superior in acetabula stabilized with SWP. Mean values +/- standard deviation for load at failure and stiffness of the intact acetabula were 2,796 +/- 152.9 N and 267.5 +/- 61.9 N/mm. Corresponding values for SWP and VAP were 1,192 +/- 202.7 N and 136.3 +/- 76.5 N/mm, and 1.100.5 +/- 331.6 N and 110.0 +/- 51.3 N/mm, respectively. The mean load at failure and stiffness of intact acetabula was significantly greater than acetabula stabilized with SWP or VAP. There was no significant difference between SWP and VAP for load at failure or stiffness. Failure of acetabula stabilized with SWP occurred by fracture of the polymethylmethacrylate and ventrolateral bending of the wires. Acetabula stabilized with VAP failed by ventrolateral twisting of the plate and bending of the caudal screws.
SWP and VAP provide comparable rigidity, however, the SWP facilitates more accurate osteotomy reduction.
These findings support the use of the SWP technique as an alternative method of acetabular fracture repair.
比较两种髋臼截骨修复方法的复位准确性、生物力学特性及失效模式。
在16对半骨盆上制作髋臼截骨,并采用螺钉/钢丝/聚甲基丙烯酸甲酯复合固定技术(SWP)或2毫米兽用髋臼钢板(VAP)进行固定。8个完整的半骨盆用作对照。
12具犬类尸体。
通过大体观察及测量在聚乙烯硅氧烷印模石膏中形成的关节不匹配情况来评估截骨复位的准确性。使用万能试验机对髋臼进行改良弯曲加载直至失效。利用载荷-变形曲线数据确定修复后及完整髋臼的生物力学特性。通过大体观察和影像学评估失效模式。
采用SWP固定的髋臼截骨复位效果更佳。完整髋臼失效时的平均载荷及刚度的平均值±标准差分别为2796±152.9牛和267.5±61.9牛/毫米。SWP和VAP的相应值分别为1192±202.7牛和136.3±76.5牛/毫米,以及1100.5±331.6牛和110.0±51.3牛/毫米。完整髋臼失效时的平均载荷及刚度显著高于采用SWP或VAP固定的髋臼。SWP和VAP在失效载荷或刚度方面无显著差异。采用SWP固定的髋臼失效是由于聚甲基丙烯酸甲酯骨折及钢丝向腹侧弯曲。采用VAP固定的髋臼失效是由于钢板向腹侧扭转及尾侧螺钉弯曲。
SWP和VAP提供了相当的刚度,然而,SWP有助于更准确的截骨复位。
这些发现支持将SWP技术作为髋臼骨折修复的替代方法。