新型双叶型肱骨近端锁定钢板的研制与生物力学研究

发布时间：2018-09-05 09:33

【摘要】：目的研制新型双叶型肱骨近端锁定钢板以解决复杂肱骨近端骨折大、小结节的固定问题,并通过生物力学实验评估其固定肱骨大、小结节的稳定性。方法取12具新鲜冰冻带肩袖肌的肱骨标本,编号后随机分成A、B两组,建立相同的肱骨大、小结节骨折模型。其中,A组用新型双叶型肱骨近端锁定钢板固定;B组用肱骨近端锁定钢板系统(proximal humeral internal locking system,PHILOS)、缝线缝合固定,小结节同时加用1枚3.5 mm空心螺钉固定。分别对两组标本进行肩胛下肌、冈下肌及小圆肌、冈上肌牵拉实验及大、小结节抗拉实验测试。结果肩胛下肌牵拉实验:A组在180 N拉力以及疲劳实验后位移均明显小于B组(P0.05)。冈下肌及小圆肌牵拉实验:两组在150 N拉力以及疲劳实验后位移比较差异均无统计学意义(P0.05)。冈上肌牵拉实验:两组在90 N拉力以及疲劳实验后位移比较差异均无统计学意义(P0.05)。小结节抗拉实验:A组失效载荷明显大于B组,且A组失效位移明显小于B组(P0.05)。大结节抗拉实验:两组在失效载荷、失效位移比较差异均无统计学意义(P0.05)。结论该新型双叶型肱骨近端锁定钢板对肱骨小结节的固定效果较缝线+空心钉螺钉固定更坚强,具有能同时固定大、小结节的优势。研究结果为临床治疗复杂肱骨近端骨折提供新的选择。
[Abstract]:Objective to develop a new locking plate for proximal humerus to solve the problem of fixation of large and small nodules of complex proximal humerus fractures, and to evaluate the stability of the fixation of large and small nodules of humerus by biomechanical experiments. Methods 12 fresh frozen humerus specimens with rotator cuff muscle were randomly divided into two groups. Group A was fixed with a new type of double leaf locking plate of proximal humerus and group B was fixed with a locking plate system of proximal humerus (proximal humeral internal locking system,PHILOS), suture was fixed, and a small tubercle was fixed with a 3. 5 mm hollow screw at the same time. The tensile tests of subscapular muscle, subscapular muscle and tegular muscle, supraspinatus muscle and large and small tubercle were carried out in the two groups. Results the subscapular muscle stretch test in group 1: a was significantly less than that in group B at 180 N and after fatigue test (P0.05). The pulling test of inferior spinal muscle and tegular muscle: there was no significant difference between the two groups in the 150 N tensile force and the displacement after fatigue test (P0.05). The traction test of supraspinatus muscle: there was no significant difference between the two groups in 90 N tensile force and the displacement after fatigue test (P0.05). The failure load of group A was significantly larger than that of group B, and the failure displacement of group A was significantly lower than that of group B (P0.05). Large nodule tensile test: there was no significant difference in failure load and failure displacement between the two groups (P0.05). Conclusion the fixation effect of the new double leaf proximal locking plate of humerus is stronger than that of suture hollow screw fixation, and it has the advantage of simultaneous fixation of large and small nodules. The results provide a new choice for the treatment of complex proximal humerus fractures.
【作者单位】：暨南大学附属珠海医院珠海市人民医院创伤骨科;上海交通大学附属第六人民医院骨科;
【基金】：上海市自然科学基金项目(12ZR1422300)
【分类号】：R318.01;R687

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