复合腱-骨固定的生物力学及形态学研究

发布时间：2018-05-30 11:52

本文选题：复合固定技术 + 前交叉韧带　；参考：《中国矫形外科杂志》2017年10期

【摘要】：[目的]探讨不同固定方式对前交叉韧带重建中股骨隧道内移植物的影响。[方法]成年猪膝关节64个,以足部肌腱为移植物模拟前交叉韧带重建股骨侧腱-骨固定,固定方式随机分为5组,分别采用7 mm×23 mm界面螺钉固定(A组)、6 mm×23 mm界面螺钉固定(B组)、聚酯缝线4孔微钢板股骨外口固定(C组)、Endobutton固定(D组)和B与C固定组合(E组),进行生物力学测试并观察股骨隧道内口移植腱横截面积及厚度。[结果]持续施加200 N的轴向牵拉力条件下,A、B、E组轴向位移均为0 mm,C组的轴向位移为(5.51±0.53)mm,D组的为(5.49±0.51)mm;C组和E组移植物轴向位移差异有统计学意义(P0.05)。最大损毁强度A组为(350.62±17.81)N,B组为(260.71±18.44)N,C组为(650.50±24.34)N,D组为(565.66±21.63)N,E组为(800.53±30.21)N,组间比较差异有统计学意义(F=291.352,P0.01)。移植物内口横截面形态,A组的横截面呈"新月状",足印处移植物最大宽度为1 mm,横截面积为(10.06±0.18)mm~2;B组呈近似"满月状",足印处宽度为8 mm,面积为(38.16±0.32)mm~2;C组呈"满月状",足印处宽度为8 mm,面积为(40.02±0.21)mm~2;E组呈近似"满月状",足印处厚度为8 mm,面积为(38.86±0.29)mm~2。A、E组间比较差异有统计学意义(F=290.568,P0.01)。此外,A组的挤压程度较重,B组较轻,C组的无挤压,E组同B组。[结论]复合固定技术不仅提供了足够的移植物初始固定强度,还有效避免了"雨刷和蹦极效应",减少了螺钉对肌腱的挤压切割,有利于移植物骨愈合和足印重建。
[Abstract]:[objective] to investigate the effect of different fixation methods on the reconstruction of anterior cruciate ligament (ACL). [methods] Sixty-four knee joints of adult pigs were reconstructed with tendon of foot as a model of anterior cruciate ligament (ACL) for reconstruction of femur tendon-bone fixation, and were randomly divided into 5 groups. 7 mm 脳 23 mm interfacial screws were used to fix 6 mm 脳 23 mm interfacial screws in group B, group C in group C for external fixation of femoral orifice with polyester suture 4 hole plate) and group E in combination B and C for biomechanical test. The transverse area and thickness of tendon grafted through the femoral tunnel were observed. [results] under the condition of 200 N axial traction, the axial displacement of group A and B were all 0 mm ~ (-1). The axial displacement of group D was 5.49 卤0.51 卤0.51 卤0.51 卤0.51 卤0.51 卤0.51 卤0.51 卤0.51 卤0.51 卤0.51 卤0.51 卤0.51 卤0.51 卤0.51 卤0.51 卤0.51 卤0.51 卤0.51 卤0.51 卤0.51 卤0.51 卤0.51 卤0.51 卤0.51 卤0.51 卤0.51 卤0.51 卤0.51 卤0.51 卤0.51 卤0.51 mm respectively. The maximum damage intensity of group A was (350.62 卤17.81) n (n = 260.71 卤18.44) and group C (n = 650.50 卤24.34) was 800.53 卤30.21 (n = 6). The difference between the two groups was statistically significant (P < 0.01). The cross section of group A is "crescent", the maximum width of the graft is 1 mm, the cross-sectional area is approximately "full moon" in group B, the width of foot mark is 8 mm, the area is "full moon" in group A, and the shape of foot is "full moon" in group C. The width of the stamp was 8mm, the area was 40.02 卤0.21mm / 2e, the thickness of the foot mark was 8mm and the area was 38.86 卤0.29mm / 2. There was significant difference between the two groups. In addition, the degree of extrusion in group A was higher than that in group B, and the degree of extrusion in group E was less than that in group C, and that in group E was the same as that in group B. [conclusion] the composite fixation technique not only provides sufficient initial graft fixation strength, but also effectively avoids "wiper and bungee jumping effect", reduces the compression cutting of tendon by screw, and is beneficial to graft healing and footprint reconstruction.
【作者单位】：潍坊医学院附属医院骨关节一科;
【分类号】：R318.01;R687.4

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