不同接骨板组合治疗干骺端粉碎股骨远端骨折的动物实验

发布时间：2018-10-07 18:56

【摘要】：目的初步探讨单钢板和不同组合的双钢板治疗干骺端粉碎股骨远端骨折的疗效,为大样本量实验提供研究方向,为临床治疗提供指导。方法健康实验猪(巴马小型猪)5头,建立双侧股骨远端粉碎性骨折模型[国际内固定研究学会(AO/ASIF)分型为33-C2.3型]。分为5组,对照组1头双侧后肢予单纯外侧解剖锁定钢板固定;锁定重建钢板组和普通重建钢板组共2头,每头猪一侧后肢予外侧解剖锁定钢板+内侧锁定重建钢板固定,对侧后肢予外侧解剖锁定钢板+内侧普通重建钢板固定,左右侧随机;锁定加压钢板组和普通加压组共2头,每头猪一侧后肢予外侧解剖锁定钢板+内侧锁定加压钢板固定,对侧后肢予外侧解剖锁定钢板+内侧普通加压钢板固定,左右侧随机。术后4、8、12周分别行X线摄片观察骨折愈合和内固定松动情况。术后12周处死实验猪,在股骨远端侧位X线片上测量骨痂最大前后径。所有股骨标本去除内固定后行垂直压缩实验,记录最大轴向压缩位移,计算平均轴向刚度。结果术后5头猪均存活,骨折均愈合,未出现感染、内固定失效。在大体标本中,各双钢板组实验猪双侧后肢的骨痂最大前后径的均值均大于单钢板组,且锁定重建钢板组最大(5.02cm),锁定加压钢板组最小(4.16cm)。在垂直压缩实验中,各双钢板组实验猪双侧后肢的最大轴向压缩位移的均值均小于单钢板组,平均轴向刚度的均值均大于单钢板组。在双钢板组中,锁定重建钢板组实验猪双侧后肢的最大轴向压缩位移的均值最小(2.50mm),平均轴向刚度的均值最大(1 200.71N/mm);普通加压钢板组实验猪双侧后肢的最大轴向压缩位移最大(2.91 mm),平均轴向刚度的均值最小(1 032.76N/mm)。结论双钢板固定是治疗干骺端粉碎股骨远端骨折较理想的方法之一,外侧使用解剖锁定钢板、内侧使用锁定重建钢板可能最有利于骨折的愈合。
[Abstract]:Objective to explore the curative effect of single plate and different combination of double plate in the treatment of metaphyseal comminuted distal femur fracture, to provide research direction for large sample size experiment and to provide guidance for clinical treatment. Methods A model of bilateral distal femoral comminuted fracture was established in 5 healthy pigs (Bama miniature pig) [International Institute of Internal Fixation (AO/ASIF) classified as 33-C2.3 type]. The control group was divided into five groups: the control group (n = 1) was fixed with a single lateral anatomic locking plate, the control group (n = 2) with a locked reconstruction plate and a control group (n = 2), each pig side of the hind limb was fixed with a lateral anatomic locking plate (LLP). The contralateral hindlimb was fixed with lateral anatomical locking plate, medial reconstruction plate, left and right side randomly, two of them were in locking compression plate group and common compression group, and each pig was fixed with lateral anatomical locking plate on the medial side of the posterior limb. The contralateral hindlimb was fixed with lateral anatomic locking plate medial compression plate. The fracture healing and internal fixation loosening were observed by X-ray radiography at 4 ~ 8 ~ 12 weeks postoperatively. Experimental pigs were killed 12 weeks after operation and the maximum anteroposterior diameter of callus was measured on lateral X-ray films of distal femur. All femur specimens were subjected to vertical compression experiment after removal of internal fixation. The maximum axial compression displacement was recorded and the average axial stiffness was calculated. Results all 5 pigs survived, fracture healed, no infection occurred and internal fixation failed. In the gross specimens, the mean value of the maximum anteroposterior diameter of callus in each double plate group was higher than that in the single plate group, and the largest (5.02cm) in the locked reconstruction plate group and the smallest (4.16cm) in the locking compression plate group. In the vertical compression experiment, the mean value of maximum axial compression displacement of both hind limbs of pigs in each double plate group was lower than that of single plate group, and the mean axial stiffness of each double plate group was higher than that of single plate group. In the double plate group, The maximum axial compression displacement (2.50mm) and average axial stiffness (1 200.71N/mm) of both hind limbs were the smallest (2.50mm) and the maximum axial compression displacement (2. 91 mm), level) of both hind limbs in the LRP group and the normal compression plate group respectively. The mean value of mean axial stiffness is minimum (1 032.76N/mm). Conclusion double plate fixation is an ideal method for the treatment of metaphyseal comminuted distal femur fracture. The lateral anatomic locking plate and the medial locking reconstruction plate may be the most beneficial to the healing of the fracture.
【作者单位】：上海交通大学医学院附属新华医院骨科;
【分类号】：R687.3

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