胫骨远端后侧锁定接骨板固定Pilon后柱骨折的力学分析

发布时间：2019-05-11 09:14

【摘要】：背景:Pilon后柱骨折行切开解剖复位内固定治疗已达成共识,但关于内固定方案的选择尚无统一标准。目的:探讨两种内固定方式修复Pilon后柱骨折的生物力学性能,为临床选择合适的内固定提供参考。方法:将20具右侧人工胫骨随机分成2组,根据Pilon后柱骨折特点及临床分型制造出Pilon后柱骨折模型。锁定接骨板组采用5孔胫骨远端后侧锁定接骨板系统固定,螺钉组采用2枚3.5 mm皮质骨螺钉由后向前双皮质固定。分别置于电子动静态万能材料试验系统中,垂直加载至内固定失效,记录出现不同台阶时的轴向加载负荷。结果与结论:(1)加载后2组标本均未发生螺钉弯曲或断裂;(2)出现0.5,1.0,1.5,2.0 mm台阶时,胫骨远端后侧锁定接骨板组的轴向加载负荷均大于螺钉组,随着后柱骨折块位移的增加,2组间的轴向加载力差值也越来越大,且组间比较差异均有显著性意义(P0.05);(3)生物力学检测分析表明,在治疗Pilon后柱骨折中,胫骨远端后侧锁定接骨板的固定效果优于螺钉。
[Abstract]:Background: there is a consensus in the treatment of posterior column fracture with open anatomical reduction and internal fixation, but there is no unified standard for the choice of internal fixation scheme. Objective: to investigate the biomechanical properties of Pilon posterior column fracture repaired by two kinds of internal fixation, and to provide reference for clinical selection of suitable internal fixation. Methods: 20 right artificial tibia were randomly divided into two groups. According to the characteristics and clinical classification of Pilon posterior column fracture, the model of Pilon posterior column fracture was established. The locking plate group was fixed with 5 hole distal tibia posterior locking plate system, and the screw group was fixed with 2 3.5 mm cortical bone screws from back to front. It was placed in the electronic dynamic and static universal material test system, and the axial loading load was recorded when the internal fixation failed and the axial loading load appeared at different steps. Results and conclusion: (1) there was no screw bending or fracture in both groups after loading. (2) when 0.5, 1.0, 1.5, 2.0 mm steps appeared, the axial loading load of the distal tibial locking plate group was larger than that of the screw group. With the increase of the displacement of the posterior column fracture block, the difference of the axial loading force between the two groups became larger and larger. There were significant differences between groups (P0.05). (3) biomechanical analysis showed that the fixation effect of distal tibia posterior locking plate was better than that of screw in the treatment of Pilon posterior column fracture.
【作者单位】：大连医科大学附属第一医院;
【基金】：国家自然科学基金专项基金项目(81350017)~~
【分类号】：R687.3

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