中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (13): 2333-2336.doi: 10.3969/j.issn.1673-8225.2010.13.014

• 脊柱植入物 spinal implant • 上一篇    下一篇

前置与上置重建钢板固定锁骨中段骨折生物力学性能比较

石继祥，曹成福，石文俊，纪  斌，周  强，周军杰，赵  映，刘孚瑛   

  1. 上海中医药大学附属普陀医院，上海市普陀区中心医院骨科，上海市  200062
  • 出版日期:2010-03-26 发布日期:2010-03-26
  • 作者简介:石继祥☆，男，1975年生，湖北省咸宁市人，汉族，2002年上海中医药大学毕业，博士，主治医师，主要从事脊柱及四肢创伤的中西医结合治疗的研究。 shijixiang75@sina.com
  • 基金资助:

    上海市重点建设学科项目(T0303)；上海中医药大学附属普陀医院项目(2007J049B；C-88)。

Biomechanical comparison between anterior and upper reconstruction plate internal fixation for middle clavicular fractures

Shi Ji-xiang, Cao Cheng-fu, Shi Wen-jun, Ji Bin, Zhou Qiang, Zhou Jun-jie, Zhao Ying, Liu Fu-ying   

  1. Department of Orthopaedics, Putuo District Center Hospital, Putuo Hospital Affiliated to Shanghai University of TCM, Shanghai   200062, China
  • Online:2010-03-26 Published:2010-03-26
  • About author:Shi Ji-xiang☆, Doctor, Attending physician, Department of Orthopaedics, Putuo District Center Hospital, Putuo Hospital Affiliated to Shanghai University of TCM, Shanghai 200062, China shijixiang75@sina.com
  • Supported by:

    the Key Discipline Construction Item of Shanghai, No. T0303*; Item of Putuo Hospital, Affiliated to Shanghai University of TCM, No. 2007J049B;C-88*

PDF

432

被引次数

22

摘要：

背景：锁骨中段粉碎性骨折采用切开复位内固定时，其钢板放置方法尚有争议，须经研究证实重建钢板前置与上置的生物力学差异，从而为临床治疗提供有效指导。
目的：比较前置与上置重建钢板固定锁骨中段骨折的生物力学性能。
方法：采集12具成人新鲜锁骨标本(共24根)，致中段锁骨粉碎骨折，分别采用6孔钢板固定并将标本随机分为3组：钢板上置组(n=9)：重建钢板经塑形后，固定于锁骨骨折标本上方，保证骨折线两端均有3枚螺钉；钢板前置组(n=9)：重建钢板经塑形后，固定于锁骨骨折标本上方，保证骨折线两端均有3枚螺钉；正常标本组(n=6)：无任何干预措施。测试各组试件的生物力学特性，并进行比较。
结果与结论：三点弯曲强度、扭转强度和刚度测量表明，钢板上置组和钢板前置组与正常标本组相比，差异无显著性意义(P > 0.05)；而拉伸试验表明，钢板前置组内固定抗拉强度和刚度优于钢板上置组(P < 0.05)；抗拔力亦明显优于钢板上置组(P < 0.05)；同时钢板前置组内固定应力遮挡小，明显优于钢板上置组(P < 0.05)。提示钢板前置是治疗锁骨中段粉碎性骨折的一种可靠治疗方法。

关键词: 锁骨骨折, 中段骨折, 重建钢板, 前置, 上置, 生物力学

Abstract:

BACKGROUND: It is dispute which placement methods are adaptable when repairing clavicle middle segment comminuted fractures using open reduction and internal fixation, therefore, the biomechanical difference between anterior and upper reconstruction plate internal fixation should be verified, which can provide guidance for clinical treatment.
OBJECTIVE: To compare the biomechanical characteristics of upper and anterior reconstruction plate internal fixation for middle clavicular fractures.
METHODS: Totally 12 adult clavicles (24 clavicles) were prepared for middle fractures models, fixed using 6 holes reconstruction plate, and randomly divided into 3 groups: in the upper plate group (n=9) and the anterior plate group (n=9), the reconstruction plates were fixed at the upper or anterior of the clavicle fracture specimen, there were 3 screws at the each end of fracture lines. In the normal specimen group (n=6), there was no treatment. The biomechanical characteristics of each specimen were tested and compared. 
RESULTS AND CONCLUSION: Three-point bending test, torsional strength and stiffness measurement demonstrated that there were no significant difference between the upper plate, anterior plate and normal specimen groups (P < 0.05); the tension test showed that the tensile strength and stiffness of the anterior plate group were larger than that of the upper plate group (P < 0.05), with stronger pull-out resistance (P < 0.05). Simultaneously, the anti-putout power of the anterior plate group was less than the upper plate group (P < 0.05). It revealed that the anterior reconstruction plate internal fixation is an ideal method for treating middle clavicular fracture.

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