胫骨横断骨折钢板固定螺钉与骨折线距离对骨折稳定性的影响  

The influence of the stability in the distance from screws to the fracture line in the fracture of tibia

作　　者：宋景仑[1] 张奉琪[1] 王俊江[1] 

机构地区：[1]冀中能源邢台矿业集团总医院骨科,河北省邢台市054000

出　　处：《疑难病杂志》2012年第2期118-119,共2页Chinese Journal of Difficult and Complicated Cases

基　　金：河北省邢台市科学技术研究与发展指导计划项目(No.2007sp052)

摘　　要：目的探讨胫骨横断骨折钢板固定时螺钉与骨折线距离对骨折稳定性的影响。方法选取骨密度值相近的胫骨干标本20个,于骨干中间部位制作成横断骨折标本,用12孔胫骨干加压钛质接骨板固定于前外侧。将标本随机分成外翻位移试验组(A组)、外旋转角试验组(B组),每组又按试验过程中螺钉与骨折线不同距离分成a、b、c 3个亚组。调制好的牙托粉将标本两端固定后,将A组标本水平位放置于生物力学机上,钢板侧在下方,于骨折处垂直向下载荷,记录胫骨外翻位移。将B组标本竖直固定于生物力学机上,胫骨平台侧向上,给胫骨外旋负荷,记录外旋转角。结果 a、b、c亚组外翻位移分别为(3.41±0.21)mm、(5.07±0.35)mm和(5.46±0.32)mm,外旋转角分别为(1.55±0.22)°、(2.07±0.20)°和(2.65±0.31)°3个亚组间两两比较差异均有统计学意义(P<0.01)。结论胫骨骨折钢板固定时,螺钉越靠近骨折线时稳定性越强,内固定时螺钉应尽量靠近骨折线。Objective To investigate the influence of the stability in the distance from screws to fracture line in the fracture of tibia.Methods Twenty samples of tibia specimen which had similar bone density scanned by DEXA were selected. All skin,muscles and fasciae were stripped.The samples were made into specimens of transverse fracture,followed with 12 hole Titanium tibial compression plate.The specimens were divided into valgus displacement experimental group(A group)and external rotation angle experimental group(B group)randomly.Furthermore,the different groups were divided into subgroups(a,b,c subgroups)according into the distance between screws to fracture line.After the both ends of the specimen were fixed by the modulated dental base acrylic resin powder,the specimen keeping stretch(A group)and lateral (B group) were placed in the both ends of the level support of the biomechanics machine freely.The specimen which plate was underside was imposed vertically by the machine while the eversion displacement was recorded.After the specimen was fixed in the biomechanics machine vertically whose tibia plateau was upside,the tibia was made external rotation and the external rotation angle was recorded.Results The eversion displacements and the external rotation angle in a,b,and c subgroups were(3.41±0.21) mm,(5.07±0.35) mm,(5.46±0.32 )mm respectively and(1.55±0.22)°,(2.07±0.20)°, (2.65±0.31).The stability increased gradually when screws are away from fracture line,which were statistically significant difference(P<0.01).Conclusion It proved that the screws was nearer to fracture line,the stability was stronger,so screws should be as closely as to near the fracture line when tibia internal fixation.

关 键 词：螺钉 骨折线 胫骨 生物力学 

分 类 号：R687.3[医药卫生—骨科学]