三种不同固定方法治疗桡骨远端关节内骨折的离体生物力学研究  

Three fixation options for trealment of intra-articular fractures of the distal radius： an ex vivo biomechanical study

作　　者：胡玉明[1] 谢仁国[1] 邢树国[1] 王古衡[1] 茅天[1] 

机构地区：[1]南通大学附属医院手外科,江苏南通226001

出　　处：《中华手外科杂志》2014年第2期135-137,共3页Chinese Journal of Hand Surgery

基　　金：国家自然科学基金资助项目（81071479）;江苏省卫生厅“科教兴卫工程”重点人才基金资助项目（RC2011101）

摘　　要：目的比较分析克氏针、空心加压螺钉与掌侧锁定加压接骨板治疗桡骨远端关节内骨折的生物力学特性。方法将18例成人上肢防腐标本制作成桡骨远端关节内骨折模型，随机分成3组，分别进行克氏针、空心加压螺钉和掌侧锁定加压接骨板固定。并将3组标本置于生物力学测试机上进行轴向压缩实验，测定每例标本骨折线发生垂直移位、水平移位和完全破坏时的压缩载荷。结果掌侧锁定接骨板组、空心加压螺钉组和克氏针组的垂直移位压缩载荷分别为（808．8±25．0）N、（404．2±26．0）N和（243．1±23．5）N；水平移位压缩载荷分别为（1196．1±114．8）N、（439．5±28．7）N和（323．7±20．4）N；破坏压缩载荷分别为（1333．6±139．3）N、（463．1±31．7）N和（348．2±20．4）N。三组之间的垂直移位、水平移位和破坏压缩载荷的差异均有统计学意义。结论空心加压螺钉治疗桡骨远端关节内骨折的稳定性优于克氏针，次于掌侧锁定加压接骨板。Objective To compare the biomechanical properties of three iixation options, i.e. Kirschner wires, cannulated screws and locking compression plates, for intra-articular fractures of the distal radius. Methods Intra-articular distal radius fracture was created in 18 cadaver radius specimens. The specimens were randomly assigned to K-wire fixation group, cannulated screw fixation group, and volar locking compression plate ftion group. All specimens were placed in the material testing machine for axial loading test. The mechanical loads at vertical displacement, lateral displacement and the failure point in the fracture line were recorded. Results The vertical displacement load in the volar locking compression plate fixation group, cannulated screw fixation group and K-wire fixation group was （ 808.8 ± 25. 0） N, （404.2 ± 26.0） N and （243.1 ± 23.5） N respectively. The lateral displacement load in these three groups was （1196.1 ± 114.8）N, （439.5 ±28.7）N and （323.7± 20.4） N, respectively, while the load at the destroying point was （ 1333.6±139.3） N, （ 463.1± 31.7）N and （348.2 ± 20.4）N. The differences in the axial compression load among the three groups were statistically significant. Conclusion Cannated screw ixation provides more stability than K-wire fixation, but less stabilitv than volar lockin comnression nlatin in the treatment of intra-articular fractures of the distal radius.

关 键 词：生物力学 内固定器 桡骨远端骨折 

分 类 号：R687.3[医药卫生—骨科学]