桡骨远端骨折掌、背侧钢板固定的生物力学研究  

The Biomechanical Study of Plate Fixationin the Treatment of Distal Radius Fracture through the Volar or Dorsal Approach

作　　者：张亮[1] 邹宁[1] 周健伟 梁钟鸣 胡玉平 王兴元 刘磊[1] Zhang Liang;Zou Ning;Zhou Jianwei(Department of Baoshan Branch,Huashan North Hospital,Fudan University,Shanghai Renhe Hospital,Baoshan District,Shanghai 201907,China;Department of Orthopaedics,Huashan Hospital,Fudan University,Shanghai 200040,China)

机构地区：[1]上海市宝山区仁和医院复旦大学附属华山北院宝山分院骨科,上海201907 [2]复旦大学附属华山医院骨科,上海200040

出　　处：《实用骨科杂志》2019年第2期131-134,共4页Journal of Practical Orthopaedics

摘　　要：目的运用生物力学实验应力分析方法评价桡骨远端背侧移位型骨折,掌侧钢板和背侧钢板固定的生物力学性能比较,从而为桡骨远端骨折的治疗提供临床基础理论依据。方法选用10具桡骨远端标本,制作成背侧移位不稳定型桡骨远端骨折,并分为每对2块,随机采用掌侧钢板和背侧钢板固定,将固定好的标本进行生物力学试验。结果 a)桡骨远端背侧移位型骨折,掌侧钢板固定与背侧钢板固定的应力强度、轴向刚度和剪切刚度差异无统计学意义(P>0.05);b)采用两种不同钢板固定,其扭转力学性能,扭矩和扭转刚度差异无统计学意义(P>0.05);c)将固定好的两种标本进行轴向破坏力学测试,极限强度及骨吸收能量差异无统计学意义(P>0.05);d)实验结果与组合杆应力理论分析相比较仅相差6%,佐证了实验应力分析的正确性。结论桡骨远端背侧移位型骨折,掌侧钢板和背侧钢板固定的生物力学性能两者相当,背侧钢板固定略占优势,但差异无统计学意义。从临床手术角度考虑一般采用掌侧钢板固定,简单、方便、实用、疗效较好,是行之有效的术式。Objective To compare the biomechanical properties of distal radius fracture by volar or dorsal plate fixation.And provide theoretical basis for the strategy of treatment for the distal radius fracture. Methods The unstable type of fracture were established in 10 distal radius specimens.The specimens were randomly assigned to volar or dorsal plate fixation groups (n=5 in each group).Biomechanical testings were conducted in these specimens after plate fixation.Results a) In the dorsal displacement type of distal radius fracture,there was no significant difference between volar and dorsal plate fixation groups in stress intensity,axial rigidity or shearing rigidity (P >0.05).b) No significant difference was found in the torque or torsional rigidity between the volar and dorsal plate fixation groups (P >0.05).c) In the axial stress testings,no significant difference was found in the ultimate strength of absorbed energy by bone between the two groups (P >0.05).d) The present results were only 6% different from the theoretical analysis of combined rod stress,which proved the validity of the present experimental stress results. Conclusion In the dorsal displacement type of distal radius fracture,the biomechanical properties were similar between the volar and dorsal plate fixation groups.Although dorsal plate fixation resulted in better outcomes,there were no significant differences between the two groups.In clinical practice,however,it is easier,more convenient,more practical and more effective to use the volar plate fixation.

关 键 词：桡骨远端骨折 掌侧钢板固定 背侧钢板固定 生物力学 

分 类 号：R318.01[医药卫生—生物医学工程]