微型钩钢板固定指骨掌板撕脱性骨折的生物力学研究  

Biomechanical Study on Fixation of Avulsion Fracture of Phalangeal Metacarpal Plate With Micro Hook Plate

作　　者：尚晓强 段祥林 王钧 杨平 周祥昆 孙伟 陶圣祥[2] 郑洲[3] Shang Xiaoqiang;Duan Xianglin;Wang Jun;Yang Ping;Zhou Xiangkun;Sun Wei;Tao Shengxiang;Zheng Zhou(Department of Orthopaedics,Wuhan Red Cross Hospital ,Wuhan 430015,China;Department of Orthopaedics,Central South Hospital of Wuhan University,Wuhan 430071,China;Department of Anatomy,Hubei University of Traditional Chinese medicine,Wuhan 430070,China)

机构地区：[1]武汉红十字会医院骨科,湖北武汉430015 [2]武汉大学中南医院骨科,湖北武汉430071 [3]湖北中医药大学解剖教研室,湖北武汉430070

出　　处：《实用骨科杂志》2022年第7期616-618,632,共4页Journal of Practical Orthopaedics

基　　金：武汉市卫生与计划生育委员会2020年医学科研项目面上项目(WZ20B29)。

摘　　要：目的探讨微型钩钢板在固定指骨掌板撕脱性骨折中的力学稳定性。方法将6对手标本的中节指骨制作成掌板撕脱性骨折模型,同一标本左、右手抽签分为实验组和对照组。实验组均采用微型钩钢板固定,对照组示指行微型螺钉固定,中指行克氏针固定,环指行普通钢板塑形后固定,小指行双孔横形微型带钩钢板固定。对掌板牵引测力,记录骨折端分离2 mm的最大张力,对比不同内固定方式的力学差异。结果实验组示指、中指、环指、小指中节骨折端分离2 mm的最大张力分别为:(50.17±1.92)N,(45.80±4.02)N,(46.68±3.33)N,(43.75±3.34)N;对照组分别为:(20.15±2.14)N,(10.55±1.46)N,(45.23±3.73)N,(28.88±2.00)N。力学测试中环指组对比未见明显差异,余手指组实验组与对照组差异均有统计学意义(P<0.05)。结论微型钩钢板在手指掌板撕脱性骨折的固定中生物力学稳定,对肌腱及骨质无明显卡压,能早期行功能锻炼。Objective To investigate the mechanical stability of micro hook plate in the fixation of avulsion fracture of metacarpal plate of phalanx.Methods The middle phalanx of 6 hand specimens were made into a model of avulsion fracture of the metacarpal plate.The same specimen was divided into experimental group and control group by drawing lots on the left and right hands.The experimental group was fixed with a new hook steel plate,while the control group was fixed with micro screws for the index finger,kirschner wire for the middle finger,ordinary steel plate for the ring finger,and double hole transverse micro hook steel plate for the little finger.We measured the traction force of the volar plate,recorded the maximum tension of 2mm separation of the fracture end,and compared the mechanical differences of different internal fixation methods.Results The maximum tension of 2 mm was(50.17±1.92)N,(45.80±4.02)N,(46.68±3.33)N,(43.75±3.34)N in the experimental group.The control group was(20.15±2.14)N,(10.55±1.46)N,(45.23±3.73)N,(28.88±2.00)N respectively.There was no significant difference between the ring finger group and the control group,and the difference between the other finger group and the experimental group was statistically significant(P<0.05).Conclusion The new hook plate is biomechanically stable in the fixation of avulsion fracture of the palmar plate of the finger,has no obvious compression on the tendon and bone,and can be used for early functional exercise.

关 键 词：指骨 掌板 撕脱性骨折 

分 类 号：R683.41[医药卫生—骨科学]