NICE结固定锁骨中段骨折的生物力学研究  

Biomechanical test of NICE knot fixation for mid-shaft clavicle fracture

作　　者：范振环 于振海[2] 赵廷宝 房龙 林永杰 郝伟 FAN Zhen-huan;YU Zhen-hai;ZHAO Tingbao;FANG Long;LIN Yong-jie;HAO Wei(The Second Clinical College of Medicine,Binzhou MedicalUniversity,Yantai 264000,China;Anatomy Department,Binzhou MedicalUniversity,Yantai 264000,China;Department of Joint and Sports Medicine,The Third Hospitalof Shandong Province,Jinan 250000,China;Department of Spinal Cord Surgery,The Third Hospitalof Shandong Province,Jinan 250000,China)

机构地区：[1]滨州医学院第二临床医学院,山东烟台264000 [2]滨州医学院解剖教研室,山东烟台264000 [3]山东省立第三医院关节与运动医学科,山东济南250000 [4]山东省立第三医院脊柱脊髓外科,山东济南250000

出　　处：《中国矫形外科杂志》2023年第10期912-916,共5页Orthopedic Journal of China

摘　　要：[目的]探讨NICE结固定锁骨中段骨折的生物力学特性。[方法]将60例人体锁骨标本随机分为4组,使用骨科摆锯制作锁骨中段骨折(OTA/AO分型15-A2)模型,分别行拉力螺钉固定,以及2-0线NICE结固定、1-0线NICE结固定和1#线NICE结固定。采用Instron生物力学测试机进行三点弯曲实验,测量各组不同固定方式骨折模型的失效载荷、最大位移及屈服刚度。[结果]1#线NICE组与拉力螺钉组在失效载荷[(98.4±0.7)N vs(99.0±1.7)N,P>0.05]、最大位移[(10.1±0.4)mm vs(10.0±0.4)mm,P>0.05],以及屈服刚度[(24.4±0.4)N/mm vs(24.5±0.5)N/mm,P>0.05]差异无统计学意义。拉力螺钉组在失效载荷[(99.0±1.7)N,(45.2±0.5)N,(64.8±0.7)N,P<0.05]、最大位移[(10.0±0.4)mm,(9.4±0.6)mm,(5.6±0.5)mm,P<0.05]及屈服刚度[(24.5±0.5)N/mm,(5.0±0.3)N/mm,(12.5±0.3)N/mm,P<0.05]均显著大于2-0线NICE组和1-0线NICE组。1-0线NICE组失效载荷[(64.8±0.7)N vs(45.2±0.5)N,P<0.05]、屈服刚度[(12.5±0.3)N/mm vs(5.0±0.3)N/mm,P<0.05]均显著大于2-0线NICE组,而前者的最大位移[(5.6±0.5)mm vs(9.4±0.6)mm,P<0.05]显著小于后者。[结论]使用1#线进行NICE结环绕捆扎固定锁骨中段骨折,与使用拉力螺钉固定方式的生物力学性能相当。[Objective]To investigate the biomechanical properties of NICE knot fixation for mid-shaft clavicle fracture.[Methods]A total of 60 human clavicle specimens were randomly divided into 4 groups.The mid-shaft clavicle fracture models(OTA/AO type 15-A2)were made with an oscillating saw.After that,the fracture was fixed with lag screw,2-0 suture NICE knot,1-0 suture NICE knot and 1#suture NICE knot,respectively.Failure load,maximum displacement and yield stiffness of fracture models were measured by Instron biomechanical machine.[Results]There were no significant differences between the lag screw group and 1#suture NICE knot group in terms of failure load[(98.4±0.7)N vs(99.0±1.7)N,P>0.05],the maximal displacement[(10.1±0.4)mm vs(10.0±0.4)mm,P<0.05]and yield stiffness[(24.4±0.4)N/mm vs(24.5±0.5)N/mm,P>0.05].However,the lag screw proved significantly superior to 2-0 suture NICE group and 1-0 suture NICE group in terms of the failure load[(99.0±1.7)N vs(45.2±0.5)N and(64.8±0.7)N,P<0.05],the maximal displacement[(10.0±0.4)mm vs(9.4±0.6)mm and(5.6±0.5)mm,P<0.05]and yield stiffness[(24.5±0.5)N/mm vs(5.0±0.3)N/mm and(12.5±0.3)N/mm,P<0.05].In addition,the 1-0 suture group was significantly superior to the 2-0 suture NICE group regarding failure load[(64.8±0.7)N vs(45.2±0.5)N,P<0.05]and yield stiffness[(12.5±0.3)N/mm vs(5.0±0.3)N/mm,P<0.05],despite that the former had significantly less maximum displacement than the latter[(5.6±0.5)mm vs(9.4±0.6)mm,P<0.05].[Conclusion]The biomechanical performance of NICE knot with 1#suture for fixation of mid-shaft clavicle fractures is comparable to that of lag screw fixation.

关 键 词：锁骨中段骨折 NICE结固定 拉力螺钉 生物力学测试 

分 类 号：R683.41[医药卫生—骨科学]