不同固定方法治疗胫骨平台外后侧骨折的生物力学分析研究  

Biomechanical analysis of different fixation methods for treating posterior tibial plateau fractures

作　　者：毛冯缘 程邦君[2] 黄燕峰[2] 罗轶[2] MAO Fengyuan;CHENG Bangjun;HUANG Yanfeng;LUO Yi(Anhui Medical University,Hefei,Anhui 230022,China;Orthopedics Department,Jinshan Branch,Shanghai Sixth People's Hospital,Shanghai 201599,China)

机构地区：[1]安徽医科大学,安徽合肥230022 [2]上海市第六人民医院金山分院骨科,上海201599

出　　处：《中国医学工程》2024年第8期38-41,共4页China Medical Engineering

基　　金：上海市金山区医药卫生类科技创新项目课题(2020-3-27);上海健康医学院运动医学临床研究中心科研课题(20MC2020003)。

摘　　要：目的通过生物力学分析研究采用掌骨T形钢板和拉力螺钉治疗胫骨平台外后侧骨折的疗效。方法将20具人工合成的右侧胫骨模形,根据胫骨平台外后侧劈裂塌陷性骨折的形态学特征,建立胫骨平台外后侧劈裂塌陷性骨折模形,随机分为两组(n=10):A组采用3.5掌骨T形钢板固定;B组采用2枚拉力螺钉固定。测量两组在轴向负荷加载起始为10 N,最大为2000 N的压力下的垂直位移和最大失效载荷。结果钢板组和螺钉组在250 N载荷下骨折块的垂直位移分别为(0.21±0.15)mm和(0.35±0.11)mm,在500 N载荷下骨折块的垂直位移分别为(0.32±0.12)mm和(0.91±0.27)mm,在1000 N载荷下骨折块的垂直位移分别为(0.76±0.16)mm和(1.75±0.21)mm,在1500 N载荷下骨折块的垂直位移分别为(0.93±0.14)mm和(2.37±0.26)mm,在同一载荷下二者比较差异有统计学意义(P<0.05)。钢板组和螺钉组的最大失效载荷分别为(1865±183)N和(1242±146)N,二者最大失效载荷比较差异有统计学意义(P<0.05)。结论掌骨T形钢板固定胫骨平台外后侧骨折,可以对塌陷的胫骨平台外后侧骨折块起到有效、稳定、坚强的固定,具有较强的稳定性和明显的生物力学优势。【Objective】To investigate the therapeutic effect of using metacarpal T-shaped steel plate and tension screw to treat posterior tibial plateau fractures through biomechanical analysis.【Methods】Twenty artificially synthesized right tibial models were used to establish a tibial plateau lateral split collapse fracture model based on the morphological characteristics of the fracture.The models were randomly divided into two groups(n=10):Group A was fixed with a 3.5 metacarpal T-shaped steel plate;Group B was fixed with 2 tension screws.Measure the vertical displacement and maximum failure load of two groups under axial load starting at 10 N and maximum pressure of 2000 N.【Results】The vertical displacements of the fracture blocks in the steel plate group and screw group under 250 N load were 0.21±0.15 mm and 0.35±0.11 mm.The vertical displacements of the fracture blocks under 500 N load were 0.32±0.12 mm and 0.91±0.27 mm.The vertical displacements of the fracture blocks under 1000 N load were 0.76±0.16 mm and 1.75±0.21 mm.The vertical displacements of the fracture blocks under 1500 N load were 0.93±0.14 mm and 2.37±0.26 mm.There was a statistically significant difference between the two under the same load(P<0.05).The maximum failure loads of the steel plate group and screw group were 1865±183 N and 1242±146 N and there was a statistically significant difference in the maximum failure loads between the two groups(P<0.05).【Conclusion】The use of metacarpal T-shaped steel plate fixation for posterior tibial plateau fractures can effectively,stably,and strongly fix collapsed posterior tibial plateau fractures,demonstrating strong stability and significant biomechanical advantages.

关 键 词：胫骨平台骨折 胫骨外后侧平台骨折 外后侧骨折 支撑钢板 螺钉 

分 类 号：R683.42[医药卫生—骨科学]