三种方式固定治疗猪Meyers-McKeeverⅢ型前交叉韧带胫骨止点撕脱骨折的生物力学比较研究  

Biomechanical comparison study on three fixation methods for the treatment of avulsion fracture of Meyers-McKeever typeⅢanterior cruciate ligament tibial avulsion fracture in swine

作　　者：朱信飞 郝亮 贾方腾 刘勇 张传开 Zhu Xinfei;Hao Liang;Jia Fangteng;Liu Yong;Zhang Chuankai(Department of Orthopedics,Xuzhou Renci Hospital,Xuzhou 221000,China)

机构地区：[1]徐州仁慈医院关节外科,徐州221000

出　　处：《中华解剖与临床杂志》2024年第9期616-621,共6页Chinese Journal of Anatomy and Clinics

摘　　要：目的探讨三种方式固定治疗猪Meyers-McKeeverⅢ型前交叉韧带胫骨止点撕脱骨折的生物力学特性。方法选取猪龄11~16个月新鲜冷冻猪膝关节标本24具,每具膝关节标本仅保留股骨-前交叉韧带-胫骨复合体,骨刀截骨制作Meyers-McKeeverⅢ型骨折模型。24具骨折模型按数字表法随机分为可吸收缝线组、高强线组、全缝线锚钉组3组,每组8具,均行模拟复位固定手术,其中可吸收缝线组采用双股可吸收缝线固定,高强线组采用双股高强非吸收性线固定,全缝线锚钉组采用全缝线锚钉固定。术后24具模型标本均固定于电子万能试验机进行生物力学测试。观察项目:(1)观察Meyers-MckeeverⅢ型骨折模型制备情况及3组骨折模型模拟手术复位、固定情况。(2)对比3组模型的初始位移、屈服载荷、峰值载荷、失效载荷、固定强度等生物力学测试指标。(3)生物力学试验完成后,统计各组模型的内固定失效模式。结果(1)24具骨折模型标本均制备成功,前交叉韧带胫骨止点撕脱骨块完整,骨道周围骨结构无爆裂。3组骨折模型经模拟手术骨折均解剖复位,固定材料置入准确在位,牢固固定。(2)可吸收缝线组的初始位移、屈服载荷、峰值载荷、失效载荷、固定强度分别为(3.64±0.34)mm、(358.19±26.03)N、(397.62±49.78)N、(92.36±5.40)N、(41.10±4.65)N/mm,高强线组分别为(3.63±0.51)mm、(358.83±38.04)N、(416.24±50.87)N、(93.85±8.48)N、(41.70±4.28)N/mm,全缝线锚钉组分别为(2.93±0.73)mm、(401.30±30.59)N、(427.50±40.95)N、(107.06±13.34)N、(47.46±5.97)N/mm。全缝线锚钉组的初始位移小于可吸收缝线组和高强线组,屈服载荷、失效载荷、固定强度均大于可吸收缝线组和高强线组,差异均有统计学意义(P值均<0.05);而可吸收缝线组与高强线组初始位移、屈服载荷、失效载荷、固定强度比较,差异均无统计学意义(P值均>0.05)。3组间的峰值载荷比较,差Objective This study aimed to explore the biomechanical characteristics of three fixation methods for the treatment of Meyers-Mckeever typeⅢanterior cruciate ligament tibial avulsion fracture in swine.Methods A total of 24 fresh and frozen knee joint specimens of pigs aged 11-16 months were selected.The femur-anterior cruciate ligament-tibia complex was retained in each knee joint specimen.A Meyers-McKeever typeⅢfracture model was established using a bone knife.The 24 fracture models were randomly divided into three groups(eight in each group):absorbable suture group,high-strength suture group,and all-suture anchor group.All fracture models simulated reduction and fixation operation,in which the absorbable suture group was fixed with double-strand absorbable suture,the high-strength suture group was fixed with double-strand high-strength non-absorbable suture,and the all-suture anchor group was fixed with all-suture anchor.After operation,24 model specimens were fixed in the electronic universal testing machine for biomechanical testing.(1)The preparation of Meyers-McKeever typeⅢfracture model and the reduction and fixation of the three groups of fracture models were observed.(2)The initial displacement,yield load,peak load,failure load,and fixation strength of the three fracture models after reduction and fixation were compared.(3)After the biomechanical test was completed,the internal fixation failure modes of all fracture models were recorded.Results(1)All 24 fracture model specimens were successfully prepared.The bone block at the tibial interstitial point of anterior cruciate ligaments was intact.The bone structure around the bone canal was intact without bursting.All fracture models in the three groups were anatomically reduced,the fixation materials were placed accurately and firmly fixed.(2)The initial displacement,yield load,peak load,failure load,and fixed strength of the absorbable suture group were(3.64±0.34)mm,(358.19±26.03)N,(397.62±49.78)N,(92.36±5.40)N,and(41.10±4.65)N/mm,respectively;t

关 键 词：胫骨骨折 前交叉韧带 撕脱骨折 骨折固定术 内 模型 动物 猪 固定方式 生物力学 

分 类 号：R687.4[医药卫生—骨科学] R318.01[医药卫生—外科学]