局限性腕骨融合术新型内固定方式的探讨——四角腕骨融合器

Approach of new fixation of carpal bones for limited intercarpal arthrodesis——four-corner arthrodesis apparatus

目的:研发新型四角腕骨融合器。方法:根据所测国人头、月、三角和钩骨关节有关数据设计草图,选用钛合金制出粗样,然后置入新鲜尸体腕关节标本模拟四角腕骨融合术,修改后制作成品。结果:四角腕骨融合器的钢板部分由锥形板和相连的中心圆桶状结构组成。锥形板开有4个螺钉孔,各通过一根松质骨螺钉与4块腕骨固定,中心圆桶状结构中空可供植骨,外侧面制有螺纹与腕骨紧密咬合,同时制作了配套工具。结论:四角腕骨融合器可使4块腕骨间的固定强度大大提高,并可防止融合体向关节中心的旋转和塌陷,是局限性腕骨融合术中新型、可靠的内固定方式。

Objective ：To develope a new type of fusion apparatus for four-comer athrodesis. Methods：The design drafts of the apparatus were drawn based on the Chinese datum measured from cadaver wrists. The semifinished products made of titanium alloy were checked out .The finished apparatuses were made after revising. Results ：The fusion plate for four-comer athrodesis composes of taper plate connected to cylinder. Four carpal bones were fixed using the taper, one screw for one carpal bone. Bone graft could be done through the hollow cylinder. The outer threads of hollowed cylinder made the fusion plate very tightly contact to carpal bones, the responding tool was made as well. Conclusions ：The rational design of the fusion apparatus improves the mechanical strength of fixation.The fusion apparatus can prevent the rotation and collapse of fused unite towards the center of the joint among capitate, hamate, lunate, and triquetrum. It is a reliable new internal fixation using the fusion apparatus for the limited intercarpal arthrodesis.