LISS钢板治疗股骨远端骨折的生物力学研究

Biomechanical evaluation of the less invasive stabilization system used to treat distal femur fractures

目的探讨采用LISS钢板治疗股骨远端骨折时,通过合理分配骨折近端单双皮质固定螺钉,达到有效固定的问题。方法取115根新鲜羊右侧股骨,造成股骨远端AO分型33-A3型骨折,并均采用5孔右侧股骨远端LISS钢板予以固定,在骨折近端固定螺钉单双皮质不同分布状态下,分别作拔出和扭转的生物力学对比试验研究。结果骨折近端螺钉第1、3孔采用双皮质固定在钢板和螺钉的固定平衡性及对抗扭转拔出方面明显优于其他各试验组。结论采用LISS钢板治疗股骨远端33-A3型骨折时,骨折近端螺钉第1、3孔双皮质固定在钢板、螺钉的固定平衡性及对抗扭转拔出方面明显优于其他各试验组,能够有效地降低钢板、螺钉与骨质之间的剪切力和扭转力,从而防止螺钉、钢板早期松动脱落。

Objective To investigate how to achieve the effective fixation when treating distal femur fractures by using unicortical or bicortical screws in the proximal end of the less invasive stabilization system （LISS）. Method 115 caprine right femurs were taken and created to simulate AO/33-A3 fracture. All fracture models were fixed bythe right 5 hole LISS Plate,which treated differentiy by using unicortical or bicortical screws in the proximal end of the LISS plate. And then withdrawal force and torsional force were given on them to make comparison. Result By using bicortical locked screws in the first and third hole of the proximal end of LISS, it could reach the best balance with the distal end, and also create the biggest force to resist torsional force compared with other groups. Conclusions This test indicates that using bicortical screws in the first and third hole of the proximal end of the LISS is the best way for treating distal femur fractures AO/33-A3, it can not only reach the best balance and it create the biggest force to resist torsional force, but also decrease the shearing force, torsional force so as to prevent hardware failure.