撬压型钢板内固定治疗肩锁关节脱位的生物力学分析及临床研究

Biomechanical analysis and clinical application of "pry and press" type plate in treating acromioclavicular dislocation

目的:测试自行研制撬压型钢板螺钉内固定治疗肩锁关节脱位的生物力学特性,为临床治疗提供理论依据。方法:取新鲜尸体肩关节带肱骨上半部、锁骨和肩胛骨标本,制成肩锁关节脱位模型,用自行研制的撬压型钢板固定,并与正常、肩锁关节AO钩钢板、钢丝固定进行对照比较。结果:肩锁关节脱位后,应用肩锁关节撬压型钢板固定的效果优于传统的肩锁关节AO钩钢板和钢丝,但尚未达到正常。撬压型钢板内固定符合肩锁关节的生物力学性能,能满足肩锁关节强度的需要,符合人体正常生理功能要求。临床应用撬压型钢板内固定治疗肩锁关节脱位38例,随访8～24个月,优良率达94%。结论:撬压型钢板内固定治疗肩锁关节脱位具有良好的生物力学性能,且能达到解剖复位、操作简便、固定牢固、适应早期功能锻炼的目的。

Objective： To evaluate the biomechanical characteristics of clinical application of self-developed ＂pry and press＂ type plate in treating acromioclavicular dislocation. Methods： Acromioclavicular dislocation models were simulated using fresh specimens of shoulder joint with proximal half part of humerus, elavicula and scapula. The models were fixed by self-developed ＂pry and press＂ plate. The fixation effect was compared with normal and fixed by AO claw plate of acromioelavieular joint and wire lock. Results： The fixation effect of ＂pry and press＂ type plate was better than other two fixation methods to treat the acrominoclavicular dislocation. However, it was worse than the effect of normal aeromioclavicular joint. Thus, the implant of ＂pry and press＂ type plate fitted for the biomechanical properties of aeromioclavicular joint which could meet the requirement of strength of acromioelavicular joint and could fit the requirement of normal physiological function of human body. Accordingly, 38 cases of aeromioclavicular dislocation were treated with ＂pry and press＂ type plate,the excellent and good rate was 94% in follow-up studies of 8 to 24 months. Conclusion： The ＂pry and press＂ type plate has favorable biomechanical properties to treat aeromioclavicular dislocation. Furthermore, it has good qualities of anatomy reestablishment, simply operation and fast fixation, which fit for the purpose of early functional exercise.