复杂胫骨平台骨折三种内固定方法生物力学研究

Three kinds of internal fixations for treatment of complex tibial plateau fractures： a comparative biomechanical study

目的对复杂胫骨平台骨折三种内固定方法进行生物力学评价。方法采集18具成人防腐尸体胫骨平台标本，制成复杂胫骨平台骨折模型（Schatzker分型Ⅵ型）。分别用高尔夫钢板（GP）、改良双钢板（外侧高尔夫钢板加内侧5孔1／3管型防滑钢板）（DP）、锁定加压钢板（LCP）固定，进行强度、刚度和稳定性的研究。结果DP组和LCP组生物力学强度、刚度和稳定性明显优于GP组（P〈0．05），而DP组和LCP组之间比较，差异无统计学意义（P〉0．05）。结论LCP与DP是治疗复杂胫骨平台骨折较理想的内固定器。但LCP注重软组织和血供的保护，更符合生物学固定的要求，是目前最理想的内固定器。

Objective To evaluate the biomechanism of three kinds of internal fixations in treatment of complex tibial plateau fractures. Methods Eighteen human antiseptic cadaver tibial plateau specimens were used to make models of complex tibial plateau fracture （ type Ⅵ fractures of Schatzker classification）. The models were fixated with a lateral Golf-buttress plate（GP）, modified dual plate （a lateral Golf-buttress plate plus a medial five-hole one-third tubular antiglide plate） （DP） or a lateral locking compression plate （LCP） respectively to compare strength, rigidity and stability of different fixation methods. Results The biomechanical strength, rigidity and stability in DP group and LCP group were better than those in GP group （ P 〈 0.05 ）, while there was no statistical difference between LCP group and DP group （ P 〉 0.05）. Conclusions Locking compression plate and modified dual plate are fairly ideal internal fixators for treatment of complex tibial plateau fractures. In the meantime, locking compression plate emphasizes conservation of soft tissues and blood supply, can better meet the requirement of the biological fixation of fracture and is the most ideal internal fixator at present.