胫骨远端前外侧解剖型锁定钢板治疗不稳定性Pilon骨折的生物力学研究

Biomechanical Study for Anterolateral Distal Tibial Anatomic Locking Plate for Treatment of Unstable Pilon Fracture

目的探讨胫骨远端前外侧解剖型锁定钢板治疗不稳定性Pilon骨折的生物力学性能。方法将7具新鲜湿润的成人踝关节标本随机分为四组,1具标本作为正常对照组(N组);其余6具均造成胫骨远端不稳定性Pilon骨折,分成3组,每组2具标本,分别采用胫骨远端前外侧解剖型锁定钢板(A组)、三叶草钢板(B组)、重建钢板固定(C组),后两组为对照组,测试各组的远端轴向强度、刚度,扭转生物力学性能,胫距关节面接触特征。结果 A组在胫骨远端不稳定性Pilon骨折的远端轴向强度、刚度,扭转生物力学性能以及胫距关节面接触特征上接近N组(P>0.05),优于B、C组(P<0.05)。结论胫骨远端前外侧解剖型锁定钢板治疗不稳定性Pilon骨折不但具有优越的生物力学性能,而且操作简便、安全可靠,Pilon骨折固定的关节稳定性明显比其他内固定材料占有较大的优势,是较为理想的选择。

Objective To explore the biomechanical properties of the anterolateral distal tibial locking plate in treatment of anatomic instability Pilon fracture. Methods Seven fresh adult ankle specimens were randomly divided into four groups of block （n = 2）, a normal tibia as the normal control group （normal N） and 6 resulted in unstable distal tibial Pilon fracture, respectively anterolateral distal tibial anatomic locking plate fixation （A）, clover plate （B）, the reconstruction plate fixation （C group）. The latter 2 groups served as the control group to test the remote axis in each group to the strength, axial stiffness of the remote to reverse the biomechanical performance, tibia characteristics from the articular surface of contact. Results In distal tibial Pilon fracture instability remote axial strengthi axial stiffness of the remote to reverse the biomechanical properties, and tibia from the joint surface contact characteristics were close to normal N group （P〉0.05）, excellent in the reconstruction plate, cloverleaf plate （P〈0.05）.Conclusion The anterolateral distal tibial locking plate for treatment of anatomic Pilon fracture instabihty has superior biomechanical properties. In addition it is easy to operate, safe and reliable, and better than other materials in Pilon fracture fixation stability, and it is an ideal choice for open reduction and fixation for Pilon fracture.