胫骨平台后侧解剖型钢板治疗胫骨平台后侧骨折的生物力学研究

Biomechanic study of posterior tibial anatomic plate in the treatment of posterior tibial plateau fracture

目的 探讨胫骨平台后侧解剖型钢板的生物力学性能.方法 将25具新鲜冰冻成年尸体胫骨上端及匹配的股骨下端标本按随机数字表法分为四组.1具标本作为正常对照组（N组）.其余24具均造成Schatzker Ⅵ型胫骨平台骨折,随机分为三组,每组8具,后侧分别采用胫骨平台后侧解剖型钢板（A组）、＂T＂形钢板（B组）、直型重建钢板（C组）固定,后两组为对照组,测试各组钢板的强度、刚度、扭转生物力学及失效载荷性能.结果 试验组复杂胫骨平台骨折的强度和刚度超过N组（P＞0.05）,在扭转生物力学性能上接近N组（P＞0.05）;试验组在强度、刚度、扭转生物力学性能和失效载荷性能优于B、C组（P＜0.05）.结论 胫骨平台后侧解剖型钢板具有优越的生物力学性能,在治疗胫骨平台后侧骨折及膝关节的稳定性较其他内固定材料好,是胫骨平台后侧骨折固定较为理想的选择.

Objective To investigate the biomechanical properties of the posterior tibial anatomic plate. Methods A total of 25 fresh frozen adult tibial top and matching femur specimens were randomly divided into four groups. One specimen was used as normal control （ N group）, and the remaining 24specimens were with Schatzker Ⅵ tibial plateau fracture and accompanied by rear split and backward fracture displacement. The lateral margin of the tibia was fixed with a L-type plate, and the medial margin was fixed with the same plate after remodeling. The 24 specimens were divided into three groups, eight specimens per group. The posterior margin of the tibia was fixed by posterior tibial anatomic plate （ Group A）, T-type plate （ Group B） or straight reconstruction plate （ Group C）. The strength, stiffness, torsional biomechanics and failure load performance of the plates in each group were evaluated. Results The strength and stiffness of test groups was superior to that of Group N （ P 〉 0.05 ）, and the torsional biomechanics of test groups was close to that of Group N （ P 〉 0.05 ）. The posterior tibial anatomic plate was superior to T-type plate and straight reconstruction plate in aspects of strength, stiffness, torsional biomechanics and failure load performance （ P 〈 0.05 ）. Conclusions Posterior tibial anatomic plate has excellent biomechanical properties, and it is superior to other materials in treating posterior tibial plateau fracture and restoring the stability of the knee.