胫骨骨折侧方成角畸形对胫股关节生物力学的影响

Effects of lateral angular deformity of tibial fracture on tibiofemoral joint biomechanics

背景:关于胫骨骨折有许多治疗方法的报道,但是究竟什么角度的胫骨骨折侧方成角畸形,才能对膝关节的生物力学特性产生明显影响尚无统一结论。目的:制作胫骨骨折后侧方不同角度成角畸形模型,利用生物力学方法及压敏片技术测试胫骨向侧方成角时,胫股关节接触特性的变化,预测胫骨骨折侧方成角的最大允许角度。方法:纳入6具下肢标本,所有标本实验前均为正常膝关节,制作胫骨侧方成角畸形模型,应用压敏片技术测量胫骨侧方成角5°,10°,15°时胫股关节接触面积、平均应力、最大应力值并进行比较分析。结果与结论:胫骨骨折侧方成角5°即明显改变胫股关节的接触特性。所以临床上在处理胫骨骨折时,对于大于5°的胫骨侧方成角都要给予纠正,应尽可能恢复胫骨的解剖复位。

BACKGROUND：The angular deformity of tibial fracture on biomechanical characteristics of knee joint remains controversial.OBJECTIVE：To evaluate the effect of tibial fracture on biomechanical characters of knee joint and prescribe the most acceptable extent of lateral angular deformity using biomechanics and pressure sensitive film.METHODS：The six specimens of lower limbs were obtained from fresh human cadavers.The cadaveric specimens were not infected with diseases.Model of lateral angular deformity was established,and tibiofemoral joint contact area,mean stress,and maximum stress were measured under tibial lateral angulation at 5°,10°,15° using pressure sensitive film.RESULTS AND CONCLUSION：The 5° lateral angular deformity had changed the contact character of the tibiofemoral joint.Thus,when dealing with tibial fracture,a lateral angular deformity 5° should be reduced,and the anatomic position of tibia should be recovered.