桡骨干骨折钢板内固定的生物力学研究

Biomechanics research of fracture of radial diaphysis fixed by plate and screws

目的比较桡骨干上中下段不同部位骨折时,钢板固定在掌侧和背侧的生物力学差异。方法将18对桡骨随机分为3组,分别造上、中、下段横骨折模型,再将各组分为掌侧钢板固定组和背侧钢板固定组,DCP钢板固定后将各标本依次进行轴向压缩实验、三点弯曲实验和扭转实验。结果在桡骨上段骨折组和桡骨中段骨折组,掌侧钢板固定组较背侧钢板固定组位移大;在桡骨下段骨折组,掌侧钢板固定组较背侧钢板固定组位移小。结论本实验为临床手术选择钢板固定位置提供了理论依据,桡骨干上、中段骨折时钢板固定在背侧比较稳定,下段骨折固定在掌侧更稳定。

Objective It is to compare the difference in the biomechanics between dorsal and volar plate fixation to the radial shaft fractures in each upper,middle and distal third portion.Methods 18 pairs of radius were divided into three groups according to the transverse fractures in upper,middle and distal third parts.Each group was further divided into two subgroups according to dorsal plate fixation and volar plate fixation.Each sample fixed by dynamic compression plate was tested by axial compression,bending and torsion.Results The migration was more in the subgroup of volar plate fixation than dorsal plate fixation in either upper or middle third part.Meanwhile,the migration was less in the subgroup of volar plate fixation than dorsal plate fixation in distal third part.Conclusion This research provides some theory evidences for the fixed position of operation with plate and screws in clinic.If the fractures are located on upper or middle third parts of the radius,the dorsal plate fixation is more stable than volar plate fixation.Otherwise,volar plate fixation is more stable if the fractures are located.