肱骨远端骨折内固定的生物力学比较

BIOMECHNICAL COMPARISON OF INTERNAL FIXATION OF TNE DISTAL HUMERUS FRACTURE

目的：确定肱骨远端骨折最佳的固定方式．方法：用新鲜尸体肱骨远端髁上截骨后，不同标本分别应用交叉松质骨螺钉、后侧倒“Ｙ”形钢板、“Ｊ”形和１／３管形板及重建钢板内固定，生物力学测定方法为三点弯曲法，即前后弯曲及内外侧向弯曲时测定其强度。结果：双钢板平面相互垂直（内侧板置于尺侧缘，外侧板置于后外侧）固定，是最坚固和稳定的固定方式（方差分析Ｐ＜０．０１）。结论：肱骨远端应用双钢板平面相互垂直固定，重建了由内外柱及滑车构成的等边三角形结构，在力学上最为合理。

To establish the best configuration of fixation for distal humerus fracture. Method : Afterdistal humerus osteotomy, different fixations were applied for different specimens, include crosscancellous screws, single 'Y' type plate, 'J' type plate, 1/3 tubular plate and reconstruction plate.'Three-point bending' test was applied to measure the biomechanical strength of anterior-posteriorbending and medial-lateral bending. Result: Two plate construct placing at 90'(the medial one atulna side,and the other at posterior- lateral) is the most rigidity and stability(ANOVA, P<0.01).Conclusion: Because two plate system to fix the distal humerus fracture reconstructed the humerusdistal triangle structure which is consisted of medial, lateral columns and burneral trochlea, it isthe most rigid fixation.