垂直钢板与平行钢板固定治疗肱骨髁间粉碎性骨折的生物力学比较研究

A biomechanical comparison of parallel plating and vertical plating for humeral intercondylar corn-minuted fractures

目的从生物力学方面比较平行钢板与垂直钢板固定治疗肱骨髁问粉碎性骨折的优缺点，为临床治疗方法的选择提供理论基础。方法取3具成人匕肢尸体标本（6个），用骨刀将肱骨远端制成T型骨折模型。将同一具尸体的左、右两侧肱骨标本分别干亍垂直钢板与平行钢板固定。将固定好的标本以5N／s的速率进行纵向垂直加载，最大加载负荷为2000N，共3次，取其平均值，记录肱骨被压缩时的垂直压缩位移、髁问分离的开口位移、内外髁内部的形变及垂直压缩刚度。结果在相同载荷下，应用平仃钢板吲定的胝缩位移、开口位移及内外髁形变均小于垂直钢板吲定，差异有统计学意义（P〈0．05），采用平行钢板固定的轴向压缩刚度大于垂直钢板固定，差异有统计学意义（P〈0．05）。结论平行钢板固定治疗眩骨髁问粉碎性骨折的生物力学性能优于垂直钢板固定定。

Objective To compare biomechanical pertormances of parallel plate fixation and vertical plate fixation for better clinical treatment of humeral intereondylar comminuted fractures （HICF）. Methods Models of T-shaped fracture were created using an osteotome at the distal end of humerus in 6 specimens of upper limb in 3 truman adult cadavers. The 2 fractttre models of left and right bumeri in lhe same cadaver were re- spectively fixated with parallel plating and vertical plating. On a biomaterial-testing machine, a vertical load was applied onto the fixated distal humerus at a speed of 5 N/s till it reached 2000 N. The loading was repeated 3 times. Vertical compression displacement, intercondylar separating displacement, defi）rmation of medial and lateral condyles and vertical compression stiffiless were documented lot statistic analyses. Results Under the same load, parallel plating led to significantly less compression displacement, separating displacement and defi）rmation of condyles（ P 〈 0.05） but significantly greater axial compression stiffiless（ P 〈 0.05） than vertical plating. Conclusion In biomeehanics, parallel plate fixation has better performance than vertical plate fixation for HICF.