微型钢板内固定掌指骨骨折的生物力学评价

Mini-plate internal fixation for the treatment of metacarpal and phalangeal fractures:Biomechanical evaluation

背景:掌指骨骨折是常见的骨折之一,临床多应用内固定物置入治疗。目的:评价不同内固定物置入固定掌指骨骨折的生物力学性能以及相应的临床应用效果。方法:通过测定掌指骨骨折微型钢板内固定、螺钉内固定、克氏针内固定以及钢丝内固定的轴向压缩应变、轴向移位和弯曲应变等生物力学性能的变化,明确掌指骨骨折理想的内固定置入物,并明确临床应用的内固定效果。结果与结论:生物力学测试结果显示,在相同的生理载荷作用下,微型钢板内固定掌指骨骨折的轴向压缩应变、轴向移位以及弯曲应变均最小,其次是交叉克氏针内固定,而钢丝内固定的轴向压缩应变、轴向移位和弯曲应变均最大。测试结果表明微型钢板内固定是掌指骨骨折首选的内固定置入物。并且临床结果显示微型钢板内固定掌指骨骨折的优良率可达87%,无内固定物的松动、断裂以及复位丢失等并发症的发生,能够获得满意的内固定效果。

BACKGROUND：Metacarpal and phalangeal fractures is one of the common fracture, and usual y treated with internal fixation in clinic. OBJECTIVE：To evaluate the biomechanical performance as wel as the corresponding clinical effect of different internal fixation implants for the treatment of metacarpal and phalangeal fractures. METHODS：The changes of biomechanical performance, such as the axial compressive strain, the axial displacement and bending strain of mini-plate internal fixation, screw internal fixation, Kirschner wire internal fixation and wire internal fixation in the treatment of metacarpal and phalangeal fractures were measured to determine the ideal internal fixator for the treatment of metacarpal and phalangeal fractures, and to identify the clinical effect. RESUTLS AND CONCLUSION：Biomechanical test showed that under the same physiological loads, the mini-plate internal fixation showed the lowest axial compressive strain, axial displacement and bending strain, fol owed by Kirschner wire internal fixation, while the wire internal fixation showed the highest axial compressive strain, axial displacement and bending strain. The test results indicate that mini-plate internal fixation is the preferred internal fixation implant for the treatment of metacarpal and phalangeal fractures. The clinical results suggest that the excel ent and good rate of mini-plate internal fixation for the treatment of metacarpal and phalangeal fractures can reach 87%, and the mini-plate internal fixation can achieve the good fixation effect without complications of loosening of implants, fracture and loss of reduction.