H形钢板固定骶髂关节分离的生物力学评价

Biomechanical assessment on internal fixation with H-shaped reconstruction plate for sacroiliac joint dislocation

目的:设计针对骶髂关节脱位内固定治疗的H形钢板,并行生物力学评价。方法:根据解剖特点,设计并制作适用于骶髂关节脱位的H形钢板。收集12个成年防腐骨盆标本,切断骶髂前韧带、骶髂后韧带和骶髂骨间韧带,制作成12对骶髂关节分离模型并随机分为两组,分别使用H形钢板固定和传统的双钢板固定。应用万能生物力学试验机,分别测量侧方和垂直方向上骶髂关节间位移1、2和3mm时所需要的载荷。结果:在侧方位移1、2和3mm和垂直位移1mm时,H形钢板固定组所需载荷均大于传统双钢板固定组(t=4.774,4.202,5.561和2.793,P<0.05)。垂直位移2和3mm时,两组间所需载荷差异无统计学意义(t=1.362,0.775,P>0.05)。结论:H形钢板应用于骶髂关节分离的固定时,对抗旋转和垂直方向上的初始移位的能力更强,具有更好的力学稳定性。

Aim： To design H-shaped reconstruction plate for the fixation of sacroiliac joint dislocation and to observe its biomechanical characteristics.Methods： H-shaped reconstruction plate was designed based on anatomical features of sacroiliac joint.A total of 12 pelvises of cadaver were achieved,and dissected sagittally through the midline of the sacrum and the pubic symphysis.All ligaments surrounding the sacroiliac joints were removed.12 pairs of sacroiliac joint dislocation model were obtained and divided into two groups randomly.Six samples（Group A） were fixed with H-shaped plates and 4 screws,another 6 samples（Group B） were fixed with two traditional reconstruction plates and 4 screws.Then biomechanical tests were performed to measure the loading force at the different displacement （1,2,and 3 mm） in the lateral and vertical direction,respectively.Results： The loading force of Group A was larger than that of Group B at 1,2 and 3 mm displacement in lateral direction and 1 mm displacement in vertical direction（t=4.774,4.202,5.561 and 2.793,P0.05） .Conclusion： The H-shaped reconstruction plate could resist the rotational and vertical displacement better than the traditional plate,and it is more stable when used for fixation of sacroiliac joint dislocation.