锁骨瓣切除对锁骨力学性质影响的实验研究

The effect of clavicular flap resection on torsional strength of clavicle

目的 :评价锁骨半片骨瓣截取后的生物力学变化。方法 :选取经防腐固定的成人锁骨左右配对14根标本 ,测试完整锁骨的扭转刚度 ;然后随机配对分为两组 :一组在靠近锁骨内侧端切取长为 8.5cm的半片骨瓣 ;另一组在靠近锁骨的内侧端切取长为 4.5cm的半片骨瓣。测试切取骨瓣后锁骨的扭转刚度和强度。结果 :完整锁骨左右两侧的扭转刚度无显著性差异 (P >0 .0 5 ) ,切取半片骨瓣后其扭转刚度显著下降 (P <0 .0 1) ,锁骨在切取短骨瓣与切取长骨瓣后两者相比较其刚度、强度变化不大。骨瓣切取后抗扭转强度的破坏发生在骨瓣切取处外侧端。结论 :锁骨作为供骨修复骨缺损时 ,切取半片骨瓣在保证肩锁、胸锁关节完整前提下具有可行性。

Objective:To evaluate torsional strength of clavicle after semi resection of clavicular flap.Methods:14 calvicles gotten from 7 adult cadavers were divided into 2 groups randomly.After the torsional stiffness of those intact specimens were measured,a 8.5cm long clavicular flap was resected at the medial part of the clavicle in one group,while a 4.5 cm long clavicular flap was resected at the medial part of the clavicle in another group.Both of the torsional stiffness and strength of the resected clavicle were measured.Results:No significant difference was found between the stiffness of intact left and right clavicles.The stiffness of clavicle significantly decreased after semi resection of clavicular flap ( P <0.05).There was no significant difference for the torsional stiffness and strength between the 2 groups after resection ( P >0.05).Most of the fracture happened at the lateral part of clavicle during torsional test.Conclusion:When clavicle was used as donator to repair bone defects,it is possible to design the semi clavicular bone flap only if the acromioclavicular joint and articular sternoclavicularies are intact and the length of the flap can be taken as long as needed.