胫骨平台塌陷性骨折克氏针网状固定的生物力学评价

Biomechanical study on a net fixation of Kirschner wire in treating depressed tibial plateau fractures

目的:评价采用克氏针束网状支撑固定治疗胫骨平台塌陷性骨折的生物力学性能。方法:在自行设计的骨折模型上,分别用8枚1.5 mm克氏针网状固定和2枚3.5 mm皮质骨螺钉固定,分别进行面压缩试验和点压缩试验,对这两种固定方式在最大抗压缩力、固定强度等方面进行生物力学评价。结果:面压缩试验中,平均最大抗压缩力,螺钉固定为(1 925.31±444.26)N,克氏针束网状固定为(1 609.62±277.72)N;平均最大固定强度,螺钉固定为(2.28±0.53)N/mm2,克氏针束网状固定为(1.90±0.33)N/mm2,两种固定方式生物力学性能接近(P>0.05);在点压缩试验组中平均最大抗压缩力,螺钉固定为(411.13±233.88)N,克氏针束网状固定为(1 105.58±290.66)N;平均最大固定强度,螺钉固定为(2.66±1.52)N/mm2,克氏针束网状固定为(7.18±1.89)N/mm2,网状固定明显具有生物力学优势(P<0.01)。结论:克氏针网状支撑固定胫骨平台骨折,对骨折施行生物学固定,固定牢靠。

Objective： To evaluate the biomechanical properties of tibial plateau depressed fracture fixed with a net-fixa- tion of Kirschner wires. Methods ：Twenty homemade fracture models were fixed with eight 1.5 mm Kirschner wires in a net-fix- ation;20 homemade fracture models were fixed with two 3.5 mm cortical screws. Plane-compressed and dot-compressed test were made on each 10 models of the two groups. The maximal force of anti-ompress and stiffness were measured and evaluated. Results： In plane-compressed test, mean maximal force of anti-compress and stiffness for screw fixation was （ 1 925.31 ±444.26 ） N and （2.28±0.53） N/ram2, respectively, for net-fixation was （ 1 609.62±277.72） N and （ 1.90±0.33 ） N/mm2, respectively. There was no statistical difference between the two fixation methods （P〉0.05）. In dot-compressed test, mean maximal force of anti-compress and stiffness for screw fixation was （411.13±233.88） N and （2.66＋1.52） N/mm2,respectively,for net-fixation was （1 105.58±290.66） N and （7.18±1.89） N/mm2,respectively,the net-fixation was better than that of the screw fixation（P〈 0.01 ）. Conclusion ：Treatment of tibial plateau depressed fracture with a net-fixation of Kirschner wires is a biological fixation and is a reliably method.