Endobutton带袢钢板治疗下胫腓联合分离的生物力学研究

Biomechanical study of tibiofibular joint separation with Endobutton plate treatment

目的探讨Endobutton带袢钢板固定下腓联合分离的生物力学特性,为临床应用提供科学依据。方法将9具新鲜成人尸体足标本分为3组:A组为带袢钢板固定组,B组为全螺纹(直径3.5 mm)1枚皮质骨螺钉固定组,C组为可吸收螺钉固定组。运用生物力学实验应力分析方法和压敏片技术,测量3组与原始标本胫腓骨的强度、刚度、分离位移、足不同位置关节处的应变、胫距关节接触面积等生物力学特性。结果 3组及原始标本胫腓骨强度及刚度,水平位移、垂直位移及跖屈位移差异均有统计学意义(均P<0.05);A组胫腓刚度及强度,水平位移、垂直位移及跖屈位移均高于B组及C组(均P<0.05),与原始标本差异均无统计学意义(均P>0.05)。3组胫距关节接触面积及接触压差异均有统计学意义(P<0.05),A组与B组及C组差异均有统计学意义(均P<0.05)。结论带袢钢板固定下胫腓联合分离具有优越的生物力学特性,是目前下胫腓联合分离内固定的一种优良术式。

Objective To discuss the biomechanical properties of Endobutton fixation of the syndesmosis separation and its scientific basis of clinical application. Methods Nine fresh adult cadaveric foot specimens were divided into three groups： Group A treated with Endobutton fixation group, group B with one full thread（diameter of 3.5mm） a cortical bone screw fixation, group C with absorbable screw fixation. The biomechanical properties of three kinds of joints, such as strength, stiffness, displacement of the joints, the contact area of the tibia and the joints were measured by stress analysis method and pressure sensitive film technology.Results There were significant difference on tibiofibular strength and rigidity, horizontal displacement, vertical displacement and plantar flexion displacement among three groups and the original specimens（P〈0.05）.Tibiofibular stiffness and strength, horizontal displacement, vertical displacement and displacement of plantar flexion of group A were higher than those of group B and group C（all P〈0.05）, while there were no significant differences compared with the original specimens（P〉0.05）. There were significant differences among three groups on tibia from the joint contact area and contact pressure（P〈0.05）. Conclusions With superior biomechanical properties,the Endobutton fixation of distal tibiofibular syndesmosis separation is an excellent operation of internal fixation.