锁骨接骨板预弯塑形的生物力学研究

Biomechanical Study on Pre-bending of Clavicle Plate

目的比较解剖型锁骨板与重建型锁骨板的生物力学特性,并探究预弯塑形及反复弯制对重建型锁骨板生物力学性能的影响,为临床治疗锁骨中段骨折提供生物力学依据。方法依据解剖型锁骨板的形状对重建型锁骨板分别进行1、2、3、5次弯制,通过静态压缩实验测试并比较各组试件的生物力学差异性。结果解剖型骨板固定刚度和强度显著优于重建型未弯制骨板。人工预弯1次后的重建型骨板与解剖型骨板间固定刚度和强度差异不明显。弯制对骨板力学性能有较大影响,且弯制1次后骨板固定刚度和强度明显提高。骨板仅弯制1次后再弯制会明显降低骨板的力学性能。结论与锁骨贴合度更高的解剖板和弯制1次的解剖型重建板与未塑形重建板相比,固定刚度和强度更佳。建议术者在使用重建型锁骨板进行骨折固定手术时,应根据患者锁骨解剖形态进行适当的预弯塑形,并尽量减少重复弯制次数,以维持骨板的刚度与强度。

Objective To compare biomechanical properties between the anatomical clavicle plate and the reconstructed clavicle plate,and investigate the influence of pre-bending or repeated bending process on biomechanical properties of the reconstructed clavicle plate,so as to provide biomechanical evidence for treating midshaft clavicle fracture in clinic. Methods The reconstructed clavicle plate was bent by 1,2,3,5 times respectively based on shape of the anatomical clavicle plate. The biomechanical differences in anatomical plate group,reconstructed plate group and pre-bending plate group were compared by static compression test. Results The fixation stiffness and strength of the anatomical plate were better than those of the reconstructed plate. There was no significant difference in stiffness and strength between the anatomical plate group and one-time bending group. Prebending had a great effect on mechanical properties of the clavicle plate,and stiffness and strength of the clavicle plate were obviously improved after one-time bending. The mechanical properties of the clavicle plate were obviously reduced by bending of the clavicle plate after one-time bending. Conclusions The stiffness and strength of the anatomical plate and one-time bending plate are higher than those of the normal reconstructed plate. It is recommended that surgeons should perform bending appropriately according to the patient＇s clavicle anatomy when using the reconstructed clavicle plate for fracture fixation,and minimize the number of repeated bending to maintain stiffness and strength of the clavicle plate.