新型胸锁关节钩状板的研发与生物力学测定

Development and biomechanical study of a new sternoclavicular hook plate

背景:目前临床上治疗不稳定性胸锁关节脱位大多数都是将肩锁关节钩状钢板插入胸骨髓腔内或置于胸骨后侧,因钢板不敷贴导致手术操作难度增加,降低了关节复位的疗效。目的:课题组研发了新型的胸锁关节钩状板(专利号:ZL201520515237.3),从生物力方面比较肩锁关节钩状板和新型胸锁关节钩状板固定胸锁关节的生物力学性能差异。方法:用长方形人工骨替代胸锁关节两端的胸骨和锁骨,共18对人工胸锁关节,随机分为2组:对照组(n=6)将最短杆段3孔普通肩锁关节钩状板的钢板螺钉孔段固定于人工锁骨端,钩状端置于人工胸骨后侧,采用MTS生物材料测试系统检测人工胸骨骨折时的载荷、位移变化;实验组(n=12)将最短杆段2孔新型胸锁关节钩状板的钢板螺钉孔段固定于人工锁骨端,钩状端插入人工胸骨内,采用MTS生物材料测试系统检测人工胸骨前侧皮质骨(n=6)、后侧皮质骨(n=6)骨折时的载荷、位移变化。结果与结论:对照组最大破坏力值均数为(390±51)N,实验组前侧皮质骨的最大破坏力均数为(421±55)N,实验组后侧皮质骨的最大破坏力值均数为(437±56)N,3组数据两两比较差异均无显著性意义(P>0.05)。结果表明:新型胸锁关节钩状板内固定胸锁关节并未增加胸骨骨折的风险,是一种安全有效的内固定材料。

BACKGROUND:At present,most of the treatment of unstable dislocation of sternoclavicular joint is to insert the hook plate of acromioclavicular joint into the cavity of sternal bone marrow or put it behind the sternum.The difficulty of operation is increased because of the insufficient application of steel plate,which reduces the effect of joint reduction.OBJECTIVE:The research team has developed a new type of sternoclavicular hook plate(Patent No.ZL201520515237.3),and compared the biomechanical properties of acromioclavicular hook plate and new sternoclavicular hook plate to fix sternoclavicular joint from the aspect of biomechanics.METHODS:The sternum and clavicle at both ends of the sternoclavicular joint were replaced with a rectangular artificial bone.Eighteen pairs of artificial sternoclavicular joints were randomly divided into two groups.In control group(n=6),the plate screw hole section of the shortest segment 3-hole common acromioclavicular hook plate was fixed to the artificial clavicle end;and the hook end was placed on the back side of the artificial sternum.Load and displacement changes in artificial sternal fractures were measured with MTS biomaterial test system.In the experimental group(n=12),the plate screw hole section of the shortest rod section 2 hole new sternoclavicular hook plate was fixed to the artificial clavicle end;and the hook end was inserted into the artificial sternum.The MTS biomaterial test system was used to detect changes in load and displacement of the anterior cortical bone(n=6) and posterior cortical bone(n=6).RESULTS AND CONCLUSION:In the control group,the mean of maximum destructive force was(390±51) N.The mean of maximum destructive force of anterior corti.cal bone was(421±55) N.In the experimental group,the mean of maximum destructive force of posterior cortical bone was(437±56) N.There were no significant differences between the three groups(P> 0.05).Results indicated that the new sternoclavicular hook plate did not increase the risk of sternum fracture,and it was a safe and effective internal fixation material.