下胫腓联合分离内固定术式的生物力学研究

BIOMECHANICAL STUDY OF INTERNAL FIXATION OF ABRUPTION OF LOWER TIBIOFIBULAR LIGAMENT UNION

目的 探讨下胫腓联合分离采用新型内固定术式———下胫腓钩板固定器 (Hook -platefixation ,HPF)的生物力学特性 ,与螺钉、钢板和带钩固定器三种内固定方式比较 ,为临床提供科学依据。方法 采用新鲜成人尸体足标本 6具 ,运用生物力学实验应力分析方法和压敏片技术 ,测量不同内固定术式的远端胫腓骨强度、应变、负重面积、接触应力和足弓承载能力及踝关节稳定性的变化。结果 新型下胫腓钩板固定器内固定术式无论在胫腓骨强度和刚度、负重面积、接触压力、足弓的变形、移位强度和刚度、承载能力以及踝关节的稳定性方面均优于其它三种内固定术式 ,具有显著性差异 (P <0 .0 1)。结论 实验结果表明 ,采用下胫腓钩板固定器 (HPF) ,既有利于提高生物力学性能 ,又有利于改善踝关节的稳定性 ,与传统手术方式相比可减少一次手术 ,避免了断钉等并发症 ,且能有效地提高足部承载能力 。

Objective To evaluate the biomechanical characteristics of Hook-plate fixation (HPF) in abruption of lower tibiofibular ligament union,comparing with screw,plate,hook fixation. Methods 6 fresh specimen of adult foot were used. Biomechanical tests such as stress analysis and press sensitive film patch technique were performed to measure the change of intensity,strain,load area,contact pressure of lower tibiofibular,carrying capacity of digitoplantar and stability of ankle joint in each fixation. Results HPF was superior to the other three fixations. The difference was significant(P<0.01) Conclusion This study suggests that HPF was favorable to improve the biomechanical capability and stability of the ankle joint,save once operation and screw broken, improving carrying capacity of digitoplantar. It was one the best fixations of abruption of lower tibiofibular ligament union.