微动解剖型肩锁钢板的研制及生物力学研究

目的 研制一种符合肩锁关节微动牛理特点的微动解剖犁肩锁钢板,并对其进行生物力学研究,了解该钢板是否符合肩锁关节微动生理特点.方法 根据肩锁关节的解剖学形态及微动生理特点,设计制作出微动解剖型肩锁钢板.牛物力学测试:成人新鲜上肢标本10具,用MTS模拟上肢重力作用对标本进行加载,运用激光扣描仪测量每个标本在正常状态(对照组)、肩锁韧带完全断裂(肩锁组)、肩锁韧带及喙锁韧带均断裂(喙锁组)、克氏针钢丝张力带固定(克氏针组)、AO钩钢板同定(钩钢板组)、微动解剖型肩锁钢板固定(肩锁钢板组)及Dewar手术(Dewar组)后肩锁关节在X、Y、Z轴向的位移及旋转情况.结果微动解剖型肩锁钢板具有微动特点,固定肩锁关节后肩锁钢板组与对照组在各轴向的位移及旋转活动相比较差异均无统计学意义(P＞0.05);肩锁钢板组与克氏针组比较筹异有统计学意义(P＜0.01);在Z轴向上的旋转及Y轴向的位移,肩锁钢板组与钩钢板组比较差异无统计学意义(P值分别为0.85、0.54),但肩锁钢板组与钩钢板组在X、Z轴向上的位移及X、Y轴向的旋转有差异有统计学意义(P＜0.05);肩锁钢板纽与Dewar组在各轴向的比较差异无统计学意义(P＞0.05).结论 微动解剖型肩锁钢板符合肩锁关节的生理微动特点,固定肩锁关节后保留了肩锁关节的活动.＃

Development of micro-movement and anatomical acromioclavicular plates:a biomechanical study

Objective To study the biomechanical performance of a new kind of internal fixator developed by us. The micro-movement and anatomical acromioclavicular plate, to see whether it fits the biomechanical features of the acromioelavicular (AC)joint. Methods The acromioclavicular plate was designed according to the anatomical and micro. Movement features of the AC joint, and was made of Ti-6A1-4V (GB/T13810-1997) titanium alloy. Ten pairs of fresh cadaverie specimens of adult upper limb were used for biomechanical tests. The upper limbs were fixed by the MTS testing device and loaded, simulating the gravity effect on the limb. The motions of every specimen were measured in its normal state, and in the states of acromioclavicular ligament rupture, acromioclavicular ligament and coracoclavicular ligament rupture. Tension band wiring fixation, AO. Plate fixation, micro-movement and anatomical aeromioclavicular plate fixation and Dewar's procedure. Results There was no significant difference between normal state and micro-movement and anatomical acromioclavieular plate fixation in the displacement and rotation at axes X,Y or Z(P＞0.05).There was obvious significance between tension band wiring fixation and tension band wiring fixation(P＜0.01＝.In the rotation at axis Y and displacement at axis Z, there was no significant difference between micro-movement and anatomical acromioclavicular plate fixation and AO-plate fixation (P＞0.05).but there was significant differtenee between them in the rotation at axes X and Z and displacement at axes X and Y. There was no significant difference between micro-movement and anatomical acromioclavieular plate fixation and De war's procedure. Conclusions The micro-movement and anatomical acromioclavicular plate fits the biomechanical feature of the AC joint, because it allows micro-movement of the joint after fixation.