不同内固定物治疗胫骨平台后内侧骨折的生物力学分析

背景：胫骨平台后内侧骨折的治疗较困难，容易出现因骨折固定方式选择不当导致骨折再次移位、骨不连、内固定失效及关节功能活动障碍等并发症。目的：分析3种胫骨平台后内侧骨折不同固定方法的生物力学效果。方法：27具新鲜骨标本，制成胫骨平台后内侧骨折模型，分别制成正常组，双钢板固定组，T形钢板固定组，拉力螺钉固定组。对以上3组进行压力、载荷一位移、应力强度、刚度和旋转性能测试。结果与结论：双钢板固定组载荷一位移显著小于T型钢板固定组和拉力螺钉固定组，双钢板固定组轴向刚度、水平剪切刚度及转矩扭角变化，均显著大于T型钢板固定组和拉力螺钉固定组。提示胫骨平台后内侧骨折双钢板固定较其他2种方法更具有生物力学上的稳定性。

Biomechanical analysis of different fixation methods in the treatment of posteromedial tibial plateau fracture

BACKGROUND： The treatment of posteromedial tibial plateau fracture is difficult which is prone to have re-displacement, nonunion, fixation failure and joint function movement disorder＇caused by inappropriate choice of fixation method.OBJECTIVE： To analyze the biomechanical performance of three different fixation methods for posteromedia tibial plateau fracture. METHODS： Twenty-seven fresh tibia specimens were made into models of posteromedial tibial plateau fracture. The models were divided into normal group, dual plate fixation group, T-shaped plate fixation group and lag screw fixation group. The stress, load-displacement, stress intensity, stiffness and rotation performance of the three experimental groups were tested. RESULTB AND CONCLUSION： The load-displacement in the dual plate fixation group was significantly lower than that in the T-shaped plate fixation group and lag screw fixation group, while the axial stiffness, horizontal shear stiffness and torque torsion angle in the dual plate fixation group were larger than those in the T-shaped plate fixation group and lag screw fixation group. The results indicate that biomechanical stability of dual plate fixation for the treatment of posteromedial tibial plateau fracture is better than the other two methods.