跨腕关节支撑钢板外固定架治疗桡骨远端粉碎性骨折的生物力学实验

目的比较跨腕关节支撑钢板与外固定支架治疗桡骨远端粉碎性骨折的生物力学特性。方法取16个新鲜前臂标本的桡骨远端,制备AO C3型不稳定性骨折模型。标本随机分为A、B、C、D 4组（n=4）,A组为钢板固定组,B组为钢板结合克氏针固定组,C组为外固定架固定组,D组为外固定架结合克氏针固定组。每组标本在生物力学实验机上依次进行抗压缩、抗弯曲、抗扭转实验,并收集数据进行比较。结果生物力学结果显示,在轴向压缩以及弯曲试验中,钢板组稳定性要强于外固定架组（P〈0.05）;在扭转试验中,两组间差异无统计学意义（P〉0.05）;结合克氏针固定后,可以增加钢板组与外固定架组的抗弯曲和抗扭转的强度（P〈0.05）。结论对于桡骨远端粉碎性骨折,跨腕关节支撑钢板固定在抗压缩和抗弯曲的稳定性上,要强于外固定架,而在抗水平扭转的稳定性上两种方法无差异;结合克氏针固定,可以增加跨腕关节支撑钢板和跨腕关节外固定架,抗弯曲以及抗扭转的稳定性。

Biomechanical study on distraction plates and external fixation devices for treatment of distal radial comminuted fractures

Objective To provide the scientific theoretical basis for clinical practice by comparing biomechanical characteristics of distraction Plates and external fixation devices for treatment of distal radial comminuted fractures.Methods Sixteen wet radial bone specimens of adult cadaver were made distal radial comminuted fracture models(AO C3) and divided into 4 groups according to fixation methods.Group A was fixed by distraction Plates,group B by distraction Plates with K′s wires,group C by external fixators,and group D by external fixators with K′s wires.Each group was measured in compress test and torsion test.Results In axial compression and bending test,the distraction Plate group(group A) had better compress and bending intensity than the external fixator group(group B).In torsion test,there was no significant difference between the two groups(P>0.05).With K′s wires,the two groups have better compress and torsion intensity(P<0.05).Conclusion 1.Those fracture models fixed by distraction Plate have better compress and bending intensity than by external fixator,but there was no difference on torsion rigidity;2.With K′s wires,those fracture models fixed by distraction Plate and external fixors all have better compress and bending intensity.