腓骨头纵行逐级截骨治疗胫骨后外平台骨折的膝关节生物力学稳定性

 目的  探讨纵行逐级截除腓骨小头治疗胫骨后外平台骨折的膝关节生物力学稳定性。方法  选用10具通过遗体捐献获取的新鲜尸体膝关节标本,依次截取腓骨小头内1/3,中1/3及外侧1/3,在生物力学扭转机加载下分别测量不同外旋转矩下的胫骨外旋角。结果  截取腓骨小头内1/3及中1/3,在不同外旋转矩下膝关节胫骨外旋角较正常标本无显著改变,截取腓骨小头外侧1/3后,在不同外旋转矩下膝关节胫骨外旋角发生显著性增加。结论  腓骨小头内1/3及中1/3纵行截骨在治疗胫骨后外侧平台骨折中不降低膝关节稳定性,具有其一定的临床意义。

Effects of longitudinal stepwise removal of fibular head in the treatment of posterolateral tibia platform fracture on biomechanical stability of the knee joint

Objective  To investigate the effects from longitudinal stepwise removal of fibular head in the treatment of posterolateral tibia platform fracture on biomechanical stability of the knee joint.Methods  Ten fresh frozen knee cadaver specimens from body donation were selected,the fibular head resected in a sequential manner from inside 1/3,mid-side 1/3 to outside 1/3,biomechanical torsion testing machine was used to measure the tibial external rotation angle at differents torques for the intact and different injury stage specimens.Results  After removal of inside 1/3 and mid side 1/3 of the fibular head,there were no significant differences compared with intact specimen in the tibial external rotation angle.Removal of outside 1/3 of the fibular head resulted in a significant increase in the tibial external rotation angle at different torques.Conclusions  Longitudinal removal of inside 1/3 and mid side 1/3 of the fibular head in the treatment of posterolateral tibia platform fracture does not decrease the stability of the knee joint,the results have clinical value for subsequent research.