双侧板联锁固定股骨远端粉碎性骨折

目的　为股骨远端粉碎性骨折设计新的内固定方法 ,从生物力学角度提供其科学依据 ,以解决复位困难、固定不牢及内外翻等畸形和并发症。方法　选用 10例新鲜成人尸体股骨 ,在髁上 -髁间截骨造成粉碎性骨折模型 ,用钢板与聚乙烯板双板组合固定 (简称双板固定 ) ,对照组采用传统的单侧钢板固定 (简称单板固定 ) ,分别进行压缩、弯曲、扭转刚度试验和双板固定屈服试验。结果　双板固定组的抗弯曲、抗扭转能力较单板固定组显著增强 (P <0 0 1)。双板固定强度试验 ,其承受轴向载荷可达 115 4 0N ,前、后、内、外弯曲载荷分别可达 70 0、10 82、5 93、10 10N。结论　双板固定股骨远端粉碎性骨折可维持碎骨块解剖复位、增强骨折内固定的稳定性和牢固性 ,能满足早期功能锻炼的需要

Double-plating for comminuted fractures of distal femur

Objective To develop a new method of internal fixation for comminuted fractures of distal femur,and to offer a guide for management of these injuries based on biomechanical studies. Methods 10 fresh adult femurs of cadavers were similarly made into the models of supracondylar intercondylar fractures. Double plating was performed with a steel plate combined with a polyethylene plate with the conventional sigle plating as control.The biomechanic tests (compression,bending,torsion) were performed and comparatively evaluated. Results Bending and torsion tests showed that the double plating group were much stronger ( P <0 01) than the sigle plating group in anti bending and anti torsion.During the tests of loading, the double plating group failed at a mean peak load of 11 540 N in axial compression, 700 N in anterior bending, 1 082 N in posterior bending,593 N in medial bending,and 1 010 N in lateral bending. Conclusion Double plating is an excellent technique for severe comminuted fractures of the distal femur,which provide anatomic reduction and rigid fixation so that early mobilization and weight bearing are allowed.