Suture—Button与常规螺钉固定下胫腓联合对胫距关节的力学影响比较

目的比较Suture—Button与常规螺钉固定下胫腓联合对胫距关节的力学影响。方法8具新鲜冷冻尸体小腿，切断下胫腓联合韧带及三角韧带后，每组4具分别以Suture-Button（Suture—Button组）与常规螺钉（螺钉组）固定下胫腓联合，运用生物力学测试方法和应力应变传感技术，测量两组内固定胫距关节内的接触面积和峰值压力变化。结果两组在矢状面上不同屈伸角度下所测得的接触面积（t=3．52、4．49、5．93、4．75）、峰值压力（t=3．61、3．97、4．68、2．41）差异均无统计学意义（均P〉0．05），但指标呈改善趋势。结论Suture-Button与常规螺钉固定在力学上具有相似作用，而且下胫腓联合损伤固定后的效果比不固定有好转趋势。

Comparison of biomechanical property on Suture-Button and conventional screw fixating the distal tibiofibu- lar syndesmosis injury

Objective To explore the biomechanical property on Suture-Button and conventional screw fixa- ting the distal tibiofibular syndesmosis injury. Methods The distal tibiofibular syndesmosis injury models were made by cutting the anteroinferior tibiofibular ligaments, posteroinferior tibiofibular ligaments, interosseous tibiofibular liga- ments or deltoid ligaments of 8 fresh frozen calves. These models were randomly and equally divided into the two groups. The two groups were respectively fixed by Suture-Button and conventional screw. The contact area and peak in- tra-articular pressure of tibiatalar joint were measured by biomechanical testing methods and the stress and strain sens- ing technology. Results The maximal contact area and peak intra-articular pressure of Suture-Button fixation group had no significant differences with the conventional screw group by the four kinds of ankle flexion-extension angles in the sagittal plane （ t = 3.52,4.49,5.93,4.75, all P 〉 0.05 ）, peak intra-articular pressure was also similarly improved （t = 3.61,3.97,4.68,2.41, all P 〉 0.05 ）. But biomechanical markers of two fixation groups had an improvement trend. Conclusion Suture-Button fixing the distal tibiofibular syndesmosis injury had similar biomechanical effect to compare with traditional conventional screw, and two fixation groups both improved trend to compare with ligament-cut group.