3种固定器在治疗Lisfranc损伤中的生物力学比较与分析

刘帅; 徐永清; 张旭林; 孙培栋; 梁栋柱

doi:10.13418/j.issn.1001-165x.2018.02.019

中国临床解剖学杂志 ›› 2018, Vol. 36 ›› Issue (2) : 215-220. DOI: 10.13418/j.issn.1001-165x.2018.02.019

临床生物力学

3种固定器在治疗Lisfranc损伤中的生物力学比较与分析

刘帅^1,2，　徐永清²，　张旭林^1,2，　孙培栋³，　梁栋柱³

作者信息 +

Biomechanical comparison and analysis of three kinds of fixators in the treatment of Lisfranc injuries

LIU Shuai ^1,2, XU Yong-qing ², ZHANG Xu-lin^1,2, SUN Pei-dong ³, LIANG Dong-zhu ³

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文章历史 +

摘要

目的　评价新型镍钛记忆合金四角固定器在治疗跗跖关节损伤中的固定稳定性，并与空心拉力螺钉、背部钢板的固定强度进行对比分析。方法　在6具新鲜下肢标本中，利用Electr0Force ® 3510高精度生物材料实验系统按以下分组顺序在600 N轴向载荷下测试标本整体的静态刚度。A组为空白对照组，为无损伤状态；B组为损伤组，人为建立跗跖关节损伤模型；C组为新型镍钛记忆合金四角固定器固定组；D组为背部钢板固定组；E组为空心拉力螺钉固定组。其中B、C、D组分别给予3000个疲劳循环，测试其疲劳前后的及时稳定性及疲劳稳定性。结果　3种内固定方式疲劳前后的自身比较中，应用配对t检验，差异均无统计学意义（P＞0.05 ）。应用随机区组设计方差分析比较各组，B组与A组间差异有统计学意义（P＜0.05 ），整体刚度B组小于A组。A组、C组、D组间差异无统计学意义（P＞0.05 ），并与E组比较差异有统计学意义（P＜0.05 ），整体刚度小于E组。结论　新型镍钛记忆合金四角固定器在治疗Lisfranc损伤中可以提供充足的固定强度，这为临床实施镍钛记忆合金四角固定器内固定术提供生物力学依据。

Abstract

Objective　To evaluate the stability of new Ni-Ti memory alloy four-corner fixator in treatment of Lisfranc injuries and conduct comparative analysis with dorsal plate and transarticular screw fixation.　Methods　6 sides of lower limbs from fresh adult cadavers were chosen to test static rigidity under the condition of 600Naxial load by ElectroForce® 3510 system. Groups were set : (A) Control, Undamaged group ; (B) Damaged group without treatment ; (C) Damaged group fixed by new Ni-Ti memory alloy four-corner fixator ; (D) Damaged group fixed by dorsal Plate ; (E) Damaged group fixed by transarticular screw fixation. Group B , C and D were cyclically loaded at 5 Hz between 200 and 600 N for 3000 cycles to test the change of immediate stabilization and fatigue stabilization.　Results　Paired t test was applied to analyze the difference of each group themselves after fatigue , which turned out to be of no statistically significance (P＞0.05) . Integral rigidity in group B was less than that in group A (P＜0.05) . There was no significant difference among Group A , C and D (P＞0.05) , but their integral rigidity were less than that of group E (P＜0.05).　Conclusion　New Ni-Ti memory alloy four-corner fixator could provide significant fixation strength for the treatment of Lisfranc injuries , which lays the foundation for its clinical use.

导出引用

刘帅,徐永清,张旭林,孙培栋,梁栋柱. 3种固定器在治疗Lisfranc损伤中的生物力学比较与分析[J]. 中国临床解剖学杂志. 2018, 36(2): 215-220 https://doi.org/10.13418/j.issn.1001-165x.2018.02.019

LIU Shuai, XU Yong-qing, ZHANG Xu-lin, SUN Pei-dong, LIANG Dong-zhu. Biomechanical comparison and analysis of three kinds of fixators in the treatment of Lisfranc injuries[J]. Chinese Journal of Clinical Anatomy. 2018, 36(2): 215-220 https://doi.org/10.13418/j.issn.1001-165x.2018.02.019

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