[多轴角稳定性]。

Mark Lenz, Mirko Rocci, Martin Altmann, Boyko Gueorguiev
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引用次数: 0

摘要

多轴螺钉系统是骨折固定领域的最新技术。与传统的单轴系统相比,多轴结构可以改变螺钉角度,增强了钢板-螺钉配置在不同手术场景和不同解剖情况下的适应性。本文提供了功能原理,临床应用和多轴稳定性固有局限性的全面概述。传统的单轴技术限制了螺钉的定位,在某些骨折情况或解剖区域可能会影响固定。相比之下,多轴系统可以适应螺钉放置,解决手术中出现的特定要求。基于摩擦、变形、螺纹形式和啮合技术的各种锁定机制在实现稳定性方面发挥着至关重要的作用。本文讨论了目前使用的关键技术,它们的力学特性和比较行为,因为螺钉和钢板之间的生物力学相互作用对于实现最大稳定性和防止可能影响骨折愈合的失效模式至关重要。本文强调,虽然多轴系统提供了增强的碎片特异性螺钉定位,但其成功应用依赖于仔细的手术技术和对所涉及力学的理解。通过整合临床经验、生物力学和文献的见解,我们的目标是提高人们对多轴系统骨折管理的认识和支持决策。最后,文章提倡平衡地理解现代骨科创伤手术中多轴骨折固定的益处和挑战。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Polyaxial angle stability].

Polyaxial screw systems are the state of the art in the field of fracture fixation. In contrast to conventional monoaxial systems, the polyaxial constructs enable variable screw angulation, enhancing the adaptability of plate-screw configurations in different surgical scenarios and different anatomical circumstances. This article provides a comprehensive overview of the functional principles, clinical applications and inherent limitations of polyaxial stability. The conventional monaxial technology restricts screw positioning, potentially compromising fixation in some fracture situations or anatomical regions. In contrast, polyaxial systems enable adapted screw placement, addressing specific requirements arising during surgery. Various locking mechanisms based on friction, deformation, thread forms and engagement techniques, play crucial roles in achieving stability. The article discusses the key currently used technologies, their mechanical characteristics and comparative behavior as the biomechanical interaction between screws and plates is crucial for achieving maximum stability and preventing failure modes that could compromise fracture healing. This article emphasizes that while polyaxial systems offer enhanced fragment-specific screw positioning, their successful application relies on careful surgical technique and an understanding of the mechanics involved. By integrating insights from clinical experiences, biomechanics, and the literature, we aim to raise awareness and support decision-making in fracture management using polyaxial systems. Ultimately, the article advocates a balanced understanding of both the benefits and challenges associated with polyaxial fracture fixation in modern orthopedic trauma surgery.

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