[骨折愈合中的双相钢板控制不稳定性]。

Christoph Sommer, Moritz Lodde, Ladina Hofmann-Fliri, Michael J Raschke
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引用次数: 0

摘要

骨折的骨巩固取决于多种因素。在最佳条件下,骨折在几周内愈合。骨折愈合的基本要求是恢复足够的生物力学稳定性和尽可能理想的骨折块间运动。股骨远端骨折尤其具有挑战性,特别是在存在广泛的软组织损伤,多发碎片性骨折和累及关节时。目前应用的单外侧钢板、双钢板和髓内钉内固定手术技术及联合手术的并发症发生率较高。双相板的原理是基于放置在板上的横向和纵向槽,这使得“可控不稳定性”成为可能。这导致即使在低负荷(柔性阶段)也有相对较高的碎片间运动,而在高负荷(刚性阶段)也有较低的运动。因此,种植体在更高的机械要求下变得更加刚性。在生物力学测试中,与股骨远端锁定加压钢板(LCP-DF)相比,植入物的应力分布、失效前的循环次数和最大载荷均优于锁定加压钢板。未来的研究将需要比较和评估潜在的临床和经济效益,直接比较目前建立的手术技术。到目前为止,临床前研究已经证明了双相钢板的安全性和适用性,以及在骨折愈合中控制不稳定性的创新原理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Biphasic plate-Controlled instability in fracture healing].

The bony consolidation of fractures depends on various factors. Under optimal conditions fracture healing takes place within a few weeks. An essential requirement for fracture healing is the restoration of adequate biomechanical stability with an interfragmentary movement which is as ideal as possible. Distal femoral fractures can be particularly challenging especially in the presence of extensive soft tissue damage, multiple fragmented fractures and involvement of the joint. The currently applied surgical techniques of single lateral plate, double plate and intramedullary nail osteosynthesis as well as combination procedures have a relatively high complication rate. The principle of the biphasic plate is based on the transverse and longitudinal slots placed in the plate, which enables a "controlled instability". This results in a relatively high interfragmentary movement even at low loads (flexible phase) and a low movement at high loads (stiff phase). Therefore, the implant becomes more rigid at higher mechanical demands. In biomechanical tests the stress distribution of the implant, the number of cycles up to failure and the maximum load are superior compared to the locking compression plate distal femur (LCP-DF). Future studies will need to compare and evaluate the potential clinical and economic benefits in direct comparison to the currently established surgical techniques. Preclinical studies have so far demonstrated the safety and applicability of the biphasic plate and the innovative principle of controlled instability in fracture healing.

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