山羊胫骨节段缺损锁定钢板固定及石膏固定后步态评估

Kristin M. Bowers, Lori D. Terrones, Elizabeth G. Croy, P. Mulon, H. S. Adair, David E. Anderson
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引用次数: 2

摘要

本研究的目的是分析用于胫骨节段截骨桥接的锁定钢板固定和石膏固定对山羊步态生物力学的影响。我们假设,使用锁定钢板结构稳定固定节段性骨缺损会导致山羊步态生物力学变量的微小变化,但全肢固定会导致固定肢体步态动力学的持久改变。使用压力传感步行道测量步幅、步态和行走垂直力的生物力学特征。13只非跛脚成年布尔杂交山羊在使用仪器之前经过压力感应通道的训练。对每只山羊的右后胫骨进行节段性骨切除术,并使用带锁定加压钢板的桥接钢板固定来稳定缺损。根据一项正在进行的骨科研究的方案,这些山羊在术后1至4个月期间接受了右后肢石膏固定。术前和术后12个月收集山羊的数据,山羊的活动能力不受限制。统计分析显示,手术后与石膏固定后相比,后肢运动学和最大受力无明显变化;术后注意到前肢步幅和速度明显减少,但在放置石膏前恢复正常,表明固定整体功能稳定。石膏固定对步态有深远和持续的影响,在剩余的试验期间,前肢动力学和后肢动力学和运动学都有显著的改变;观察到后肢不对称性增加,其特征是体重分布更大,并向左后肢冲动,这表明长期肢体固定可能产生长期和/或永久的有害影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Assessment of Gait Following Locking Plate Fixation of a Tibial Segmental Defect and Cast Immobilization in Goats
The purpose of this study was to analyze the effects of locking plate fixation used for bridging of tibial segmental ostectomy and of cast immobilization on gait biomechanics in goats. We hypothesized that stable fixation of a segmental bone defect, using a locking plate construct, would result in minimal changes in biomechanical variables of gait in goats, but full-limb immobilization would result in lasting alterations in the immobilized limb’s gait kinetics. A pressure-sensing walkway was used to measure biomechanical characteristics for stride, gait, and walking vertical force. Thirteen, non-lame adult Boer-cross goats were trained to walk over a pressure-sensing walkway prior to instrumentation. Segmental ostectomy was performed on the right hind tibia of each goat and the defect was stabilized using bridging plate fixation with a locking compression plate. Per the protocol of an ongoing orthopedic study, the same goats underwent right hindlimb cast immobilization between one and four months postoperatively. Data was collected preoperatively and then over twelve months postoperatively in goats with unrestricted mobility. Statistical analysis revealed no significant alterations in hindlimb kinematics or maximum force when comparing the period after surgery with that after cast immobilization; significant decreases in forelimb stride length and velocity were noted postoperatively but normalized prior to cast placement, suggesting the overall functional stability of fixation. Cast immobilization had a profound and sustained effect on gait with significant alterations in both forelimb kinetics and hindlimb kinetics and kinematics for the remainder of the trial period; increased hindlimb asymmetry characterized by greater weight distribution and impulse to the left hindlimb was observed, suggesting the potential for long-term and/or permanent detrimental effects of prolonged limb immobilization.
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