Relative stability of conventional and locked plating fixation in a model of the osteoporotic femoral diaphysis.
Relative stability of conventional and locked plating fixation in a model of the osteoporotic femoral diaphysis.
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DOI：
10.1016/j.clinbiomech.2008.11.002
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发表时间：
2009-02
期刊：
影响因子：
--
通讯作者：
Bottlang M
中科院分区：
文献类型：
--
作者：
Fitzpatrick DC;Doornink J;Madey SM;Bottlang M
本研究研究了单皮质和双皮质锁定钢板相对于传统的非锁定钢板在骨质疏松性股骨干中的刚度和强度。四种桥式钢板配置应用于骨质疏松性股骨干模型。一个非锁定的常规配置作为基线。锁紧配置包括双皮质锁紧、单皮质锁紧和单皮质锁紧螺钉与双皮质锁紧螺钉相结合的混合模式锁紧。对于所有配置，应用11孔钢板，在钢板的第1、3和5个孔内放置4.5 mm螺钉。每种构型的5个试件进行动态加载，直至扭转、轴向压缩和弯曲破坏，以确定结构刚度、强度和破坏模式。在扭转和弯曲方面，锁定钢板结构提供的刚度和强度明显低于传统结构。单皮质锁定结构的扭转强度比常规结构弱69% (P<0.001)，但增加一枚双皮质锁定螺钉后其扭转强度提高了73% （P<0.001）。在轴向压缩中，四组之间的结构刚度变化小于10%。然而，与传统结构相比，双皮质和混合模式锁定结构的强度分别显著增加了12% （P= 0.001）和11% （P=0.002）。骨质疏松性骨干锁定钢板可以提高轴向载荷下的固定强度，但与常规钢板相比，可能会降低弯曲和扭转时的固定强度。建议在单皮质结构中加入一枚双皮质锁定螺钉以提高扭转强度。
This study investigated the stiffness and strength of bridge plating with uni-cortical and bi-cortical locking plate constructs relative to a conventional, non-locked construct in the osteoporotic femoral diaphysis. Four bridge plating configurations were applied to a validated model of the osteoporotic femoral diaphysis. A non-locked conventional configuration served as baseline. Locked configurations included bi-cortical locked plating, uni-cortical locked plating and mix-mode locked plating, which combined uni and bi-cortical locking screws. For all configurations, an 11-hole plate was applied with 4.5-mm screws placed in the 1st, 3rd, and 5th plate hole. Five specimens of each configuration were dynamically loaded until failure in torsion, axial compression, and bending to determine construct stiffness, strength and failure modes. In torsion and bending, locked plating constructs provided a significantly lower stiffness and strength than the conventional construct. The uni-cortical locked construct was 69% weaker (P<0.001) in torsion than the conventional construct, but its torsional strength improved 73% (P<0.001) by adding one bi-cortical locked screw. In axial compression, construct stiffness varied by less than 10% between the four groups. However, the bi-cortical and mixed-mode locked constructs provided a significant increase in strength of 12% (P = 0.001) and 11% (P=0.002), respectively, compared to the conventional construct. Locked plating in the osteoporotic diaphysis can improve fixation strength under axial loading, but may reduce fixation strength in bending and torsion compared to conventional plating. Adding one bi-cortical locked screw to an otherwise uni-cortical construct is recommended to improve torsional strength.
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影响因子：
5.3
作者：
Kubiak, Erik N.;Fulkerson, Eric;Egol, Kfdineth A.
通讯作者：
Egol, Kfdineth A.
DOI：
10.1097/00005373-199601000-00002
发表时间：
1996-01-01
影响因子：
--
作者：
Kowalski, MJ;Schemitsch, EH;Swiontkowski, MF
通讯作者：
Swiontkowski, MF
影响因子：
2.6
作者：
Hasenboehler, Erik;Smith, Wade R;Morgan, Steven J
通讯作者：
Morgan, Steven J
DOI：
10.3109/17453677308988672
发表时间：
1973-01-01
期刊：
ACTA ORTHOPAEDICA SCANDINAVICA
影响因子：
--
作者：
HUBBARD, MJS
通讯作者：
HUBBARD, MJS
影响因子：
2.4
作者：
MARTENS, M;VANAUDEKERCKE, R;MULIER, JC
通讯作者：
MULIER, JC