轴向载荷下马蹄环式外固定架固定AO-C2型Pilon骨折稳定性研究
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1.中国中医科学院望京医院;2.中医正骨技术北京市重点实验室;3.北京中医药大学;4.北京中医药大学第三附属医院

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Stability of fixation of AO-C2 Pilon fracture with horseshoe ring external fixator under axial load
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    摘要:

    目摘要:目的 在传统环形外固定架构型基础上进行重新设计,使其更适合关节内Pilon骨折的固定。通过定量分析负重载荷下应用马蹄环形外固定架固定Pilon骨后骨折端位移以验证该外固定架的稳定性。方法 采用摆锯依据预先制定的截骨线制备AO-C2型Pilon骨折模型,应用马蹄环形外固定架对其固定,然后于力学加载机上进行轴向载荷力学加载。轴向载荷加载方式为从0N开始依次加载至150N、300N及450N。用动态捕捉仪记录轴向载荷加载过程中骨折块在X(左右)、Y(上下)、Z(前后)三个轴的位移变化。结果 腓骨左右方向整体移位数值范围为0.32mm~0.70mm;上下方向整体移位数值范围-0.23mm~-0.27mm;前后方向整体移位范围0.23mm~0.32mm,最大差值0.09mm。胫骨内踝侧骨折块左右方向整体移位数值范围为0.02mm~0.14mm;上下方向整体移位数值幅度-0.8mm~-0.19mm;前后方向整体移位数值范围-0.13mm~-0.78mm。胫骨外踝侧骨折块左右方向整体移位数值范围为0.05mm~-0.07mm;上下方向整体移位数值范围为-0.03mm~-0.36mm;前后方向整体移位数值范围0.27~0.47mm。结论 马蹄环形外固定架不仅能实现骨折端的稳定固定且能产生有利于骨折愈合的微动,符合骨折愈合的生物力学特点。该外固定架构型简单,适合Pilon骨折的治疗,值得推广应用。

    Abstract:

    Abstract: Objective To redesign the traditional circular external fixation structure to make it more suitable for intraarticular Pilon fracture fixation.the stability of the horseshoe annular external fixator was verified by analyzing the fracture displacement of the Pilon bone after fixation with the external fixator under load. Methods AO-C2 Pilon fracture model was prepared by pendulum saw according to the predetermined osteotomy line, and then fixed by horseshoe annular external fixator. the fixed ankle model was subjected to mechanical loading for axial loading. The axial force loading mode is from 0N to 150N, 300N and 450N successively .Dynamic capture instrument was used to record the displacement changes of fracture blocks in X (left and right), Y (upper and lower) and Z (front and rear) axes during 0-450N loading process. Results The overall left-right displacement of fibula ranged from 0.32mm to 0.70mm.The overall shift values range from -0.23mm to -0.27mm;The displacement range of the whole body before and after the fibula was 0.23mm-0.32mm, and the maximum difference was 0.09mm.The whole displacement value of the medial malleolus of the tibia was 0.02mm-0.14mm.The overall shift value amplitude in the upper and lower directions is -0.8mm -- -0.19mm;In the front and back direction, the overall shift value ranges from -0.13mm to -0.78mm.The global displacement of the lateral malleolus of the tibia was 0.05mm -- 0.07mm in the left and right directions. in the upper and lower direction, the overall shift value range is -0.03mm -- -0.36mm;In the anteriorly and anteriorly direction, the fracture fragment gradually shifted forward when the load increased from 300N to 450N, and the overall displacement value ranged from 0.27 mm to 0.47mm. Conclusion The horseshoe annular external fixator can not only stabilize the fracture end but also produce micromotion that is beneficial to fracture healing, which is in line with the biomechanical characteristics of fracture healing. the external fixation structure is simple, suitable for the treatment of Pilon fracture, and worthy of popularization and application.

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  • 收稿日期:2021-05-07
  • 最后修改日期:2021-09-03
  • 录用日期:2021-09-07
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