目的 将自主研制新型肩胛颈部解剖锁定钢板与 Watson 重建接骨板进行生物力学对比分析,观察其生物力学方面的特点及优势。 方法 选取 12 具防腐、湿润的成人肩胛骨尸体标本(男 7 具,女 5 具),造模成肩胛颈骨折(Miller 分型 II B 型)标本,根据取标本的先后顺序及性别随机分为实验组和对照组:实验组采用新型肩胛颈部解剖锁定钢板内固定,对照组采用 Watson 重建接骨板内固定。 将标本安置钢板后在生物力学实验机上分别进行肩胛颈部抗拉伸实验、钢板螺钉抗拔出实验、动态疲劳实验。 通过与实验终端相连接的计算机采集实验数据,并绘制力-位移曲线以及周期-位移曲线。 结果 在肩胛颈部抗拉伸实验中,实验组平均抗拉伸力[(356. 50±32. 19) N]优于对照组[(193. 83±29. 39) N] (P<0. 05)。 在肩胛颈部钢板螺钉抗拔出实验中,实验组平均抗拔出力[( 263. 83±22. 85) N]优于对照组[(135. 50±15. 40) N)](P<0. 05)。 在动态疲劳实验中,300 个周期内实验组平均位移小于对照组(P<0. 05),且均未出现钢板、螺钉断裂松动现象。 结论 自主研制的新型肩胛颈部解剖锁定钢板在抗拉伸、抗拔出、动态疲劳生物力学性能优于重建接骨板,可为临床上治疗肩胛骨颈部骨折提供一种较为理想的内固定系统。

Objective The biomechanical comparison between the novel scapular neck anatomical locking plate (SNALP) and the Watson reconstruction plate (WTRP) was conducted, so as to observe characteristics and advantages of the SNALP in the aspect of biomechanics. Methods Twelve preserved and moistened adult scapula cadaver specimens (7 males and 5 females) were selected and molded into scapular neck fracture (Miller's type II B) specimens, which were randomly divided into experimental and control groups according to the order of specimen collection and gender: the SNALP for internal fixation was used in experimental group, and the WTRP for internal fixation was used in control group. The specimens were placed on the biomechanical testing machine, then the scapular neck tensile test, plate screw anti-pullout test and dynamic fatigue test were conducted respectively. The experimental data were collected by the computer connected to the experimental terminal, and the stress-displacement curves and cycle-displacement curves were plotted. Results In the scapular neck tensile test, the average tensile strength of experimental group [(356.50±32.19) N ] was better than that of control group [(193.83±29.39) N] (P<0.05). In the anti-pullout test of scapular neck plate and screw, the average anti-pullout force of experimental group [(263.83±22.85) N] was better than that of control group [(135.50±15.40) N] (P<0.05). In dynamic fatigue test, the average displacement of experimental group was smaller than that of control group within 300 cycles (P<0.05), and no fracture and loosening of the steel plate and screw occurred. Conclusions The novel SNALP is better than the WTRP in terms of tensile, pullout and dynamic fatigue biomechanical properties, and can provide a more ideal internal fixation system for clinical treatment of scapular neck fractures.

四川省科技厅项目(2022NSFSC1534),泸州市科技局课题(2021-JYJ-60),泸县人民政府与西南医科大学联合课题(2020LXXNYKD-03)