摘要
目的对浮肩损伤临床常用的3种内固定术式进行生物力学评价,为手术选择内固定方式提供生物力学依据。方法 7例包含锁骨及肩胛骨的左侧上肢防腐尸体标本,解剖出肩胛上悬吊复合体(SSSC),人为制造浮肩损伤模型,对4种状态进行试验:正常标本、单纯锁骨固定、锁骨加肩胛颈单钢板固定、锁骨加肩胛颈双钢板固定。利用脊柱三维运动分析系统测定不同状态下肩胛颈的运动范围(ROM),比较不同内固定方式对失稳SSSC的稳定作用。结果生物力学测试表明,单纯锁骨固定的ROM值分别是:前屈(12.60±0.95)°、后伸(8.53±0.60)°、左侧弯(12.47±0.73)°、右侧弯(12.32±0.69)°、左旋(10.17±0.59)°、右旋(11.42±0.62)°,与其他各组相比明显增大(P<0.05);锁骨加肩胛颈双钢板固定的ROM值分别是:前屈(5.50±0.96)°、后伸(2.77±0.67)°、左侧弯(3.61±0.70)°、右侧弯(5.06±0.71)°、左旋(3.28±0.58)°、右旋(3.58±0.92)°,与其他固定组相比明显减小(P<0.05)。结论治疗浮肩损伤的最佳内固定方式为同时固定锁骨及肩胛颈骨折,肩胛颈骨折采取双钢板坚强内固定,以避免肩胛骨畸形愈合而造成肩关节不稳定。
Objective To evaluate biomechanic effects of commonly used internal fixation methods on the treatment of floating shoulder injury.Methods The superior suspensory shoulder complex（SSSC） were dissected for simulating floating shoulder injury in 7 antiseptic upper limb specimens including collarbone and scapula.The testing included the normal specimens,simple clavicle fixation,single plate fixation of clavicle and scapula neck,and double plate fixation of clavicle and scapula neck.The ROMs of scapula neck under different states were measured by spinal motion analysis system,as well,the stability of different fixation methods for instable SSSC was compared.Results The biomechanical testing showed that,the ROMs of simple clavicle fixation were respectively（12.60±1.86）° for flexion,（8.53±1.17）° for extension,（12.47±1.43）° for left bending,（12.32±1.35）° for right bending,（10.17±1.16）° for left tortion,and（11.42±1.21）° for right tortion,which increased more obviously compared to that of other groups（P0.05）.ROMs of double plate fixation were respectively（5.53±1.12）° for flexion,（2.63±1.06）° for extension,（3.17±0.82）° for left bending,（7.03±0.60）° for right bending,（3.88±0.64）° for left tortion,and（5.33±1.54）° for right tortion,which decreased more significantly compared to that of other fixation methods（P0.05）.Conclusions Double plate fixation of clavicle and scapula neck is the best way to treat floating shoulder injury,which is helpful for avoiding scapula malunion and the instability of the shoulder.
出处
《中国临床解剖学杂志》
CSCD
北大核心
2011年第3期339-342,共4页
Chinese Journal of Clinical Anatomy
关键词
浮肩损伤
肩胛上悬吊复合体
内固定
生物力学
Floating shoulder injury
Superior suspensory shoulder complex（SSSC）
Internal fixation
Biomechanics
