摘要
目的为避免因骨折而受损害的血供再受损害，研制锥状点式接触钢板（conicalcylinderpointcontactfixator，CCPC－Fix）用于治疗骨干骨折。方法在标准普通钢板（standardconventionalplate，SCP）的底面两侧对称性地设置圆形锥状钉4－6对，通过螺钉轴向作用力使圆形锥状钉尖锐的前端钉入骨内，形成点式接触固定，在钢板与骨之间留有约1．5mm的空隙，不压迫骨膜。CCPC－Fix与材料、尺寸完全一致的SCP做三点弯曲试验与扭转试验，比较两种不同钢板的力学性能。结果两种钢板的抗弯能力差异无显著性意义；当扭转角大于18°时，SCP的抗扭能力高于CCPC－Fix。临床观察42例48侧长管状骨骨干骨折，其中包括股骨12侧，胫骨26侧，尺桡骨10侧。术后不用外固定即可开始关节伸屈活动，4－6周可部分负重行走。无一例发生骨折再移位、退钉及钢板变形或断裂。尺桡骨与胫骨骨折平均3个月愈合，无明显外骨痂。股骨骨折平均4个月愈合。术后6－10个月可取出钢板。结论CCPC－Fix固定能最大限度地保护骨膜血供，骨折愈合快，有良好的稳定性，能满足不负重的早期功能锻炼需要。
Objective To deseribe the feature and application of conical cylinder point contact (CCPC) plate in treatment of diaphyseal fracture. Methods There were 4 - 6 pairs of conical eylinder beneath the standard conventional plate (SCP) symmetrically, from 1. 5 to 4 mm in diameter. The nibs of conical cylinder were embedded ahout 1 to 1. 5 mm in the cortex by the axial force of screws. The conical cylinder provided a gap of about 1. 5 mm between the plate and the bone, which averts to compress periosteum and the cortex beneath plate. It was unnecessary to strip off the periosteum during the operation and postoperative external fixation is not needed either. Three-point bending test and torsion test were carried out with the plates fixed to plastic composite bones to compare the mechanical property of CCPC - plate and SCP. Results It was found that bending property demonstrated no significant difference between the two kinds of plates. SCP has a better torsion property than that of CCPC - plate when torsion angle was > 18°. 42 cases with the diaphyseal fractures including 12 femoral, 26 tibial and 10 radioulnar, were stabilized using the CCPC - plates.The patients could perform joint functional exercise without loading after operation. Partial weight bearing could be performed 4 to 6 weeks postoperatively. There was no obvious external callus in these cases. The average time for bone healing was 3 months at the tibia and forearm and 4 months at the femur. There was no redisplacement of fracture, deformation or breaking of plate. The implant was removed about 6 to 10 months after operation. Conclusion The CCPC - plate can drastically protect the periosteal blood supply and accelerate bone healing. It possesses enough stability meeting the need of early functional exercise.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2000年第3期133-136,共4页
Chinese Journal of Orthopaedics
