带锚钛缆重建喙锁韧带的生物力学研究

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英文篇名：Biomechanical study of coracoclavicular ligament reconstruction with MultiStrand Titanium Cable Screw 作者：金翔赟 ; 沈一凡 ; 李广翼 ; 李晓林 英文作者：JIN Xiangyun;SHEN Yifan;LI Guangyi;LI Xiaolin;Department of Orthopedic Surgery,the Sixth People’s Hospital Affiliated to Shanghai Jiaotong University; 关键词：肩锁关节脱位 ; 手术治疗 ; 喙锁韧带重建 ; 生物力学 英文关键词：Acromioclavicular dislocation;;Surgical treatment;;Coracoclavicular reconstruction;;Biomechanical test 中文刊名：GWGK 英文刊名：International Journal of Orthopaedics 机构：上海交通大学附属第六人民医院骨科; 出版日期：2019-05-25 出版单位：国际骨科学杂志 年：2019 期：v.40 语种：中文; 页：GWGK201903013 页数：4 CN：03 ISSN：31-1952/R 分类号：65-68

摘要

目的通过体外生物力学实验,评价并探讨带锚钛缆系统在解剖重建喙锁韧带的基础上增强内固定的固定刚度、降低并发症发生率的作用。方法以10个新鲜成人肩锁关节标本为研究对象,分别对完整的喙锁韧带标本和带锚钛缆重建标本进行垂直方向的疲劳实验和最大负荷实验,记录疲劳拉伸长度、最大负荷、失效时拉伸长度及刚度并进行统计学分析。结果原始喙锁韧带组与带锚钛缆重建组均能承受疲劳实验,两组疲劳拉伸长度和失效时刚度均无显著性差异[(0.31±0.18)mm对(0.32±0.16)mm、(63.5±15.1)N/mm对(54.3±9.0)N/mm,P均>0.05],但原始喙锁韧带组垂直方向最大负荷和失效时拉伸长度均显著高于带锚钛缆重建组[(459.2±64.9)N对(311.2±53.9)N、(7.6±2.0)mm对(5.9±1.3)mm,P均<0.05]。结论虽然带锚钛缆重建组最大负荷低于原始喙锁韧带组,但仍可承受术后康复时反复锻炼的生理负荷,且两组刚度相似,可减少术后半脱位的发生率。
        Objective To evaluate the role of MultiStrand Titanium Cable Screw(MSTCS)in enhancing the fixation strength and lowering the rates of complications of coracoclavicular(CC)reconstruction through in vitro biomechanical tests.Methods 10 fresh frozen adult acromioclavicular joint specimens were used in this experiment.Cyclic loading and a subsequent load-to failure protocol was performed in vertical directions on CC ligaments and repeated after reconstruction by the MSTCS.The permanent elongation,ultimate loads,failure elongation and stiffness were recorded and analyzed.Results Both CC ligaments and MSTCS survived the cyclic loading protocol.The permanent elongation and the stiffness between CC ligaments and MSTCS were not significantly different[(0.31±0.18)mm VS(0.32±0.16)mm;(63.5±15.1)N/mm VS(54.3±9.0)N/mm,P>0.05].The ultimate loads and failure elongation were significantly different between CC ligaments and MSTCS[(459.2±64.9)N VS(311.2±53.9)N;(7.6±2.0)mm VS(5.9±1.3)mm,P<0.05].Conclusion Although the ultimate load of MSTCS was lower than that of CC ligaments,MSTCS could bear the repeated physiological load during postoperative rehabilitation with similar stiffness,which might reduce the incidence of postoperative subluxation.

引文

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