首页> 中文期刊> 《中国组织工程研究》 >掌骨重建钢板模拟单节段固定修复寰椎骨折:体外三维运动生物力学分析

掌骨重建钢板模拟单节段固定修复寰椎骨折:体外三维运动生物力学分析

             

摘要

BACKGROUND:To achieve the stability of the fracture reduction and try to keep the integrity of the cervical vertebra activity, domestic and foreign scholars have carried out the clinical and experimental research on the limited internal fixation of single segment, and achieved good clinical curative effect. There was no obvious discomfort symptoms caused by the instability of the atlantoaxial joint. OBJECTIVE:To perform biomechanical analysis of fixed atlas fractures by single phase with three-dimensional motion experiment. METHODS:Six fresh upper cervical spine specimens (C0-C5) were used, and made into models of double fracture of the anterior arch of the atlas. Single segment fixation was conducted with metacarpal bone reconstruction plate system simulation. Data of each specimen in intact state, fracture state and internal fixation state were measured. The neutral zones in fracture state, internal fixation state and intact state were compared, and the difference of three-dimensional motion range and intact state were compared. RESULTS AND CONCLUSION:(1) There was statistical y significant difference between the neutral zones and range of motion with those of fracture status and intact status (al P<0.05). No significant difference was found between the result of fixation status and intact status (al P>0.05). (2) Results verify that simulation of single-segment fixation of unstable atlas fractures with metacarpal bone reconstruction plate system can obtain good stability, restore the stability of the upper cervical spine, and simultaneously ful y avoid adverse effects of fusion.%背景:为了实现骨折复位的稳定以及尽量保留颈椎活动度的完整,国内外多学者均开展了有关单节段有限内固定的临床与实验研究,均取得了良好的临床疗效,未见明显的寰枢关节失稳而引起的不适症状。目的:采用体外三维运动法对掌骨重建钢板单节段固定不稳定性寰椎骨折进行生物力学分析。方法:使用新鲜上颈椎标本(C0-C5)6例,将标本造成寰椎前弓双骨折模型,并以掌骨重建钢板系统模拟进行单节段复位固定。测量每例标本的正常状态、骨折状态及内固定状态3组数据。比较骨折状态、内固定状态、正常状态的运动中性区及三维运动范围与正常状态的差异。结果与结论:①颈椎标本骨折状态与正常状态的运动中性区、三维运动范围差异均有显著性意义(P均<0.05);而内固定状态与正常状态的运动中性区、三维运动范围差异均无显著性意义(P均>0.05);②结果表明,掌骨重建钢板系统模拟单节段固定不稳定性寰椎骨折可以获得良好的稳定性,在恢复上颈椎稳定性的同时,可充分避免融合术的不良影响。

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