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[1]孫遼軍,盧迪,余賢斌,等.喙突骨隧道位置對(duì)雙Endobutton鋼板重建 術(shù)后喙鎖韌帶力學(xué)性能的影響[J].中醫(yī)正骨,2015,27(05):1-4.
　SUN Liaojun,LU Di,YU Xianbin,et al.Effect of location of coracoid tunnel on the mechanical property of coracoclavicular ligament after reconstruction using double Endobutton[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(05):1-4.
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喙突骨隧道位置對(duì)雙Endobutton鋼板重建 術(shù)后喙鎖韌帶力學(xué)性能的影響()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第27卷
期數(shù):
2015年05期
頁碼:
1-4
欄目:
基礎(chǔ)研究
出版日期:
2015-05-30

文章信息/Info

Title:
Effect of location of coracoid tunnel on the mechanical property of coracoclavicular ligament after reconstruction using double Endobutton
作者:
孫遼軍; 盧迪; 余賢斌; 胡煒; 陳華; 郭曉山
溫州醫(yī)科大學(xué)附屬第二醫(yī)院,浙江 溫州 325027
Author(s):
SUN Liaojun; LU Di; YU Xianbin; HU Wei; CHEN Hua; GUO Xiaoshan
The Second Affiliated Hospital of Wenzhou Medical University,Wenzhou 325027,Zhejiang,China
關(guān)鍵詞:
肩鎖關(guān)節(jié);  脫位;  喙鎖韌帶重建;  喙突骨隧道;  生物力學(xué)
Keywords:
acromioclavicular joint;  dislocations;  coracoclavicular ligament reconstruction;  coracoid tunnel;  biomechanics
摘要:
目的:探討雙Endobutton鋼板重建喙鎖韌帶手術(shù)中喙突骨隧道位置對(duì)術(shù)后喙鎖韌帶力學(xué)性能的影響。方法:選取新鮮冰凍尸體肩關(guān)節(jié)30個(gè),年齡(65.5±8.3)歲。進(jìn)行模擬雙Endobutton鋼板重建喙鎖韌帶手術(shù),根據(jù)喙突隧道在喙突上表面和下表面的位置,將肩關(guān)節(jié)標(biāo)本隨機(jī)分為中心-中心組、內(nèi)側(cè)-中心組、外側(cè)-中心組、中心-內(nèi)側(cè)組和中心-外側(cè)組,每組6個(gè)肩關(guān)節(jié)。采用MTS858生物力學(xué)機(jī)對(duì)5組肩關(guān)節(jié)標(biāo)本均施加方向與中心-中心組骨隧道方向一致的載荷,模擬肩胛骨和鎖骨作用于喙鎖韌帶的拉力。持續(xù)施加載荷,直至Endobutton鋼板拉出、斷裂或喙突發(fā)生骨折。記錄每個(gè)標(biāo)本最終的破壞負(fù)荷和破壞方式。結(jié)果:5組標(biāo)本力學(xué)測(cè)試中的破壞負(fù)荷比較,差異有統(tǒng)計(jì)學(xué)意義[(536.5±142.0)N,(534.2±130.2)N,(385.4±84.3)N,(382.0±131.0)N,(360.5±90.3)N,F=3.330,P=0.026]; 中心-中心組和內(nèi)側(cè)-中心組力學(xué)測(cè)試中的破壞負(fù)荷均高于中心-內(nèi)側(cè)組、中心-外側(cè)組及外側(cè)-中心組(P=0.036,P=0.032,P=0.016; P=0.038,P=0.035,P=0.017); 其余各組間兩兩比較,組間差異均無統(tǒng)計(jì)學(xué)意義。中心-中心組和內(nèi)側(cè)-中心組破壞方式以Endobutton鋼板從喙突骨隧道拉出或鋼板斷裂為主,其余3組破壞方式以鋼板從喙突骨隧道拉出及喙突骨折為主。結(jié)論:在采用雙Endobutton鋼板重建喙鎖韌帶的手術(shù)中,選擇中心-中心型及內(nèi)側(cè)-中心型喙突骨隧道可以明顯降低術(shù)后喙突骨折和固定失敗的風(fēng)險(xiǎn)。
Abstract:
Objective:To explore the effect of location of coracoid tunnel on the mechanical property of coracoclavicular ligament after reconstruction using double Endobutton.Methods:Thirty fresh frozen shoulder joints were fetched from the cadavers aged 65.5+/-8.3 years for simulating coracoclavicular ligament reconstruction in which double Endobutton steel plates were used.The samples of shoulder joint were randomly divided into center-center group,medial-center group,lateral-center group,center-medial group and center-lateral group according to the location of bone tunnel on superior and inferior surface of coracoid process,6 cases in each group.The loads,which simulated the pullout forces on coracoclavicular ligament,were exert on shoulder joint samples in the 5 groups by using MTS858 biomechanical machine in the same direction as that of bone tunnel of center-center group.The loads increased continually until the Endobutton steel plates were pulled out or broken or the coracoids were fractured.The breakdown loads and breakdown mode of each sample were recorded.Results:There was statistical difference in the breakdown load between the 5 groups(536.5+/-142.0,534.2+/-130.2,385.4+/-84.3,382.0+/-131.0,360.5+/-90.3 N,F=3.330,P=0.026).The breakdown loads of center-center group and medial-center group were higher than that of center-medial group,center-lateral group and lateral-center group(P=0.036,P=0.032,P=0.016; P=0.038,P=0.035,P=0.017).There was no statistical difference in the breakdown load between the rest paired groups.The breakdown mode of center-center group and medial-center group presented mainly with Endobutton plates pulling out of coracoid tunnels or breaking,while it presented mainly with the plates pulling out of coracoid tunnels and coracoid fracture in the other 3 groups.Conclusion:In coracoclavicular ligament reconstruction using double Endobutton steel plates,selecting coracoid tunnel typed center-center or medial-center can significantly reduce the risk of postoperative coracoid fracture and failure of fixation.

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備注/Memo

備注/Memo:
2015-01-12收稿 2015-02-01修回
基金項(xiàng)目:溫州市科技計(jì)劃項(xiàng)目(2012S018)
通訊作者:陳華 E-mail:[email protected]
更新日期/Last Update: 2015-05-30