Abstract

Objective Successful stabilization of comminuted supracondylar humeral fractures is challenging, and biomechanical studies are scarce. This study compares double-plate (DB-PLATE) and linear external fixator with an intramedullary pin tie-in (ESF-IMP) fixation techniques in a cadaveric gap model. The hypothesis was the DB-PLATE construct would be stiffer, stronger and more resistant to repeated loading than the ESF-IMP construct in both cyclic and load-to-failure axial compression testing.

Study Design A 2 cm ostectomy was performed on 10 pairs of canine cadaveric humeri proximal to the supratrochlear foramen. Stabilization was with DB-PLATE (n = 10) or ESF-IMP (n = 10). Cyclic testing was performed by applying a 200 N load at 2 Hz for 63,000 cycles. Axial compressive load to failure testing followed. Data analysed included dynamic stiffness, stiffness and yield load.

Results No constructs failed during cyclic testing or lost stiffness over time. Mean dynamic stiffness over the final 100 cycles was greater for DB-PLATE compared with ESF-IMP. Mean stiffness of DB-PLATE in load-to-failure testing was not different than ESF-IMP. Yield load of DB-PLATE was higher than ESF-IMP.

Conclusion Both DB-PLATE and ESF-IMP survived cyclic testing with no change in dynamic stiffness. DB-PLATE was stronger than ESF-IMP in load-to-failure testing, which may make this construct preferable when prolonged healing or poor patient compliance is anticipated. Results suggest that either method may be appropriate for fixation of comminuted supracondylar humeral fractures.

Authors' Contributions

All the authors contributed to study conception and study design. They contributed to acquisition of data, data analysis and interpretation, drafting or revising the manuscript, and approved the submitted manuscript.

Publication History

Received: 26 November 2019

Accepted: 09 June 2020

Publication Date:
16 October 2020 (online)

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Stuttgart · New York

中文翻译：

---

犬尸体肱骨髁上骨折间隙模型外固定与双钢板固定的生物力学比较

摘要

目的 成功稳定粉碎性肱骨髁上骨折具有挑战性，并且生物力学研究很少。本研究在尸体间隙模型中比较了双板 (DB-PLATE) 和线性外固定器与髓内针栓 (ESF-IMP) 固定技术。假设是在循环和负载到破坏的轴向压缩测试中，DB-PLATE 结构比 ESF-IMP 结构更硬、更坚固并且更能抵抗重复加载。

研究设计 在滑车上孔近端的 10 对犬尸体肱骨上进行了 2 cm 截骨术。使用 DB-PLATE ( n  = 10) 或 ESF-IMP ( n  = 10) 进行稳定。循环测试通过在 2 Hz 下施加 200 N 的负载进行 63,000 次循环。随后进行轴向压缩载荷失效测试。分析的数据包括动态刚度、刚度和屈服载荷。

结果 在循环测试期间没有构造失败或随着时间的推移失去刚度。与 ESF-IMP 相比，DB-PLATE 在最后 100 次循环中的平均动态刚度更大。DB-PLATE 在负载到失效测试中的平均刚度与 ESF-IMP 没有区别。DB-PLATE 的屈服负荷高于 ESF-IMP。

结论 DB-PLATE 和 ESF-IMP 都经受住了循环测试，动态刚度没有变化。DB-PLATE 在负载到故障测试中比 ESF-IMP 更强，这可能使这种结构在预期愈合时间延长或患者依从性差的情况下更受欢迎。结果表明，任何一种方法都适用于固定粉碎性肱骨髁上骨折。

作者的贡献

所有作者都对研究概念和研究设计做出了贡献。他们参与了数据获取、数据分析和解释、起草或修改稿件，并批准了提交的稿件。

出版历史

收稿日期：2019 年 11 月 26 日

接受

日期：
2020 年6 月 9 日出版日期：2020 年 10 月 16 日（在线）

© 2020. 蒂姆。版权所有。

Georg Thieme Verlag KG
斯图加特·纽约