| ObjectivesDisplaced acetabular fracture,which treatment currently used floating position by ilioinguinal and K-L lateral approach,the shortcoming of the treatment is long operation time,heavy trauma,bleeding.Through a single ilioinguinal by the locking plate fixing anterior column,two lag screw fixing the posterior column guided by iliac fossa guider,shorter operative time,less invasive,low cost of surgery is the advantages that better than the locking plate.In this study,the biomechanics of internal fixation fixation stability were compared use cadavres in the analysis and evaluation of the stability and effect of two ways.Materials and MethodsChoose six corpses,making T-shaped acetabular fracture models,X-ray and CT rule out bone tumors and metabolic bone disease and other bone diseases,making T-shaped-acetabular fracture models with three fracture line,which are located in the anterior column,posterior column,and quadraus.Six acetabular fracture models divided into two groups,the right of acetabular fracture model is group A,which fixed with anterior column locking plate and two lag screw,The other group is B group which fixed with one locking plate in the anterior column and two locking plate in the posterior column,Set 6 mark points before and after the fracture in the order of anterior column with 1,2,quadraus with 3,4 and posterior column with 5,6,the specimens were fixed on the biomechanics of the pressurizer axial pressure,recording the displacement of the marked point,statistical analysis,and comparing the difference of two ways about the displacement,which stand for the difference of fixation stability.ResultsFixation stability of T-shaped fractures group A and group B:(1)no fracture or breakage of fixation occurs in experiments during the loading process,the maximum fracture displacement did not exceed 2 mm,It is concluded that in the application of locking plate in anterior and posterior column or locking plate fixing the anterior column with lag screw for the fixtion of T-shaped fractures in the vertical pressure 1500 N case,two fixation methods can provide a secure fixing to meet the requirements of fractures.(2)When 300 N loads,the displacement at point 1 of the group which fixed with anterior and posterior columns locking plate is 0.116±0.055 mm,the displacement at point 1 of the group which fixed with the anterior plate and lag screw is 0.163±0.017 mm,the displacement at point 2of the group which fixed with anterior and posterior columns locking plate is 0.088±0.035 mm,the displacement at point 2 of the group which fixed with the anterior plate and lag screw is 0.091±0.017 mm,the displacement at point 3 of the group which fixed with anterior and posterior columns locking plate is 0.148±0.034 mm,the displacement at point 3 of the group which fixed with the anterior plate and lag screw is 0.158±0.022 mm,the displacement at point 4 of the group which fixed with anterior and posterior columns locking plate is 0.160±0.027 mm,the displacement at point 4 of the group which fixed with the anterior plate and lag screw is 0.178±0.037 mm,the displacement at point 5 of the group which fixed with anterior and posterior columns locking plate is 0.067±0.016 mm,the displacement at point 5 of the group which fixed with the anterior plate and lag screw is 0.097±0.037 mm,the displacement at point 6 of the group which fixed with anterior and posterior columns locking plate is 0.110±0.030 mm,the displacement at point 6 of the group which fixed with the anterior plate and lag screw is 0.121±0.026 mm,When 600 N loads,the displacement at point 1 of the group which fixed with anterior and posterior columns locking plate is 0.253±0.086 mm,the displacement at point 1 of the group which fixed with the anterior plate and lag screw is 0.307±0.029 mm,the displacement at point 2of the group which fixed with anterior and posterior columns locking plate is 0.168±0.048 mm,the displacement at point 2 of the group which fixed with the anterior plate and lag screw is 0.182±0.023 mm,the displacement at point 3 of the group which fixed with anterior and posterior columns locking plate Is 0.256±0.054 mm,the displacement at point 3 of the group which fixed with the anterior plate and lag screw is 0.298±0.022 mm,the displacement at point 4 of the group which fixed with anterior and posterior columns locking plate is 0.306±0.039 mm,the displacement at point 4 of the group which fixed with the anterior plate and lag screw is 0.323±0.125 mm,the displacement at point 5 of the group which fixed with anterior and posterior columns locking plate is 0.118±0.026 mm,the displacement at point 5 of the group which fixed with the anterior plate and lag screw is 0.151±0.061 mm,the displacement at point 6 of the group which fixed with anterior and posterior columns locking plate is 0.192±0.042 mm,the displacement at point 6 of the group which fixed with the anterior plate and lag screw is 0.222±0.045 mm.When 900 N loads,the displacement at point 1 of the group which fixed with anterior and posterior columns locking plate is 0.384±0.103 mm,the displacement at point 1 of the group which fixed with the anterior plate and lag screw is 0.447±0.040 mm,the displacement at point 2 of the group which fixed with anterior and posterior columns locking plate is 0.248±0.051 mm,the displacement at point 2 of the group which fixed with the anterior plate and lag screw is 0.260±0.034 mm,the displacement at point 3 of the group which fixed with anterior and posterior columns locking plate is 0.347±0.075 mm,the displacement at point 3 of the group which fixed with the anterior plate and lag screw is 0.426±0.027 mm,the displacement at point 4 of the group which fixed with anterior and posterior columns locking plate is 0.424±0.033 mm,the displacement at point 4 of the group which fixed with the anterior plate and lag screw is 0.455±0.134 mm,the displacement at point 5 of the group which fixed with anterior and posterior columns locking plate is 0.201±0.029 mm,the displacement at point 5 of the group which fixed with the anterior plate and lag screw is 0.201±0.029 mm,the displacement at point 6 of the group which fixed with anterior and posterior columns locking plate is 0.275±0.058 mm,the displacement at point 6 of the group which fixed with the anterior plate and lag screw is 0.304±0.064 mm.When1200 N loads,the displacement at point 1 of the group which fixed with anterior and posterior columns locking plate is 0.516±0.124 mm,the displacement at point 1 of the group which fixed with the anterior plate and lag screw is 0.584±0.0426 mm,the displacement at point 2 of the group which fixed with anterior and posterior columns locking plate is 0.338±0.052 mm,the displacement at point 2 of the group which fixed with the anterior plate and lag screw is 0.345±0.038 mm,the displacement at point 3 of the group which fixed with anterior and posterior columns locking plate is 0.446±0.077 mm,the displacement at point 3 of the group which fixed with the anterior plate and lag screw is 0.555±0.032 mm,the displacement at point 4 of the group which fixed with anterior and posterior columns locking plate is 0.531±0.067 mm the displacement at point 4 of the group which fixed with the anterior plate and lag screw is 0.562±0.133 mm,the displacement at point 5 of the group which fixed with anterior and posterior columns locking plate is 0.275±0.038 mm,the displacement at point 5 of the group which fixed with the anterior plate and lag screw is 0.308±0.078 mm,the displacement at point 6 of the group which fixed with anterior and posterior columns locking plate is 0.371±0.070 mm,the displacement at point 6 of the group which fixed with the anterior plate and lag screw is 0.403±0.070 mm.When 1500 N loads,the displacement at point 1 of the group which fixed with anterior and posterior columns locking plate is 0.649±0.150 mm,the displacement at point 1 of the group which fixed with the anterior plate and lag screw is 0.735±0.053 mm,the displacement at point 2 of the group which fixed with anterior and posterior columns locking plate is 0.436±0.060 mm,the displacement at point 2 of the group which fixed with the anterior plate and lag screw is 0.445±0.035 mm,the displacement at point 3 of the group which fixed with anterior and posterior columns locking plate is 0.551±0.090 mm,the displacement at point 3 of the group which fixed with the anterior plate and lag screw is 0.668±0.049 mm,the displacement at point 4 of the group which fixed with anterior and posterior columns locking plate is 0.664±0.066 mm.the displacement at point 4 of the group which fixed with the anterior plate and lag screw is 0.704±0.133 mm,the displacement at point 5 of the group which fixed with anterior and posterior columns locking plate is 0.372±0.046 mm,the displacement at point 5 of the group which fixed with the anterior plate and lag screw is 0.457±0.083 mm,the displacement at point 6 of the group which fixed with anterior and posterior columns locking plate is 0.471±0.078 mm,the displacement at point 6 of the group which fixed with the anterior plate and lag screw is 0.508±0.083 mm.there was no statistically significant difference,which can be seen as two fixation methods can provide good fixed and no significant difference in the T-shaped acetabular fractures,and the two fixation during pressurization displacement are small,it can meet the requirements of clinical applications.ConclusionTreatment of displaced acetabular fractures locking plate in anterior and posterior column or locking plate fixing the anterior column with lag screw can achieve the requirements of fractures,fracture fixation strong.Through a single ilioinguinal use locking plates with lag screw for the treatment of acetabular fractures,is stability and reliable,and can reduce surgery time,reduce operation costs,an advantage compared to anterior and posterior combined approach,It is worthy of clinical application. |
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