| 刘继伟,宝泉,刘敏毅,等.双环稳定理论指导旋前-外旋Ⅳ度踝关节骨折治疗的生物力学研究.骨科,2024,15(3): 243-247. |
| 双环稳定理论指导旋前-外旋Ⅳ度踝关节骨折治疗的生物力学研究 |
| Biomechanical Study of Double Ring Stability Theory Guides the Treatment of Ⅳ Degree Pronation-external Rotation Ankle Fracture |
| 投稿时间：2024-03-26 |
| DOI：10.3969/j.issn.1674-8573.2024.03.009 |
| 中文关键词: 踝关节 下胫腓联合 环理论 双环 水平环 |
| 英文关键词: Ankle joint Lower tibiofibular joint Ring theory Double ring Horizontal plane ring |
| 基金项目:内蒙古自治区自然科学基金项目（2020LH08003）；内蒙古自治区高等学校科学研究项目（NJZY21078） |
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| 中文摘要: |
| 目的 应用生物力学方法，验证“双环稳定理论”对旋前-外旋Ⅳ度踝关节骨折治疗的指导意义。方法 6例冰鲜尸体标本，制作旋前-外旋Ⅳ度踝关节骨折模型，为控制变量模型仅行前踝截骨（下胫腓前韧带完整），后踝截骨（下胫腓后韧带完整），骨间韧带切断至踝上10 cm。分别在完整组（工况1）、模型组（工况2）、单固定后踝（工况3）、单固定前踝（工况4）、下胫腓螺钉固定（工况5）五种工况下，对标本轴向加载600 N并外旋20°，固定踝关节后行CT平扫获取参数，测量并计算下胫腓联合间隙宽度、胫腓骨前后缘距离差和下胫腓联合面积比。结果 6组标本工况2的下胫腓联合间隙宽度值均显著高于其余工况，差异具有统计学意义（P＜0.05）；除工况2外，其余工况下胫腓联合间隙宽度值差异无统计学意义（P＞0.05）。6组标本工况2的胫腓骨前后缘距离差绝对值均大于2 mm，发生率远大于其余工况，差异有统计学意义（P＜0.05）；其余工况均小于2 mm，两两之间差异无统计学意义（P＞0.05）。6组标本工况2与工况1的下胫腓联合面积比≥1.56发生率为100%，大于工况3~5与工况1的发生率（0），差异具有统计学意义（P＜0.05）；工况3~5与工况1的下胫腓联合面积比≥1.56的发生率组间比较，差异无统计学意义（P＞0.05）。结论 对于旋前-外旋Ⅳ度踝关节骨折的治疗，“双环稳定理论”具有指导意义。 |
| 英文摘要: |
| Objective To verify the guiding significance of ‘double ring stability theory’ in the treatment of Ⅳ degree pronation-external rotation ankle fracture by biomechanical methods. Methods The experimental model of ankle fracture with Ⅳ degrees of pronation-external rotation was established using 6 fresh cadaver specimens. In order to control the variables, the anterior ankle osteotomy (intact anterior inferior tibiofibular ligament), posterior ankle osteotomy (intact posterior inferior tibiofibular ligament), and resection of the interosseous tibiofibular ligament 10 cm above the ankle were done. In the complete group (working condition 1), the model group (working condition 2), the single fixed posterior ankle (working condition 3), the single fixed anterior ankle (working condition 4), and the lower tibiofibular screw fixation (working condition 5), the specimens were axially loaded 600 N, outward rotated 20°, and the parameters were obtained by CT plain scan after the ankle joint was fixed. The width of the lower tibiofibular joint space, the absolute difference of the distance between the anterior and posterior edges of the tibiofibular joint and the ratio of the lower tibiofibular joint area were measured. Results In the 6 groups of specimens, the width of the lower tibiofibular joint space in working condition 2 was significantly greater than the other working conditions (P＜0.05); the difference was not significant except working condition 2 (P＞0.05). The absolute difference of the distance between the anterior and posterior edges of the tibiofibular joint of working condition 2 was greater than 2 mm, and the incidence was significantly greater than the other working conditions (P＜0.05); that of other working conditions was less than 2 mm, and the difference between the samples was not statistically significant (P＞0.05). The ratio of the lower tibiofibular joint greater than 1.56 times between working condition 2 and working condition 1 was 100%, greater than 0 in working conditions 3-5 to working condition 1, and the difference was statistically significant (P＜0.05); the incidence of working condition 3-5 to working condition 1 was not statistically significant (P＞0.05). Conclusion The ‘double ring stability theory’ is of guiding significance for the treatment of Ⅳ degree pronation-external rotation ankle fracture. |
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