Abstract：
In the treatment of ankle fractures, complications such as wound healing problems following open reduction and internal fixation are a major problem. An innovative alternative to this procedure offers a more minimally invasive nail stabilization. The purpose of this biomechanical study was to clarify whether this method was biomechanically comparable to the established method. First, the stability (range of motion, diastasis) and rotational stiffness of the native upper ankle were evaluated in eight pairs of native geriatric specimens. Subsequently, an unstable ankle fracture was created and fixed with a locking plate or a nail in a pairwise manner. The ankles showed significantly less stability and rotational stiffness properties after nail and plate fixations than the corresponding native ankles (p < 0.001 for all parameters). When comparing the two methods, both showed no differences in their range of motion (p = 0.694) and diastasis (p = 0.166). The nail also presented significantly greater rotational stiffness compared to the plate (p = 0.001). However, both fixations remained behind the native stability and rotational stiffness. Due to the comparable biomechanical properties of the nail and plate fixations, an early weight-bearing following nail fixation should be assessed on a case-by-case basis considering the severity of fractures.
摘要：
在踝关节骨折的治疗中，切开复位和内固定后的伤口愈合问题等并发症是一个主要问题。该程序的创新替代方案提供了更微创的指甲稳定。这项生物力学研究的目的是阐明该方法在生物力学上是否与已建立的方法相当。首先,稳定性(运动范围，在八对天然老年标本中评估了天然上踝的舒张）和旋转刚度。随后，产生了不稳定的踝关节骨折，并用锁定板或钉子成对地固定。指甲和钢板固定后，脚踝的稳定性和旋转刚度特性明显低于相应的天然脚踝（所有参数均为p<0.001）。比较这两种方法时，两者的运动范围(p=0.694)和舒张范围(p=0.166)均无差异.与板相比,钉还呈现显著更大的旋转刚度(p=0.001)。然而,两种固定都保持在天然稳定性和旋转刚度之后。由于钉和板固定的生物力学特性相当，考虑到骨折的严重程度,应逐例评估钉内固定后的早期负重情况.
