Abstract：
BACKGROUND: Osteotomies are routinely incorporated in rhinoplasty, however, the influence of mass, velocity, kinetic energy (KE), and momentum (p) of the mallet on fracture patterns has not been studied.
METHODS: An experimental sledge guillotine setup was designed simulating a mallet strike with adjustable height and mass and 2 mm-thick Sawbone blocks. KE and p were calculated using KE = ½ mass × velocity2 and p = mass × velocity formulas. Fracture lengths and angles were measured.
RESULTS: Ten groups with varying mallet masses and drop heights were tested with 10 bones per group. Fracture length positively correlated with KE (R = 0.542, p < 0.001) and p (R = 0.508, p < 0.001). Fracture angle also positively correlated with KE (R = 0.367, p < 0.001) and p (R = 0.329, p < 0.001). In groups with similar KE, osteotomies with higher p (heavier mallet with slower velocity) had greater fracture lengths (29.31 ± 0.68 vs. 27.68 ± 2.12 mm, p = 0.013) but similar fracture angles (p = 0.189). In groups with similar p, osteotomies with higher KE (lighter hammer with faster velocity) had significantly greater fracture lengths (28.28 ± 1.28 vs. 20.45 ± 12.20 mm, p = 0.041) and greater divergent fracture angles (3.13 ± 1.97° vs. 1.40 ± 1.36°, p = 0.031). Regression modeling of the relationship between KE and fracture lengths and angles demonstrated that cubic followed by logarithmic regression models had the best fits.
CONCLUSIONS: Osteotomy fracture patterns positively correlated with the mallet\'s KE more so than its p, suggesting that the mallet\'s velocity has an increased impact effect than its mass. Clinically, a heavier mallet with a lower velocity will likely generate a smaller fracture length and fracture angle, indicating a more controlled and ideal fracture.
METHODS: NA Laryngoscope, 2024.
METHODS: An experimental sledge guillotine setup was designed simulating a mallet strike with adjustable height and mass and 2 mm-thick Sawbone blocks. KE and p were calculated using KE = ½ mass × velocity2 and p = mass × velocity formulas. Fracture lengths and angles were measured.
RESULTS: Ten groups with varying mallet masses and drop heights were tested with 10 bones per group. Fracture length positively correlated with KE (R = 0.542, p < 0.001) and p (R = 0.508, p < 0.001). Fracture angle also positively correlated with KE (R = 0.367, p < 0.001) and p (R = 0.329, p < 0.001). In groups with similar KE, osteotomies with higher p (heavier mallet with slower velocity) had greater fracture lengths (29.31 ± 0.68 vs. 27.68 ± 2.12 mm, p = 0.013) but similar fracture angles (p = 0.189). In groups with similar p, osteotomies with higher KE (lighter hammer with faster velocity) had significantly greater fracture lengths (28.28 ± 1.28 vs. 20.45 ± 12.20 mm, p = 0.041) and greater divergent fracture angles (3.13 ± 1.97° vs. 1.40 ± 1.36°, p = 0.031). Regression modeling of the relationship between KE and fracture lengths and angles demonstrated that cubic followed by logarithmic regression models had the best fits.
CONCLUSIONS: Osteotomy fracture patterns positively correlated with the mallet\'s KE more so than its p, suggesting that the mallet\'s velocity has an increased impact effect than its mass. Clinically, a heavier mallet with a lower velocity will likely generate a smaller fracture length and fracture angle, indicating a more controlled and ideal fracture.
METHODS: NA Laryngoscope, 2024.
摘要：
背景：截骨术通常包含在隆鼻手术中，然而,质量的影响，速度,动能(KE),尚未研究锤击在断裂模式上的动量（p）。
方法：设计了一种实验性的雪橇断头台设置，模拟高度和质量可调的锤击和2mm厚的Sawbone块。KE和p使用KE=1/2质量×速度2和p=质量×速度公式计算。测量断裂长度和角度。
结果：用10块骨头测试了10个具有不同槌块和跌落高度的组。骨折长度与KE（R=0.542，p<0.001）和p（R=0.508，p<0.001）呈正相关。骨折角度也与KE呈正相关(R=0.367,p<0.001)和p(R=0.329,p<0.001)。在具有相似KE的组中，p较高的截骨术（较重的槌，速度较慢）的骨折长度更大（29.31±0.68vs.27.68±2.12mm,p=0.013），但骨折角相似（p=0.189）。在p相似的组中，较高KE（较轻的锤击速度较快）的截骨术的骨折长度明显更长（28.28±1.28vs.20.45±12.20mm,p=0.041)和更大的发散断裂角(3.13±1.97°与1.40±1.36°,p=0.031)。KE与裂缝长度和角度之间关系的回归模型表明，立方和对数回归模型具有最佳拟合。
结论：截骨骨折类型与槌的KE呈正相关，这表明槌的速度比它的质量有更大的影响。临床上,较重且速度较低的槌可能会产生较小的骨折长度和骨折角度，表明骨折更加可控和理想。
方法：NA喉镜，2024.
方法：设计了一种实验性的雪橇断头台设置，模拟高度和质量可调的锤击和2mm厚的Sawbone块。KE和p使用KE=1/2质量×速度2和p=质量×速度公式计算。测量断裂长度和角度。
结果：用10块骨头测试了10个具有不同槌块和跌落高度的组。骨折长度与KE（R=0.542，p<0.001）和p（R=0.508，p<0.001）呈正相关。骨折角度也与KE呈正相关(R=0.367,p<0.001)和p(R=0.329,p<0.001)。在具有相似KE的组中，p较高的截骨术（较重的槌，速度较慢）的骨折长度更大（29.31±0.68vs.27.68±2.12mm,p=0.013），但骨折角相似（p=0.189）。在p相似的组中，较高KE（较轻的锤击速度较快）的截骨术的骨折长度明显更长（28.28±1.28vs.20.45±12.20mm,p=0.041)和更大的发散断裂角(3.13±1.97°与1.40±1.36°,p=0.031)。KE与裂缝长度和角度之间关系的回归模型表明，立方和对数回归模型具有最佳拟合。
结论：截骨骨折类型与槌的KE呈正相关，这表明槌的速度比它的质量有更大的影响。临床上,较重且速度较低的槌可能会产生较小的骨折长度和骨折角度，表明骨折更加可控和理想。
方法：NA喉镜，2024.
