背景:传统张力带接线(TBW)中克氏针(K线)的位移和旋转导致术后并发症率高。抗旋转张力带布线(ARTBW)可以解决这些问题,并取得满意的临床效果。本研究旨在通过有限元分析(FEA)和力学测试,研究ARTBW与传统TBW相比治疗横向髌骨骨折的生物力学性能。
方法:我们进行了FEA,以评估传统TBW和ARTBW在膝关节屈曲角度为20°时的生物力学性能,45°,90°。此外,我们通过静态拉伸试验和动态疲劳试验比较了45°屈膝下的力学性能。还进行了K线拔出测试,以评估两种手术方法的K线与松质骨之间的结合强度。
结果:FEA的结果表明,ARTBW关节面上的压缩力为28.11%,27.32%,膝关节屈曲角度为20°时,比传统TBW高52.86%,45°,90°,分别。在机械测试中,ARTBW的力学性能与传统TBW相似。在K线拔出试验中,ARTBW的拔出强度明显大于传统TBW(111.58±2.38Nvs.64.71±4.22N,P<0.001)。
结论:ARTBW保留了传统TBW的优势,并获得了更大的关节面压缩力,和更大的拉拔强度的K线。此外,ARTBW有效地避免了K线的旋转。因此,ARTBW显示出治疗髌骨骨折的潜力。
BACKGROUND: The displacement and rotation of the Kirschner wire (K-wire) in the traditional tension band wiring (TBW) led to a high rate of postoperative complications. The anti-rotation tension band wiring (ARTBW) could address these issues and achieve satisfactory clinical outcomes. This study aimed to investigate the biomechanical performance of the ARTBW in treating transverse patellar fracture compared to traditional TBW using finite element analysis (
FEA) and mechanical testing.
METHODS: We conducted a
FEA to evaluate the biomechanical performance of traditional TBW and ARTBW at knee flexion angles of 20°, 45°, and 90°. Furthermore, we compared the mechanical properties under a 45° knee flexion through static tensile tests and dynamic fatigue testing. The K-wire pull-out test was also conducted to evaluate the bonding strength between K-wires and cancellous bone of two surgical approaches.
RESULTS: The outcome of
FEA demonstrated the compression force on the articular surface of ARTBW was 28.11%, 27.32%, and 52.86% higher than traditional TBW at knee flexion angles of 20°, 45°, and 90°, respectively. In mechanical testing, the mechanical properties of ARTBW were similar to the traditional TBW. In the K-wire pull-out test, the pull-out strength of ARTBW was significantly greater than the traditional TBW (111.58 ± 2.38 N vs. 64.71 ± 4.22 N, P < 0.001).
CONCLUSIONS: The ARTBW retained the advantages of traditional TBW, and achieved greater compression force of articular surface, and greater pull-out strength of K-wires. Moreover, ARTBW effectively avoided the rotation of the K-wires. Therefore, ARTBW demonstrates potential as a promising technique for treating patellar fractures.