虽然张力带布线(TBW)是流行的,并由AO组推荐,皮肤刺激和K线迁移等并发症发生率高,不容忽视。丁氏螺旋张力带接线(DSTBW)是一种新的TBW技术,在其他骨折类型的治疗中显示出积极的效果。本研究的目的是通过生物力学测试评估DSTBW在尺骨鹰嘴骨折治疗中的稳定性。我们通过使用三种固定方法进行了Synbone生物力学模型:DSTBW,髓内螺钉和张力带接线(IM-TBW),和K线TBW,模拟修复鹰嘴骨折。我们比较了DSTBW的机械稳定性,IM-TBW,和TBW在MayoIIA型鹰嘴骨折Synbone模型中使用单循环加载至失效方案或拔出力。在生物力学测试期间,在三个不同的组中,在不同的屈曲角度下记录平均骨折间隙测量值:TBW,IM-TBW,还有DSTBW.TBW组的测量值为0.982mm,0.380mm,0.613mm,和1.285mm的弯曲角度为0°,30°,60°,分别为90°。IM-TBW组显示平均断裂间隙测量值0.953mm,0.366mm,0.588mm,和1.240mm在每个相应的弯曲角度。DSTBW组显示平均骨折间隙测量值为0.933mm,0.358mm,0.543mm,和1.106毫米在相同的弯曲角度。在循环加载阶段,每组中没有试样失效。与IM-TBW和TBW组相比,DSTBW组在60°和90°屈曲角度上存在显著差异。DSTBW组的平均最大破坏载荷为1229.1±110.0N,IM-TBW组中的990.3±40.7N,TBW组为833.1±68.7N。各组之间存在显著差异(p<0.001)。测得TBW的平均最大拉拔强度为57.6±5.1N,480.3±39.5N对于IM-TBW,DSTBW为1324.0±43.8N。两种方法的最大拉拔强度之间的差异显著为p<0.0001。对于鹰嘴骨折,DSTBW固定比IM-TBW和TBW固定模型提供了更高的稳定性。
Although tension band wiring (TBW) is popular and recommended by the AO group, the high rate of complications such as skin irritation and migration of the K-wires cannot be ignored. Ding\'s screw tension band wiring (DSTBW) is a new TBW technique that has shown positive results in the treatment of other fracture types. The objective of this study was to evaluate the stability of DSTBW in the treatment of olecranon fractures by biomechanical testing. We conducted a Synbone biomechanical model by using three fixation methods: DSTBW, intramedullary screw and tension band wiring (IM-TBW), and K-wire TBW, were simulated to fix the olecranon fractures. We compared the mechanical stability of DSTBW, IM-TBW, and TBW in the Mayo Type IIA olecranon fracture Synbone model using a single cycle loading to failure protocol or pullout force. During biomechanical testing, the average fracture gap measurements were recorded at varying flexion angles in three different groups: TBW, IM-TBW, and DSTBW. The TBW group exhibited measurements of 0.982 mm, 0.380 mm, 0.613 mm, and 1.285 mm at flexion angles of 0°, 30°, 60°, and 90° respectively. The IM-TBW group displayed average fracture gap measurements of 0.953 mm, 0.366 mm, 0.588 mm, and 1.240 mm at each of the corresponding flexion angles. The DSTBW group showed average fracture gap measurements of 0.933 mm, 0.358 mm, 0.543 mm, and 1.106 mm at the same flexion angles. No specimen failed in each group during the cyclic loading phase. Compared with the IM-TBW and TBW groups, the DSTBW group showed significant differences in 60° and 90° flexion angles. The mean maximum failure load was 1229.1 ± 110.0 N in the DSTBW group, 990.3 ± 40.7 N in the IM-TBW group, and 833.1 ± 68.7 N in the TBW group. There was significant difference between each groups (p < 0.001).The average maximum pullout strength for TBW was measured at 57.6 ± 5.1 N, 480.3 ± 39.5 N for IM-TBW, and 1324.0 ± 43.8 N for DSTBW. The difference between maximum pullout strength of both methods was significant to p < 0.0001. DSTBW fixation provides more stability than IM-TBW and TBW fixation models for olecranon fractures.