摘要

BACKGROUND:Articulated external fixation has been proposed as a method to protect ligament reconstructions while allowing aggressive and early postoperative rehabilitation after knee dislocation. However, the ability of these fixators to protect and stabilize the knee joint has not been clearly determined.
HYPOTHESIS:Articulated external fixation can reduce anteroposterior translation in the cruciate-deficient knee and reduce cruciate ligament strain in cases of intact or reconstructed ligaments.
STUDY DESIGN:Controlled laboratory study.
METHODS:Knee stability was assessed by 3 standard clinical stability tests (Lachman, anterior drawer, and posterior drawer) on 7 human cadaveric lower extremities. Instrumented forces of 100 N were applied to the tibia to measure cruciate ligament forces and tibiofemoral displacement in intact and cruciate-deficient specimens with and without articulated external fixation to determine the degree to which a fixator can protect cruciate ligaments and stabilize the knee. Articulated external fixation was applied using monolateral and bilateral fixators to comparatively analyze the effectiveness of each construct. Statistical analysis was performed using 2-tailed, paired Student t tests.
RESULTS:Application of the monolateral articulated external fixator to specimens with intact ligaments significantly reduced cruciate ligament forces by 1.0 N (P = .011), 1.7 N (P = .046), and 1.4 N (P = .009) for Lachman, anterior drawer, and posterior drawer tests, respectively. In the cruciate ligament-deficient knees, the application of a monolateral fixator significantly reduced tibiofemoral translation by 49%, 70%, and 46% for Lachman, anterior drawer, and posterior drawer tests, respectively. No significant differences between the monolateral and bilateral fixator frames, in terms of ligament protection and joint stabilization, were observed.
CONCLUSION AND CLINICAL RELEVANCE:Articulated external fixation of the knee can reduce stress in the cruciate ligaments after multiligament reconstructions and can decrease anteroposterior translation in the cruciate-deficient knee.

译文

背景: 关节外固定已被提出作为一种保护韧带重建的方法,同时允许膝关节脱位后积极和早期的术后康复。然而,这些固定器保护和稳定膝关节的能力尚未明确确定。
假设: 关节外固定可以减少交叉不足的膝关节的前后平移,并在韧带完整或重建的情况下减少交叉韧带拉伤。
研究设计: 对照实验室研究。
方法: 通过 3 项标准临床稳定性试验 (Lachman 、前抽屉和后抽屉) 对 7 具尸体下肢进行膝关节稳定性评估。对胫骨施加 100 N 的仪器力,以测量完整和交叉缺陷标本中的交叉韧带力和胫骨移位,有无关节外固定,以确定固定器可以达到的程度保护交叉韧带,稳定膝盖。使用单侧和双侧固定器进行关节外固定,比较分析每种结构的有效性。采用双尾配对学生 t 检验进行统计分析。
结果: 对韧带完整的标本应用单外侧关节外固定器可显著降低交叉韧带力 1.0 N (P = 011),1.7 N (P =。 046),而 1.4 N (P =。 009) 分别用于 Lachman 、前抽屉和后抽屉测试。在交叉韧带缺乏的膝盖中,对于 Lachman 、前抽屉和后抽屉测试,单外侧固定器的应用分别显著减少了 49% 、 70% 和 46% 的胫股翻译。在韧带保护和关节稳定方面,未观察到单侧和双侧固定架之间的显著差异。
结论和临床相关性: 关节型膝关节外固定可以减少多韧带重建后交叉韧带的应力,并可以减少交叉韧带缺陷膝关节的前后平移。

External fixation

骨科 骨折治疗 临床研究术语
概述  :  

与定义骨折是一种十分常见的疾病损伤,在急诊接诊患者中,约1/5的患者是此种损伤,而前臂骨折患者占75%。发病人群主要集中在儿童和老年人中。目前普遍认为除极少数情况外,四肢骨折患者很少发生关节的远期功能障碍,但还是会有一些并发症。老年人活动强度和运动量相对较小,发生骨折损伤时所承受的暴力相对较小,因此骨折端会出现粉碎、嵌插的情况,骨质比较松脆,临床中多数病例选择手法复位外固定的方式进行治疗。 临床治疗老年人四肢远端骨折手法整复后,给予患者小夹板或石膏外固定治疗属于一种弹性固定治疗方式

External 英 /ɪkˈstɜːnl/  美 /ekˈstərnəl; ɪkˈstərnəl/               

释义   adj. 外部的;表面的;[药] 外用的;外国的;外面的

n. 外部;外观;外面 

例句   You can be our external consultant when we need it. 如果我们需要,你可以做我们的外部顾问。

 

fixation 英 /fɪkˈseɪʃn/  美 /fɪkˈseɪʃn/              

释义   n. 异常依恋,固恋,痴迷;癖

n. 固定;定位;定影 

例句   the ideal choice of internal fixation devices should combine mechanics offixture well with skeletal biomechanics, and the balance of mechanics should be in the course of fracture healing.   理想的内固定器材,应当是其力学性能与骨骼的生物力学之间的良好结合,这种力学的平衡应当维持整个骨折愈合的全过程。


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