The Biomechanical Analysis and Clinical Trials of Shortened Hook Plate for Unstable Fracture of Distal Clavicle
| Autor: | Chien-Rae Huang, 黃建睿 |
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| Rok vydání: | 2006 |
| Druh dokumentu: | 學位論文 ; thesis |
| Popis: | 94 For unstable distal third fracture of clavicle, conservative treatment usually fails to achieve a good result. It is generally accepted that open reduction and internal fixation is the better method for treating this type of fracture. Clavicular hook plate that provides superior fixation ability due to its specific hook design is the best fixator with little complication at present. The clinical literatures available also prove the efficacy. Nevertheless, shortcomings about this implant includes unadjustable plate length and the operation wound unable to be reduced with the shortened plate were found in our clinical practice. It is our purpose in this study that evaluate the mechanical stability of the different length of hook plates fixed to the saw bones of clavicle to find the shortest hook plate that still provides the adequate stability like that of original length. And on the basis, we use the new length of hook plate shortened by high-speed burr in treating the clinical cases and collect the intra and post-operative data in comparison with the previous cases with original hook plate. In this study we designed 2 mechanical tests includes vertical loading and torsion test to evaluate the bending stiffness and torsion stiffness of these different constructs. The results revealed 3 holes hook plate is inferior to other groups statistically and it must be abandoned. On the other hand, the 4 holes hook plate is as stable as original 6 holes hook plate statistically in whether anti-bending or anti-torsion ability. It is reasonable to make the conclusion that original holes hook plate shortened to 4 holes is the best choice in present product. In clinical trials, we had collected 6 consecutive cases whose classic unstable fracture of distal clavicle were treated with 4 hole hook plate. The follow up period was 1.5 to 4 months. Until now, all has good recovery and no complication developed, the mean operation wound was 3.3 cm. The preliminary results of comparison with those treated with 6 hole hook plate in the past revealed that 4 holes hook plate is not inferior to the others. It is important to collect more cases and increase follow-up period to verify the efficacy of 4 holes hook plate statistically. In conclusion, this study try to find the appropriate length of hook plate available in Taiwan in order to apply it in clinical. The preliminary result is encouraging and it is believed that shortened hook plate is beneficial to patients |
| Databáze: | Networked Digital Library of Theses & Dissertations |
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