|
|
|
| Study of screw pilot channel placement in the locking plates using the safety dril |
| Department of Orthopaedics, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325015 |
|
| Cite this article: |
|
CHEN Chengwei,SHEN Cuihua,ZHAN Chao, et al. Study of screw pilot channel placement in the locking plates using the safety dril[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2015, 45(1): 45-.
|
|
|
|
Abstract Objective: To make use of the safety drill to deal with the placement of the screw pilot in the femoral head through proximal femoral locking plate, test the safety properties of the new safety drill compared with conventional drill. Methods: Twenty femoral heads for hole-drilling research were taken from the femoral neck fracture patients while having the hip arthroplasty in the department of orthopaedic in the 1st affiliated hospital of Wenzhou Medical University. Numbered all these femoral heads, divided them randomly into 2 groups. The N group was carried out drilling test with the new safety drill, while the O group with the traditional drill. All femoral heads were fixed firmly into Fixture in the self-made box in the same manner. Group N was carried out drilling test by new drill. All the participants were asked to perform 4 holes through the prepared pilot apparatus of the locking plate in the same order, starting with new drill clockwisely twice and then anti-clockwisely twice. They were informed to drill as deeply as they could do, but not to penetrate the joint. The drilling depth was recorded in millimeters by depth sounder after all the holes was drilled. Then they were ask to penetrate all the hole and the whole drilling depth were obtained. The difference between the two records was define as TED (tip-to-edge distance) for evaluation. Group O was carried out drilling test with traditional drill. All the participants were asked to perform 4 holes in the same manner as mentioned above. But they were informed to penetrate all the joint and record the perception of dynamics using Visual analog scales (VAS) for evaluation. Results: Ten orthopaedic surgeons took part in the tests, Mean TED for Nc, Na, Oc, Oa were respectively 5.75, 2.95, 6.55 and 3.20 mm. Mean VAS for Nc, Na, Oc, Oa were respectively 5.90, 9.55, 2.85 and 6.75 score. The drill type (factor A) for TED had no significant difference (FA=3.2603, P=0.1263) while the drill direction (factor B) for TED was statistically different (FB=294.1222, P=0.0000). The factor A and factor B for VAS had both statistically significant difference (FA=158.0891, P=0.0000; FB=378.8507, P=0.0000). Conclusion: The safety drill with reverse drilling technique (Na group) offersd a better TED while showing a higher safe threshold for penetration, which means a greater stability between screws and lower incidence of UJP.
|
|
Received: 11 March 2014
|
| |
|
|
|
| [1] 高建清, 杨胜武, 滕红林, 等. 股骨解剖型钢板治疗股骨粗隆下粉碎性骨折[J]. 温州医学院学报, 2008, 38(6): 569-570.
[2] Noordeen MH, Lavy CB, Briggs TW, et al. Unrecognised joint penetration in treatment of femoral neck fractures[J]. JBone Joint Surg Br, 1993, 75(3): 448-449.
[3] 赵鉴非, Fornasier VL. 骨关节病股骨头不同区域的骨密度测量[J]. 中华骨科杂志, 2004, 23(11): 679-681.
[4] 徐丛, 王志强, 徐世田, 等. 不同骨密度人股骨头承重区骨超微结构比较[J]. 中国组织工程研究与临床康复, 2007, 11(2): 286-289.
[5] Konrad G, Bayer J, Hepp P, et al. Open reduction and internal fixation of proximal humeral fractures with use of the locking proximal humerus plate. Surgical technique[J]. J Bone Joint Surg Am, 2010, 92 Suppl 1 Pt 1: 85-95.
[6] Fincham BM, Jaeblon T. The effect of drill bit, pin, and wire tip design on drilling[J]. J Am Acad Orthop Surg, 2011,19(9): 574-579.
[7] Mao Y, Song J, Wei J, et al. Prevention of unrecognized joint penetration during internal fixation of hip fractures: a geometric model based on Steinmetz Solid[J]. Hip Int, 2010,20(4): 547-550.
[8] Kersten P, Küçükdeveci AA, Tennant A. The use of the Visual Analogue Scale (VAS) in rehabilitation outcomes[J]. J Rehabil Med, 2012, 44(7): 609-610. |
|
|
|
