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目的:评价Jefferson骨折复位钢板(Jefferson-fracturereductionplate,JeRP)内固定系统治疗不稳定型Jefferson骨折的应用解剖及其生物力学性能。方法:(1)60例寰椎标本根据JeRP内固定需要测量寰椎侧块后缘顶点到前缘的矢状面距离(LMAPsup)、侧块的最短矢状面长度(LMAPmin)、侧块进钉点与前结节距离(AO)、两侧块进钉点距离(AA’)及前弓最小直径(MD);(2)6例新鲜上颈椎标本,模拟不稳定型Jefferson骨折分型中的前弓双骨折,以JeRP模拟行内固定,并对正常、骨折、内固定3种状态标本的活动度进行检测并前后比较。结果:(1)LMAPsup、LMAPmin、AO、AA’及MD分别为(20.60±1.84)、(19.57±1.55)、(18.68±1.89)、(35.46±2.86)及(4.66±0.65)mm;(2)JeRP固定后上颈椎6向运动范围与正常值差异无统计学意义(P>0.05)。结论:JeRP治疗不稳定型Jefferson骨折具有解剖学可行性和较好的生物力学性能。
Objective: To evaluate the applied anatomy and biomechanical properties of Jefferson-fracture reduction plate (JeRP) internal fixation system in treatment of unstable Jefferson’s fracture. Methods: (1) 60 cases of atlas were measured according to the needs of JeRP internal fixation to measure the sagittal distance (LMAPsup), the shortest length of sagittal plane (LMAPmin) (AO), the distance between the two sides of the nail into the nail point (AA ’) and the minimum diameter of the anterior arch (MD). (2) Six cases of fresh upper cervical spine were used to simulate unstable Jefferson fracture type Of the anterior arch fractures, with JeRP simulation of internal fixation, and normal, fracture, internal fixation of three kinds of state specimens were measured before and after activity and comparison. Results: (1) The values of LMAPsup, LMAPmin, AO, AA ’and MD were (20.60 ± 1.84), (19.57 ± 1.55), (18.68 ± 1.89), (35.46 ± 2.86) and (4.66 ± 0.65) There was no significant difference in the 6-way motion range between the upper cervical spine and the normal cervical spine after JeRP fixation (P> 0.05). Conclusion: JeRP treatment of unstable Jefferson fractures has anatomical feasibility and good biomechanical properties.