锁定钢板现状：优点、缺点、失败之处.docVIP

The Current Status of Locked Plating: The Good,the Bad, and the Ugly锁定钢板现状：优点、缺点、失败之处Abstract: Locked plate technology has evolved in an effort to overcome the limitations associated with conventional plating methods, primarily for improving ?xation in osteopenic bone. The development of screw torque and plate-bone interface friction is unnecessary with locked plate designs, signi?cantly decreasing the amount of soft tissue dissection required for implantation, preserving the periosteal blood supply, and facilitating the useof minimally invasive percutaneous bridging ?xation techniques. The locked plate is a ?xed-angle device because angular motion does not occur at the plate screw interface. The use of locked plate technology allows the orthopaedic surgeon to manage fractures with indirect reduction techniques while providing stable fracture ?xation. The secure‘feel’ of locked plates, ease of application, and the low incidence of complications noted in early clinical reports have contributed to the proliferation of this technology. Along with reports of clinical successes, as the use of ?xed angle/locked plates has increased, clinical failures are being noticed. This review will focus on the biomechanics of locked plate technology, appropriate indications for its use, laboratory and clinical comparisons to conventional plating techniques, and potential mechanisms of locked plate failure that have been observed.摘要：锁定钢板技术致力于克服传统钢板固定方法的局限性，并主要用于提高骨质减少的骨头的固定效果。锁定钢板的设计无需顾及螺钉扭矩和钢板与骨接触面的摩擦力，显著减少为了内固定植入所需的软组织剥离，保护了骨膜的血运，而且更有利于微创经皮桥接固定技术的使用。由于螺钉与钢板的接触面无法发生角度运动，锁定钢板是一种固定角度装置。锁定钢板技术的运用使得骨科医生可以对骨折进行间接复位并达到稳定的固定。由于早期临床报道认为锁定钢板安全、容易使用、并发症低，此项技术得以迅速推广。当固定角度（锁定）钢板使用的不断增加，伴随着临床成功报道的是临床失败逐渐被重视。本篇综述将着重于锁定钢板技术的生物力学、使用的恰当指征、与传统钢板固定技术的实验室和临床比较、以及已被发现的失败潜在机制。[/color]Key Words: locked plate, failure, complications(J Orthop Trauma 2008;22:479关键词：锁定钢板，失败，并发症(创伤骨科杂志 2008;22:479–486)[/color]INTRODUCTION前言：For the past 50 years, the general principles of fracture ?xation have been deve