锁定加压钢板原理及临床应用

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1、SUMMARY摘要Theprincipleofthelockingcompressionplate(LCP)isrepresentedbythecombinationoftwocompletelydifferentanchoragetechnologiesandtwoopposedprinciplesofosteosynthesisinoneimplantitcombinestheprinciplesofconventionalplateosteosynthesisfordirectanatomicalreductionwiththoseo

2、fbridgingplateosteosynthesis.SincetheLCPcanbeusedasaconventionalplateusingonlydynamiccompression,asapureinternalfixatorusinglockingheadscrews,orasbothcombined,itprovidesthesurgeonwithmultiplevariations.Nevertheless,thesenewpossibilitiesmeanthatpreoperativeplanningandanunde

3、rstandingofthedifferentbiomechanicalprinciplesofosteosynthesisareessentialifgoodclinicaloutcomesaretobeachievedandmaximumbenefitistobeattainedfromtheoptionsofferedbytheLCPsystem.锁定加压钢板为两种完全不同的固定技术的结合，该内植物包含两种相反的接骨术原理，即以直接解剖复位为特点的传统钢板接骨术和桥接钢板接骨术。LCP既可仅当作动力加压钢板使用，亦可通过锁定螺钉而进作

4、为内支架使用，或是上两种方式的联合，这为外科医师提供多种选择。然而，这些新的可能性亦即意味着，若要想获得LCP系统带来的最大价值及好的临床结果，则必须理解不同的生物力学接骨术原理及做好术前准备。ThecurrentarticleprovidesbiomechanicalbackgroundtoandguidelinesfortheuseofLCplatesintheoperativetreatmentoffracturesandalsoreportsexperimentalandclinicalresultsobtainedwithLCP。

5、本文既提供骨折手术治疗时LCP使用的生物力学背景及指南，亦报告应用LCP获得的实验及临床结果。INTRODUCTION引言Sincethefirstinstanceofinternalfixationwithaplate(carriedoutbyHansmanninHamburgin1886(8)andthelaterintegrationofthisprincipleintooperativefracturetreatmentasaresultofLambotte’swork,boththeimplantsusedandtherelate

6、dprinciplesoffracturetreatmenthavebeeninastateofcontinuousdevelopment.自第一例应用钢板内固定治疗（1886年，Hansmann在Hamburg实施）及其后Lambotte将这些整理为骨折手术治疗的原则以来，内植物及骨折治疗的相关原则正持续发展。Whileintheearlyyearsofinternalfixationwithplatesvariousprincipleswerepursuedinparallel,thestandardizationoftheindica

7、tionsforandtechniquesofinternalfixationwithcompressionplatesbytheSwissAssociationfortheStudyofInternalFixation(ASIF)wasoneoftheachievementsofthe1950sthatwerelatertakenfurtherbytheWorkingGrouponMattersConcernedwithInternalFixation(AO).Theobjectofthetechniqueofoperativetreat

8、mentoffractureswithcompressioninternalfixationdescribedinthefirsteditionoftheAOManualofIn