[Research progress on biomechanics for internal fixation in tibial plateau fracture].

To review the biomechanical research progress of internal fixation of tibial plateau fracture in recent years and provide a reference for the selection of internal fixation in clinic.The literature related to the biomechanical research of internal fixation of tibial plateau fracture at home and abroad was extensively reviewed, and the biomechanical characteristics of the internal fixation mode and position as well as the biomechanical characteristics of different internal fixators, such as screws, plates, and intramedullary nails were summarized and analyzed.Tibial plateau fracture is one of the common types of knee fractures. The conventional surgical treatment for tibial plateau fracture is open or closed reduction and internal fixation, which requires anatomical reduction and strong fixation. Anatomical reduction can restore the normal shape of the knee joint; strong fixation provides good biomechanical stability, so that the patient can have early functional exercise, restore knee mobility as early as possible, and avoid knee stiffness. Different internal fixators have their own biomechanical strengths and characteristics. The screw fixation has the advantage of being minimally invasive, but the fixation strength is limited, and it is mostly applied to Schatzker typeⅠfracture. For Schatzker Ⅰ-Ⅳ fracture, unilateral plate fixation can be used; for Schatzker Ⅴand Ⅵ fracture, bilateral plates fixation can be used to provide stronger fixation strength and avoid the stress concentration. The intramedullary nails fixation has the advantages of less trauma and less influence on the blood flow of the fracture end, but the fixation strength of the medial and lateral plateau is limited; so it is more suitable for tibial plateau fracture that involves only the metaphysis. Choosing the most appropriate internal fixation according to the patient's condition is still a major difficulty in the surgical treatment of tibial plateau fractures.Each internal fixator has good fixation effect on tibial plateau fracture within the applicable range, and it is an important research direction to improve and innovate the existing internal fixator from various aspects, such as manufacturing process, material, and morphology.对近年来胫骨平台骨折内固定生物力学研究进展进行综述，以期为临床内固定方式选择提供参考。.广泛查阅国内外胫骨平台骨折内固定生物力学研究相关文献，对内固定方式、位置以及螺钉、接骨板、髓内钉等不同内固定物的生物力学特点进行总结分析。.胫骨平台骨折是常见膝关节骨折类型，常规手术方式为切开或者闭合复位内固定，要求解剖复位和坚强固定。解剖复位可恢复膝关节正常形态；坚强固定提供良好的生物力学稳定性，使患者可以早期功能锻炼，尽早恢复膝关节活动度，避免关节僵硬。不同内固定物有其生物力学强度和特性，其中螺钉固定具有微创优势，但是固定强度有限，多应用于Schatzker Ⅰ型骨折。接骨板固定临床应用最广泛，SchatzkerⅠ～Ⅳ型骨折可采用单接骨板固定，Ⅴ、Ⅵ型骨折采用双接骨板固定以提供更大固定强度，避免应力集中。髓内钉固定具有创伤小、对骨折端血运影响小的优势，但是对内、外侧平台固定有限，更适用于单纯累及干骺端的胫骨平台骨折。根据患者骨折程度选择最合适的内固定方式，仍是胫骨平台骨折手术治疗一大难点。.目前临床常用的各种内固定物对适用范围内的胫骨平台骨折均有较好固定效果，从制造工艺、材料、形态等多方面对现有内固定物进行改良和创新是重要研究方向。.