通讯作者: 王国强

DOI：10.12201/bmr.202610.00012

Advances in Biomechanical Research on Internal Fixation for Distal Radius Fractures

• 摘要：桡骨远端骨折是临床常见的腕部骨折,内固定的主要目标是在维持关节面复位和桡骨高度的同时,控制关键骨块移位并减少软组织并发症。本文围绕骨折形态、固定构型、力学响应和临床转化,对人工骨、尸体试验、有限元研究及代表性临床证据进行归纳。掌侧锁定钢板靠固定角结构来支撑远端骨块,临床应用较多。背侧钢板适合于背侧骨块或者背侧塌陷严重的病例。经皮克氏针创伤小,可用于复位后稳定、骨块相对完整且能够配合外部制动的病例。当单一构型不能控制关键骨块,或骨折存在多方向失稳时,可考虑联合或辅助固定。不同模型的刚度、位移和失效载荷不可直接横向比较,实验优势并不同于临床效果。内固定的选择应该以主要失稳方向和关键骨块控制为基础,并结合软组织安全及术后负荷管理。

  关键词： 桡骨远端骨折; 内固定; 生物力学; 有限元分析; 综述

   

  Abstract: Distal radius fracture is a common wrist fracture in clinical practice. The primary goals of internal fixation are to control the displacement of key fracture fragments and reduce soft-tissue complications while maintaining articular surface reduction and radial height. This review summarizes studies involving synthetic bone models, cadaveric experiments, finite element analyses, and representative clinical evidence, with a focus on fracture morphology, fixation constructs, mechanical responses, and clinical translation. Volar locking plates support distal fracture fragments through fixed-angle constructs and are widely used in clinical practice. Dorsal plates are suitable for fractures involving dorsal fragments or severe dorsal collapse. Percutaneous Kirschner-wire fixation is minimally invasive and may be used in patients with stable reduction, relatively intact fracture fragments, and the ability to comply with external immobilization. Combined or supplementary fixation may be considered when a single fixation construct cannot adequately control key fracture fragments or when multidirectional instability is present. Stiffness, displacement, and failure load obtained from different experimental models cannot be directly compared, and biomechanical advantages observed in experimental settings do not necessarily translate into superior clinical outcomes. The selection of internal fixation should be based on the predominant direction of instability and the need to control key fracture fragments, while also considering soft-tissue safety and postoperative load management.

  Key words: distal radius fracture; internal fixation; biomechanics; finite element analysis; review

  提交时间：2026-10-08

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
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• 序号	提交日期	编号	操作
  1	2026-09-08	10.12201/bmr.202610.00012V1	下载

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