聚左旋乳酸微型接骨板行下颌骨骨折内固定的效果评价  

Evaluation in effects of poly(L-lactide) miniplates for internal fixation of mandibular fracture

作　　者：刘海鹏[1] 赵自然[1] 李蜀凤[1] 荣莉[1] 兰珊珊[1] 刘杨[1] 景遐斌[2] 张舵[1] 

机构地区：[1]吉林大学第一医院整形外科,吉林长春130021 [2]中国科学院长春应用化学研究所高分子实验室,吉林长春130022

出　　处：《吉林大学学报（医学版）》2009年第3期406-409,F0002,共5页Journal of Jilin University：Medicine Edition

基　　金：国家自然科学基金资助课题(30670563);吉林省科技厅科研基金资助课题(20030423-01)

摘　　要：目的:观察国产新型聚左旋乳酸(PLLA)微型接骨板行下颌骨骨折内固定的效果。方法:将12只犬随机分为1、3、6和12月组,每组3只,建立犬双侧下颌骨骨折的实验动物模型,实验侧采用PLLA微型接骨板螺钉固定,对照侧用金属钛板固定。在术后1、3、6、12月分别处死动物,通过大体及X线片观察局部骨折愈合情况及骨折处组织病理学改变。结果:所有实验用家犬在术后全部成活,未见骨折移位、接骨板外露等情况;大体观察:术后1月组实验侧和对照侧可见骨折缝隙,有部分外骨痂,两侧差别不明显;术后3月组,两侧骨折处均骨性愈合,骨折固定无移位;术后6月组,两侧骨折处完全骨性愈合;术后12月组,两侧骨折处难于辨别骨折线。X线片观察:术后1月组,两侧均可见清晰骨折线和钉孔;术后3月组,骨折线变模糊,但仍可辨认;术后6月组,实验侧骨折线难于辨认,对照侧骨折线消失;术后12月组,两侧骨折线均消失。组织病理学观察:术后1月组,双侧骨折断端均可见大量胶原纤维,少量新生骨小梁,对照侧骨小梁多于实验侧;术后3月组,两侧均可见大量新生骨小梁,但实验侧多于对照侧;术后6月组,骨小梁改建完全,两侧均接近正常骨组织;术后12月组,两侧均与正常骨组织无异。结论:该国产新型PLLA接骨板在下颌骨骨折固定中的固定效果可靠,PLLA接骨板能够维持骨断端的稳定性,能够完成下颌骨骨折的愈合过程。Objective To investigate the internal fixation effects of poly （L-lactide） （PLLA） miniplates on the mandibular fracture in dogs. Methods A total of 12 dogs were involved in the study. After mandibular fracture models were created on both sides, one side of the mandibular was fixed with PLLA miniplates and the other side was fixed with titanium plates as control. The dogs were sacrificed separately at 1, 3, 6, 12 months after operation, three animals at each time. Gross observation, radiography and histopathological examination were performed. Results All of the dogs were alive and fracture fixation of both sides was excellent after the operation. Gross observation： in 1 month group, the fracture line and some bony callus could be seen on both sides; in 3 months group, both sides had become into bone union; in 6 months group, both sides had become into bone union completely; in 12 months group, the fracture lines on both sides were difficult to be seen. Radiography examination： in 1 month group, the fracture lines and the screw holes could be seen on both sides; in 3 months group, the fracture lines turned ambiguity; in 6 months group, the line on the experimental side was difficult to be seen but the line on the control side disappeared; in 12 months group, the fracture lines on both sides disappeared. Histopathology examination： in 1 month group, there were lots of collagen fibers and a little bone trabecula on both sides; in 3 months group, the trabecula on the experimental side were much more than the other side; in 6 months group, the bone trabecula on both sides looked like the normal bone tissue; in 12 months group, the bone trabecula became into nomat tissue. Conclusion The effect of PLLA miniplates for internal fixation of mandibular fracture is safety, the PLLA miniplate can maintain the stability of the bone fracture during the healing process.

关 键 词：聚左旋乳酸 可降解微型接骨板 骨折内固定 

分 类 号：R782.4[医药卫生—口腔医学] R-332[医药卫生—临床医学]