聚乳酸-乙醇酸共聚物/羟基磷灰石可吸收空心螺钉治疗犬股骨外髁骨折的实验研究  

EXPERIMENTAL STUDY ON TREATMENT OF LATERAL FEMORAL CONDYLE FRACTURE WITH POLYLACTIC-CO-GLYCOLIC ACIDHYDROXYAPATITE ABSORBABLE CANNULATED SCREWS IN CANINE

作　　者：郑果[1] 刘东[2] 唐新[1] 李棋[1] 李箭[1] 李庆[3] 肖建平[3] 

机构地区：[1]四川大学华西医院骨科成都,610041 [2]遂宁市中心医院骨科 [3]中国科学院成都有机化学有限公司

出　　处：《中国修复重建外科杂志》2013年第6期680-685,共6页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：中国科学院成都有机化学有限公司与四川大学合作项目(11H1091)~~

摘　　要：目的探讨聚乳酸-乙醇酸共聚物/羟基磷灰石(polylactic-co-glycolic acid/hydroxyapatite,PLGA/HA)可吸收空心螺钉治疗犬股骨外髁骨折的内固定效果、体内降解过程及生物相容性,为其进一步改进和临床应用提供参考。方法成年雄性比格犬16只,体重9～12 kg,制备双侧股骨外髁骨折(AO分型为B1型)模型。左侧采用PLGA/HA可吸收空心螺钉固定,作为实验组;右侧采用金属螺钉固定,作为对照组。术后观察实验动物一般情况,于2、4、8、12周分别处死4只动物,大体观察并摄X线片观察骨折愈合情况,测量骨密度;取骨折端及螺钉周围组织行组织学观察;检测可吸收空心螺钉降解性能。结果所有实验动物均存活至实验完成。大体观察两组骨折无移位,均于12周时愈合;12周内实验组可吸收空心螺钉形状完整,无松动、移位及断裂。X线片示,实验组可吸收空心螺钉不显影,对照组可见金属螺钉X线显影;随时间延长,两组骨折均逐渐愈合。两组骨折部位骨密度均于8周时达峰值,但各时间点两组比较以及组内比较,差异均无统计学意义(P>0.05)。组织学观察示术后各时间点两组骨折愈合进程相似,实验组可吸收空心螺钉周围未见明显炎性反应。可吸收空心螺钉降解性能检测示,特性黏度及分子量分布术后2周内明显下降;数均分子量和重均分子量术后4周内显著下降;最大剪切力于术后8周内下降不明显,之后显著下降。各指标不同时间点间比较,差异均有统计学意义(P<0.05)。结论 PLGA/HA可吸收空心螺钉固定犬股骨外髁骨折后,骨折愈合进程与金属螺钉相似,且具有良好的生物相容性。植入8周内最大剪切力无明显下降,保证了骨折的充分愈合。Objective To evaluate the internal fixation effect,degradation,and biocompatibility of polylactic-co-glycolic acid/hydroxyapatite（PLGA/HA） absorbable cannulated screws in treatment of lateral femoral condyle fracture of canine so as to provide the theory basis for their further improvement and clinical application.Methods Sixteen adult male Beagles（weighing,9-12 kg） were selected to prepare the models of bilateral lateral femoral condyle fracture;left fracture was fixed with PLGA/HA absorbable cannulated screws as experimental group and right fracture with metal screws as control group.At 2,4,8,and 12 weeks after operation,general observation was done and X-ray films were taken for observing fracture healing;bone mineral density was measured;the histological examination was performed;and the degradation property of absorbable cannulated screws was detected.Results All animals survived to the end of the experiment.General observations showed that no fracture displacement occurred and fracture healed at 12 weeks in 2 groups;no breakage,displacement,or loosening of screws was observed in experimental group.X-ray films results showed that the absorbable cannulated screws could not be found out by X-ray in experimental group,but metal screws could be found out in control group;fracture healed with time in 2 groups.The bone mineral density reached the peak at 8 weeks in 2 groups,and no significant difference was found between 2 groups and among different time points in the same group（P 0.05）.Histological examination showed that 2 groups had similar fracture healing process at different time points;no obvious inflammatory reaction was found around absorbable cannulated screws in experimental group.The degradation results of absorbable cannulated screws showed that the intrinsic viscosity and molecular weight distribution obviously decreased at 2 weeks;the number average molecular weight and the weight average molecular weight markedly decreased at 4 weeks;and the maximum shear force did not decrease obviousl

关 键 词：聚乳酸-乙醇酸共聚物 羟基磷灰石 可吸收空心螺钉 股骨外髁骨折 内固定 生物降解 犬 

分 类 号：R687.3[医药卫生—骨科学]