可降解植入物在骨折固定中的应用  

Application of degradable implants in fracture fixation

作　　者：李俊伟[1,2] 都承斐[1,2] 尉迟晨曦 张春秋[1,2] Li Junwei;Du Chengfei;Yuchi Chenxi;Zhang Chunqiu(Tianjin Key Laboratory for Advanced Mechatronic System Design and Intelligent Control,School of Mechanical Engineering,Tianjin University of Technology,Tianjin 300384,China;National Demonstration Center for Experimental Mechanical and Electrical Engineering Education,Tianjin University of Technology,Tianjin 300384,China)

机构地区：[1]天津理工大学,天津市先进机电系统设计与智能控制重点实验室,天津市300384 [2]天津理工大学,机电工程国家级实验教学示范中心,天津市300384

出　　处：《中国组织工程研究》2018年第34期5526-5533,共8页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金项目(11432016,11602172)。

摘　　要：背景:可降解植入物具有良好的生物相容性和骨传导性,被逐渐应用于颅面重建、前交叉韧带的重建、半月板修复、踝关节骨折治疗、胫骨腓骨骨折等手术治疗中。目的:通过对比可降解植入物与非降解植入物在骨科骨折中的应用,总结可降解植入物的优缺点,并提出自己的见解。方法:以"可降解螺钉,可降解板,骨科,骨折;biodegradable screws,biodegradable plates,orthopedics,fractures"为关键词,检索CNKI数据库、万方数据库及Web of sciences数据库1960至2017年发表的相关文献,收集有关可降解植入物在骨科应用的文献,最终选取65篇文献。结果与结论:无论采用镁合金还是聚乳酸类植入物进行骨科骨折治疗,均表现出了良好的治疗效果。然而,可降解植入物自身存在一些不足:可降解螺钉的降解速率过快,将导致初始强度的快速丧失,如何控制可降解螺钉的降解速率与骨生长速率相匹配等,仍然是一个亟待解决的问题。因此在今后的研究中,需要重点研究如何减缓降解速率、增强抗磨抗腐蚀性,以及开发无毒性、含多营养元素的可降解植入物。BACKGROUND:Degradable implants have good biocompatibility and bone conductivity,which have been gradually applied in surgical craniofacial reconstruction,anterior cruciate ligament reconstruction,meniscus repair,ankle joint fracture treatment,tibia and fibula fracture treatment.OBJECTIVE:To summarize advantages and disadvantages of degradable implants and put forward our own opinions by comparing degradable and non-degradable implants in orthopedic fractures.METHODS:CNKI,WanFang and Web of Science databases were retrieved for relevant articles on the application of biodegradable implants in orthopedics published from 1960 to 2017.The keywords were“biodegradable screw,biodegradable plate,orthopedics,fractures”in Chinese and English,respectively.Finally,65 eligible articles were included in result analysis.RESULTS AND CONCLUSION:Both magnesium alloy and polylactic acid implants have good therapeutic effects in the treatment of orthopedic fractures.However,degradable implants have their own drawbacks.Too fast degradation of the screws will lead to the rapid loss of initial strength.How to control the degradation rate of degradable screws to match the bone growth rate is still an urgent problem to be solved.Therefore,future investigations on how to slow down the degradation rate,enhance anti-wear resistance and develop degradable implants with non-toxicity and carrying multi nutrient elements are warranted.

关 键 词：可降解植入物 可降解板 可降解螺钉 骨折 骨科 可吸收性植入物 骨折 组织工程 

分 类 号：R318[医药卫生—生物医学工程]