Vegt Paul, Muir Jeffrey M, Block Jon E
Department of Surgery, Albert Schweitzer Hospital, Dordrecht, The Netherlands.
The Jon Block Group, San Francisco, CA, USA.
Med Devices (Auckl). 2014 Dec 12;7:453-61. doi: 10.2147/MDER.S71790. eCollection 2014.
The treatment of osteoporotic long bone fractures is difficult due to diminished bone density and compromised biomechanical integrity. The majority of osteoporotic long bone fractures occur in the metaphyseal region, which poses additional problems for surgical repair due to increased intramedullary volume. Treatment with internal fixation using intramedullary nails or plating is associated with poor clinical outcomes in this patient population. Subsequent fractures and complications such as screw pull-out necessitate additional interventions, prolonging recovery and increasing health care costs. The Photodynamic Bone Stabilization System (PBSS) is a minimally invasive surgical technique that allows clinicians to repair bone fractures using a light-curable polymer contained within an inflatable balloon catheter, offering a new treatment option for osteoporotic long bone fractures. The unique polymer compound and catheter application provides a customizable solution for long bone fractures that produces internal stability while maintaining bone length, rotational alignment, and postsurgical mobility. The PBSS has been utilized in a case series of 41 fractures in 33 patients suffering osteoporotic long bone fractures. The initial results indicate that the use of the light-cured polymeric rod for this patient population provides excellent fixation and stability in compromised bone, with a superior complication profile. This paper describes the clinical uses, procedural details, indications for use, and the initial clinical findings of the PBSS.
由于骨密度降低和生物力学完整性受损，骨质疏松性长骨骨折的治疗具有挑战性。大多数骨质疏松性长骨骨折发生在干骺端区域，由于髓内体积增加，这给手术修复带来了额外的问题。在这类患者中，使用髓内钉或钢板进行内固定治疗的临床效果不佳。后续骨折和诸如螺钉拔出等并发症需要额外的干预措施，延长了康复时间并增加了医疗成本。光动力骨稳定系统（PBSS）是一种微创手术技术，临床医生可以使用包含在可充气球囊导管内的光固化聚合物修复骨折，为骨质疏松性长骨骨折提供了一种新的治疗选择。独特的聚合物化合物和导管应用为长骨骨折提供了一种可定制的解决方案，在保持骨长度、旋转对线和术后活动度的同时产生内部稳定性。PBSS已应用于33例患有骨质疏松性长骨骨折患者的41例骨折病例系列中。初步结果表明，对于这类患者，使用光固化聚合物棒在受损骨中提供了出色的固定和稳定性，并发症情况较好。本文描述了PBSS的临床用途、操作细节、使用指征以及初步临床发现。
