Yu Yi-Hsun, Fan Chin-Lung, Hsu Yung-Heng, Chou Ying-Chao, Ueng Steve W N, Liu Shih-Jung
Department of Orthopedic Surgery, Musculoskeletal Research Center, Chang Gung Memorial Hospital, Tao-Yuan 33305, Taiwan.
Department of Mechanical Engineering, Chang Gung University, Tao-Yuan 33302, Taiwan.
Materials (Basel). 2015 Nov 13;8(11):7714-7722. doi: 10.3390/ma8115415.
Osteosynthesis surgery for rib fractures is controversial and challenging. This study developed a noval poly(ε-caprolactone) (PCL)-based biodegradable "cable-tie" fixator for osteosynthesis surgery for rib fractures. A biodegradable fixator specifically for fractured ribs was designed and fabricated by a micro-injection molding machine in our laboratory. The fixator has three belts that could be passed through matching holes individually. The locking mechanism allows the belt movement to move in only one direction. To examine the biomechanical performance, ribs 3-7 from four fresh New Zealand rabbits were employed. The load to failure and stress-strain curve was compared in the three-point bending test among native ribs, titanium plate-fixed ribs, and PCL fixator-fixed ribs. In the animal study, the sixth ribs of New Zealand rabbits were osteotomized and osteosynthesis surgery was performed using the PCL fixator. Outcomes were assessed by monthly X-ray examinations, a final micro-computed tomography (CT) scan, and histological analysis. The experimental results suggested that the ribs fixed with the PCL fixator were significantly less stiff than those fixed with titanium plates ( < 0.05). All ribs fixed with the PCL fixators exhibited union. The bridging callus was confirmed by gross, radiographic micro-three-dimensional (3D) CT, and histological examinations. In addition, there was no significant inflammatory response of the osteotomized ribs or the PCL-rib interface during application. The novel PCL fixator developed in this work achieves satisfactory results in osteosynthesis surgery for rib fractures, and may provide potential applications in other orthopedic surgeries.
肋骨骨折的骨固定手术存在争议且具有挑战性。本研究开发了一种新型的基于聚（ε-己内酯）（PCL）的可生物降解“束带”固定器，用于肋骨骨折的骨固定手术。一种专门用于肋骨骨折的可生物降解固定器在我们实验室通过微注塑成型机设计并制造出来。该固定器有三条束带，可分别穿过匹配的孔。锁定机制使束带只能沿一个方向移动。为了检测生物力学性能，使用了来自四只新鲜新西兰兔的第3 - 7肋骨。在三点弯曲试验中比较了天然肋骨、钛板固定肋骨和PCL固定器固定肋骨的破坏载荷和应力 - 应变曲线。在动物研究中，对新西兰兔的第六肋骨进行截骨，并使用PCL固定器进行骨固定手术。通过每月的X线检查、最终的微型计算机断层扫描（CT）以及组织学分析来评估结果。实验结果表明，用PCL固定器固定的肋骨比用钛板固定的肋骨刚度明显更低（ < 0.05）。所有用PCL固定器固定的肋骨均显示愈合。通过大体观察、影像学微型三维（3D）CT和组织学检查证实了骨痂的形成。此外，在应用过程中，截骨肋骨或PCL - 肋骨界面没有明显的炎症反应。本研究中开发的新型PCL固定器在肋骨骨折的骨固定手术中取得了满意的结果，并可能在其他骨科手术中提供潜在应用。
