Yanagisawa Yohei, Ito Atsuo, Hara Yuki, Mutsuzaki Hirotaka, Murai Shinji, Fujii Kengo, Sogo Yu, Hirose Motohiro, Oyane Ayako, Kobayashi Fumiko, Yamazaki Masashi
Department of Emergency and Critical Care Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
Health Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Central 6, 1-1-1 Higashi, Tsukuba, Ibaraki, 305-8566, Japan.
J Orthop. 2018 Dec 20;16(1):69-73. doi: 10.1016/j.jor.2018.12.012. eCollection 2019 Jan-Feb.
Pin tract infection and loosening are major complications and challenges in the treatment of fractures by external fixation. To address this issue, we developed titanium pins coated with a fibroblast growth factor 2 (FGF-2)-apatite composite layer. The purpose of this initial clinical trial is to clarify the safety and feasibility of using these pins for the external fixation of distal radius fractures.
Unstable, displaced fractures of the distal radius that were medically suitable for external fixation were treated using external fixation pins coated and uncoated with an FGF-2-apatite composite layer. The coated pin group (n = 5) comprised 5 women (average age, 70.4 ± 5.9 years), whereas the uncoated pin group (n = 10) comprised 8 women and 2 men (average age, 64.4 ± 11.7 years). The average duration of external fixation was 40.8 ± 1.3 and 41.6 ± 2.1 days for the coated and uncoated pin groups, respectively.
All patients achieved fracture union. One patient in the uncoated group had severe pin tract infection on the day of pin extraction. No pin loosening or difficulty in pin removal was observed in either group. Bacterial growth was present in 5% and 25% of the pin sites in the coated and uncoated groups, respectively ( = 0.059). No adverse events such as tumor formation were observed for more than 2 years after surgery in the coated pin group.
This study clarified the safety and feasibility of using pins coated with an FGF-2-apatite composite layer for the external fixation of distal radius fractures.
针道感染和松动是外固定治疗骨折的主要并发症和挑战。为解决这一问题,我们研发了涂有成纤维细胞生长因子2(FGF - 2)-磷灰石复合层的钛针。这项初步临床试验的目的是阐明使用这些针进行桡骨远端骨折外固定的安全性和可行性。
对医学上适合外固定的不稳定、移位的桡骨远端骨折,使用涂有和未涂有FGF - 2 -磷灰石复合层的外固定针进行治疗。涂覆针组(n = 5)包括5名女性(平均年龄,70.4 ± 5.9岁),而未涂覆针组(n = 10)包括8名女性和2名男性(平均年龄,64.4 ± 11.7岁)。涂覆针组和未涂覆针组的平均外固定时间分别为40.8 ± 1.3天和41.6 ± 2.1天。
所有患者均实现骨折愈合。未涂覆组有1例患者在拔针当天出现严重针道感染。两组均未观察到针松动或拔针困难。涂覆组和未涂覆组针道部位细菌生长分别为5%和25%(P = 0.059)。涂覆针组术后2年多未观察到肿瘤形成等不良事件。
本研究阐明了使用涂有FGF - 2 -磷灰石复合层的针进行桡骨远端骨折外固定的安全性和可行性。