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遥控式儿童患者牵引成骨内置延长器。

Remote-controlled internal lengthening plate for distraction osteogenesis in pediatric patients.

机构信息

a Department of Mechanical Engineering , École Polytechnique of Montreal , Montréal , Québec , Canada.

b Department of Surgery , Shriners Hospital for Children , Montréal , Québec , Canada.

出版信息

Expert Rev Med Devices. 2019 Apr;16(4):333-339. doi: 10.1080/17434440.2019.1599283. Epub 2019 Apr 1.

Abstract

OBJECTIVES

Limb lengthening by distraction osteogenesis is a technique widely used to treat limb length discrepancy resulting from trauma, congenital limb defects and long bone non-union. For decades, patients have resorted to the Ilizarov apparatus, prone to pin tract infections and scarring. Although implantable lengthening nails have reduced the incidence of complications, they are not applicable in pediatric patients with open growth plates. The aim of this project is to design a remote-controlled internal lengthening device suitable for implantation in children.

METHODS

The proposed device has the form of an internal remote-controlled telescopic lengthening plate, screwed to the lateral side of the bone with locking screws. This is appropriate for use with pediatric patients. It has been tested on an experimental bench which has the form of a vertically sliding platform, on which were stacked weights simulating soft-tissue resistance forces.

RESULTS

This internal lengthening plate generated distraction forces of up to 735 N on wooden and synthetic bones (Sawbones). Furthermore, it maintained a constant distraction speed over the course of the procedure for a given weight.

CONCLUSIONS

This device represents a major advancement in the field of pediatric limb-lengthening, addressing a demographic gap left open by current implantable devices.

摘要

目的

通过骨牵引成骨术进行肢体延长是一种广泛用于治疗创伤、先天性肢体缺陷和长骨不愈合导致的肢体长度差异的技术。几十年来,患者一直依赖伊利扎罗夫(Ilizarov)外固定架,该外固定架容易发生钉道感染和瘢痕。尽管可植入的延长钉减少了并发症的发生,但它们不适用于骺板未闭合的儿童患者。本项目旨在设计一种适用于儿童植入的遥控式内置延长装置。

方法

拟议的装置采用内部遥控伸缩式延长钢板的形式,通过锁定螺钉拧到骨的外侧。这适用于儿科患者。该装置已在一个实验台上进行了测试,该实验台为垂直滑动平台的形式,在该平台上堆叠了模拟软组织阻力的重物。

结果

这种内置延长钢板在木制和合成骨(Sawbones)上产生了高达 735 N 的分离力。此外,它在给定重量的情况下,在整个过程中保持了恒定的分离速度。

结论

该装置代表了儿童肢体延长领域的重大进展,解决了当前可植入装置留下的一个人口统计学空白。

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