Zieliński Rafał, Kozakiewicz Marcin, Świniarski Jacek
Department of Maxillofacial Surgery, Medical University of Lodz, 1st Haller Plac, 90-647 Lodz, Poland.
Department of Strength of Materials and Structures, Technical University of Lodz, Stefanowskiego 1/15, 90-924 Lodz, Poland.
Materials (Basel). 2019 Apr 3;12(7):1110. doi: 10.3390/ma12071110.
(1) Background: The main disadvantage of rigid fracture fixation is remain material after healing period. Implementation of resorbable plates prevents issues resulting from left plates. The aim of this study is to compare the usage of bioresorbable and titanium "A" shape condyle plate in condylar fractures. (2) Methods: Thickness of 1.0 mm, height of 31 mm, and width of 19 mm polylactic acid (PLLA) and titanium "A" shape plate with 2.0 mm-wide connecting bar and 9 holes were tested with finite element analysis in high right condylar neck fracture. (3) Results: On bone surface the highest stress is on the anterior bridge around first hole (approx. 100 MPa). The highest stress on screws is located in the first screw around plate in the anterior bridge and is greater in titanium (150 MPa) than PLLA (114 MPa). (4) Conclusion: Pressure on bone in PLLA osteosynthesis is two times higher than in titanium fixation. On small areas where pressure on bone is too high it causes local bone degradation around the fracture and may delay the healing process or make it impossible. Fixation by PLLA is such flexible that bone edges slide and twist what may lead to degradation of callus.
(1) 背景：坚固性骨折固定的主要缺点是愈合期后仍有材料留存。可吸收接骨板的应用避免了残留接骨板带来的问题。本研究的目的是比较生物可吸收“ A”形髁突接骨板与钛质“ A”形髁突接骨板在髁突骨折中的应用情况。(2) 方法：采用有限元分析对厚度为1.0 mm、高度为31 mm、宽度为19 mm的聚乳酸（PLLA）接骨板以及带有2.0 mm宽连接杆和9个孔的钛质“ A”形接骨板在右侧高位髁突颈部骨折中的情况进行测试。(3) 结果：在骨表面，最高应力出现在第一个孔周围的前桥处（约100 MPa）。螺钉上的最高应力位于前桥接骨板周围的第一个螺钉处，钛质接骨板（150 MPa）的应力大于PLLA接骨板（114 MPa）。(4) 结论：PLLA骨内固定时对骨的压力比钛质固定时高两倍。在骨压力过高的小区域，会导致骨折周围局部骨降解，可能延迟愈合过程或使其无法愈合。PLLA固定过于灵活，会使骨边缘滑动和扭转，这可能导致骨痂降解。
