Chow Dick Ho Kiu, Wang Jiali, Wan Peng, Zheng Lizhen, Ong Michael Tim Yun, Huang Le, Tong Wenxue, Tan Lili, Yang Ke, Qin Ling
Musculoskeletal Research Laboratory, Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China.
Innovative Orthopaedic Biomaterial and Drug Translational Research Laboratory, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
Bioact Mater. 2021 Apr 27;6(11):4176-4185. doi: 10.1016/j.bioactmat.2021.03.044. eCollection 2021 Nov.
Displaced fractures of patella often require open reduction surgery and internal fixation to restore the extensor continuity and articular congruity. Fracture fixation with biodegradable magnesium (Mg) pins enhanced fracture healing. We hypothesized that fixation with Mg pins and their degradation over time would enhance healing of patellar fracture radiologically, mechanically, and histologically. Transverse patellar fracture surgery was performed on thirty-two 18-weeks old female New Zealand White Rabbits. The fracture was fixed with a pin made of stainless steel or pure Mg, and a figure-of-eight stainless steel band wire. Samples were harvested at week 8 or 12, and assessed with microCT, tensile testing, microindentation, and histology. Microarchitectural analysis showed that Mg group showed 12% higher in the ratio of bone volume to tissue volume at week 8, and 38.4% higher of bone volume at week 12. Tensile testing showed that the failure load and stiffness of Mg group were 66.9% and 104% higher than the control group at week 8, respectively. At week 12, Mg group was 60.8% higher in ultimate strength than the control group. Microindentation showed that, compared to the Control group, Mg group showed 49.9% higher Vickers hardness and 31% higher elastic modulus at week 8 and 12, respectively. At week 12, the new bone of Mg group remodelled to laminar bone, but those of the control group remained woven bone-like. Fixation of transverse patellar fracture with Mg pins and its degradation enhanced new bone formation and mechanical properties of the repaired patella compared to the Control group.
髌骨移位骨折通常需要切开复位手术和内固定,以恢复伸肌连续性和关节一致性。使用可生物降解的镁(Mg)钉进行骨折固定可促进骨折愈合。我们假设,用镁钉固定及其随时间的降解会在放射学、力学和组织学上促进髌骨骨折的愈合。对32只18周龄的雌性新西兰白兔进行了横断髌骨骨折手术。骨折用不锈钢或纯镁制成的钉子以及8字形不锈钢带钢丝进行固定。在第8周或第12周采集样本,并通过微型计算机断层扫描(microCT)、拉伸试验、微压痕和组织学进行评估。微观结构分析表明,镁组在第8周时骨体积与组织体积的比率高12%,在第12周时骨体积高38.4%。拉伸试验表明,镁组在第8周时的破坏载荷和刚度分别比对照组高66.9%和104%。在第12周时,镁组的极限强度比对照组高60.8%。微压痕显示,与对照组相比,镁组在第8周和第12周时的维氏硬度分别高49.9%和弹性模量高31%。在第12周时,镁组的新骨重塑为层状骨,但对照组的新骨仍保持编织骨样。与对照组相比,用镁钉固定横断髌骨骨折及其降解可促进修复后髌骨的新骨形成和力学性能。