Dragosloveanu Şerban, Cotor Dragoş Corneliu, Dragosloveanu Christiana D M, Stoian Cătălin, Stoica Cristian Ioan
Department of Orthopedics, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Department of Ophthalmology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Exp Ther Med. 2021 Jul;22(1):731. doi: 10.3892/etm.2021.10163. Epub 2021 May 7.
The highly comminuted calcaneal fractures represent a challenge for surgeons and require bone grafts for a good clinical outcome. Postoperative results are generally associated with increased morbidity and long periods of inactivity. The biomedical community promotes the use of artificial materials for grafts in order to achieve improved results. In an era when cosmetic concerns as well as the satisfaction of patients are mandatory and the use of autologous bone grafts is not without complications, an artificial replacement appears to be a favorable option. Synthetic bone grafts are known to fail under stress shield or are associated with systemic side effects. The purpose of the present study was to investigate and determine an already commercially available magnesium (Mg) alloy whose design is most suitable for long-term use. The mechanical properties of Mg1Ca and MgYREZr compared with normal cortical and cancellous bone were assessed. Another discussed aspect was the influence of the alloy in the graft fixation. The results revealed that Mg1Ca and MgYREZr alloys had a low tensile strength of 75 and 250 MPa, respectively. For this reason, it was surmised that MgYREZr alloy could be an optimal choice with favorable corrosion resistance. Since calcaneal fractures are prone to skin necrosis and septic complications, the need for antibacterial procedures and antibiotic prophylaxis is highlighted. Thus, an attempt was also made to identify the relationship between Mg alloy products and bacterial load. However, the most important feature of the present study was the creation of a 3D model grafting, with an anti-sliding design, which can be potentially used with the preferred Mg alloy in this type of fractures. In conclusion, artificial materials are the future in medicine, replacing the body-limiting capabilities of grafts. They are safe and incur less comorbidities. This method could pave the way for reducing patient discomfort and increasing patient satisfaction. Although further testing is required, this research represents a great starting point for calcaneal fractures.
高度粉碎性跟骨骨折对外科医生来说是一项挑战，为获得良好的临床效果需要进行骨移植。术后结果通常伴随着发病率增加和长期的活动受限。生物医学界提倡使用人工材料进行移植以取得更好的效果。在一个对美观和患者满意度都有要求，且自体骨移植并非没有并发症的时代，人工替代物似乎是一个不错的选择。已知合成骨移植材料会在应力屏蔽作用下失效，或者伴有全身性副作用。本研究的目的是调查并确定一种已经商业化的镁（Mg）合金，其设计最适合长期使用。评估了Mg1Ca和MgYREZr与正常皮质骨和松质骨相比的力学性能。另一个讨论的方面是合金在移植固定中的影响。结果显示，Mg1Ca和MgYREZr合金的抗拉强度较低，分别为75MPa和250MPa。因此，推测MgYREZr合金可能是具有良好耐腐蚀性的最佳选择。由于跟骨骨折容易发生皮肤坏死和感染并发症，抗菌程序和抗生素预防的必要性凸显出来。因此，还尝试确定镁合金产品与细菌负荷之间的关系。然而，本研究最重要的特点是创建了一种具有防滑设计的三维模型移植体，它有可能与这种类型骨折中首选的镁合金一起使用。总之，人工材料是医学的未来，可替代移植体对身体的限制。它们安全且并发症较少。这种方法可为减轻患者不适和提高患者满意度铺平道路。尽管还需要进一步测试，但这项研究是跟骨骨折研究的一个很好的起点。
