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用于肋骨骨折修复的可吸收3D打印接骨板

Resorbable 3D-Printed Osteosynthetic Plates for Rib Fracture Repair.

作者信息

Augustine Emily K, Camarena Adrian, Klein Taylor R, Kang Lillian, Wimmer Georgia, Stinson Natasha C, Fernandez-Moure Joseph S, Becker Matthew L

机构信息

Thomas Lord Department of Mechanical Engineering and Materials Science, Duke University, Durham, NC, 27708, USA.

Department of Surgery, Duke University School of Medicine, Durham, NC, 27708, USA.

出版信息

Adv Healthc Mater. 2025 Jun;14(16):e2500409. doi: 10.1002/adhm.202500409. Epub 2025 May 19.

Abstract

Rib fractures are common among blunt chest trauma patients and are a hallmark of severe thoracic injury with high morbidity and mortality rates. The standard treatment of most rib fracture cases is limited to pain control and respiratory support, with the surgical stabilization of rib fractures (SSRF) using titanium plates reserved for severely injured patients. Although SSRF has been shown to improve long-term patient outcomes, its expanded use has been limited by the invasiveness of the procedure and a lack of safe and effective resorbable fixation materials. While resorbable metal and polymeric plates have each been used in the clinic, many failures have been reported and challenges remain to control the mechanical properties of the plate during the degradation process. The 3D printing of resorbable, fumarate-based copolyester-hydroxyapatite (HAp) composite osteosynthetic plates for use in SSRF is presented, and assess their efficacy in vivo in a rabbit rib fracture model. Compared to rigid titanium fixation plates, ribs fixed with 3D printed composite plates elicit fracture calluses with decreased inflammatory response, enhanced osseointegration, and bone morphometry at 2- and 4-weeks post-fracture comparable to clinically used titanium plates.

摘要

肋骨骨折在钝性胸部创伤患者中很常见,是严重胸部损伤的标志,发病率和死亡率很高。大多数肋骨骨折病例的标准治疗仅限于疼痛控制和呼吸支持,使用钛板进行肋骨骨折手术固定(SSRF)仅适用于重伤患者。尽管SSRF已被证明可改善患者的长期预后,但其广泛应用受到该手术侵入性以及缺乏安全有效的可吸收固定材料的限制。虽然可吸收金属板和聚合物板都已在临床上使用,但已报道了许多失败案例,并且在降解过程中控制板材的机械性能仍然存在挑战。本文介绍了用于SSRF的可吸收富马酸酯基共聚酯-羟基磷灰石(HAp)复合骨合成板的3D打印,并在兔肋骨骨折模型中评估其体内疗效。与刚性钛固定板相比,用3D打印复合板固定的肋骨在骨折后2周和4周时产生的骨折骨痂具有炎症反应减轻、骨整合增强和骨形态测量结果,与临床使用的钛板相当。

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