Mechanical Comparison of Novel Bioabsorbable Plates with Titanium Plates and Small-Series Clinical Comparisons for Metacarpal Fractures
Mechanical Comparison of Novel Bioabsorbable Plates with Titanium Plates and Small-Series Clinical Comparisons for Metacarpal Fractures
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DOI：
10.2106/jbjs.j.01673
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发表时间：
2012-09-05
影响因子：
5.3
通讯作者：
Nakamura, Toshitaka
中科院分区：
文献类型：
--
作者：
Sakai, Akinori;Oshige, Toshihisa;Nakamura, Toshitaka
背景：使用生物可吸收植入物无需随后移除，可为骨折固定提供重大的临床优势。本研究的目的是在骨折模型中比较新型生物可吸收板与钛板的机械性能，并展示使用这些新型板治疗掌骨骨折的临床结果。方法：第一组实验比较了生物可吸收板和钛板的机械性能。测试了两种类型的由羟基磷灰石/聚 L-丙交酯制成的生物可吸收板（横截面为三分之一管状和半管状）和两种类型的钛板（用于 1.5 和 2.0 毫米螺钉）。每个板都固定在聚醚醚酮（PEEK）棒上，该棒的中部被横向切割。研究的第二部分比较了生物可吸收板和钛板的临床结果，这些板用于 16 名非随机连续掌骨骨折患者。结果：三分之一管状生物可吸收板结构的弯曲强度和刚度与用于 1.5 毫米螺钉的钛板相当，二分之一管状生物可吸收板的弯曲强度和刚度与用于 2.0 毫米螺钉的钛板相当。半管状生物可吸收板的平均扭转强度（和标准偏差）（79.0 +/- 7.9 N.cm）明显大于 2.0 mm 螺钉钛板的平均扭转强度（和标准偏差）（56.7 +/- 4.0 N.cm）（p < 0.05）。接受生物可吸收板的患者和接受钛板的患者术后六个月的临床结果没有显着差异（主动运动总范围为267.0度+/-6.0度，对侧为250.0度+/-28.3度；握力为92.7%+/-19.7%，对侧为86.4%+/-28.6%）。结论：弯曲当固定在 PEEK 杆上时，新型三分之一或半管状生物可吸收板的强度、刚度和扭转强度与 1.5 或 2.0 毫米螺钉的钛板相当。经过短期随访，在一小部分患者中，这两种类型的钢板的临床结果没有显着差异。
Background: The use of bioabsorbable implants to negate the need for subsequent removal could offer major clinical advantages for the fixation of fractures. The aims of this study were to compare the mechanical properties of novel bioabsorbable plates with those of titanium plates in a fracture model and to demonstrate the clinical results of the use of these new plates for metacarpal fractures.Methods: The first set of experiments compared the mechanical properties of bioabsorbable and titanium plates. Two types of bioabsorbable plates (one-third tubular and semi-tubular in cross-section) made of hydroxyapatite/poly-L-lactide and two types of titanium plates (for 1.5 and 2.0-mm screws) were tested. Each plate was fixed on a polyether ether ketone (PEEK) rod, which was transversely cut at its midsection. The second part of the study compared the clinical results associated with the bioabsorbable and titanium plates that were used in sixteen nonrandomized consecutive patients with metacarpal fractures.Results: The bending strength and stiffness of one-third tubular bioabsorbable plate constructs were comparable with those of titanium plates for 1.5-mm screws, and those of one-half tubular bioabsorbable plates were comparable with those of titanium plates for 2.0-mm screws. The mean torsional strength (and standard deviation) of the semi-tubular bioabsorbable plates (79.0 +/- 7.9 N.cm) was significantly greater than that of titanium plates for 2.0 mm screws (56.7 +/- 4.0 N.cm) (p < 0.05). There were no significant differences in six-month postoperative clinical results between patients who received bioabsorbable plates and those who received titanium plates (total range of active motion, 267.0 degrees +/- 6.0 degrees compared with 250.0 degrees +/- 28.3 degrees; grip strength, 92.7% +/- 19.7% compared with 86.4% +/- 28.6% of that on the contralateral side).Conclusions: The bending strength, stiffness, and torsional strength of novel one-third or semi-tubular bioabsorbable plates, when fixed on a PEEK rod, were comparable with those for titanium plates for 1.5 or 2.0-mm screws. There were no significant differences in clinical results between these two types of plates in a small group of patients after short-term follow-up.