High-purity weight-bearing magnesium screw: Translational application in the healing of femoral neck fracture
High-purity weight-bearing magnesium screw: Translational application in the healing of femoral neck fracture
复制标题
高纯度负重镁螺钉：在股骨颈骨折愈合中的转化应用
DOI：
10.1016/j.biomaterials.2020.119829
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发表时间：
2020-04-01
期刊：
影响因子：
14
通讯作者：
Zhao, Dewei
中科院分区：
文献类型：
--
作者：
Huang, Shibo;Wang, Benjie;Zhao, Dewei
镁（Mg）基金属由于其特殊的性能可用作下一代骨折内固定器械。我们采用带血管蒂的骨移植，用可降解纯镁螺钉固定，治疗股骨头坏死，取得了满意的效果。然而，这些螺钉的机械性能使其比传统金属制成的螺钉更弱。特别是，使用镁基金属制成的螺钉的主要挑战之一是它们在人体重要承重部位的固定中的应用。股骨颈骨折是临床常见的损伤。在这种损伤中，连接处的大承载应力需要具有极高机械强度的固定装置。手术及适当的内固定可加速股骨颈骨折的愈合。传统的内固定器械在术后有一些缺点，包括应力遮挡效应和需要二次手术取出螺钉。在前人工作的基础上，我们研制了高强度纯镁螺钉治疗股骨颈骨折。在这项研究中，我们描述了第一次使用高纯镁制备大尺寸承重螺钉固定山羊股骨颈骨折。然后，我们使用体内转化实验进行了48周的随访研究。结果表明，这些可生物降解的高纯镁承重螺钉具有足够的机械强度和与骨修复相容的降解速率。在股骨头和股骨颈的骨组织和血供的降解和重建过程中，获得了良好的骨形成。本研究为生物可降解高纯镁承重螺钉的临床转化研究提供了基础。
Magnesium (Mg)-based metals can be used as next-generation fracture internal fixation devices due to their specific properties. We used vascularized bone grafting fixed by degradable pure Mg screws and obtained satisfactory results in the treatment of osteonecrosis of the femoral head. However, the mechanical properties of these screws make them weaker than those made of traditional metals. In particular, one of the main challenges of using screws made of Mg-based metals is their application in fixation at important weight-bearing sites in the human body. Femoral neck fracture is a common clinical injury. In this injury, the large bearing stress at the junction requires a fixation device with extremely high mechanical strength. Surgery and appropriate internal fixation can accelerate the healing of femoral neck fractures. Traditional internal fixation devices have some disadvantages after surgery, including stress shielding effects and the need for secondary surgery to remove screws. On the basis of previous work, we developed high-strength pure Mg screws for femoral neck fractures. In this study, we describe the first use of high-purity Mg to prepare large-size weight-bearing screws for the fixation of femoral neck fractures in goats. We then performed a 48 weeks follow-up study using in vivo transformation experiments. The results show that these biodegradable high-purity Mg weight-bearing screws had sufficient mechanical strength and a degradation rate compatible with bone repair. Furthermore, good bone formation was achieved during the degradation process and reconstruction of the bone tissue and blood supply of the femoral head and femoral neck. This study provides a basis for future research on the clinical transformation of biodegradable high-purity Mg weight-bearing screws.