骨折的生物学内固定及内固定材料性能分析

背景:近年来,骨折内固定已经从强调坚强内固定、绝对稳定和解剖复位,转向强调保留软组织血运、相对稳定和解剖轴线排列的生物学固定。目的:总结不同骨折内固定材料的临床应用特点,分析内固定器置入后的生物相容性。方法:应用计算机检索CNKI和重庆维普数据库中1990-01/2011-11关于骨折内固定材料的文章,在标题和摘要中以"骨折、内固定、钢板、螺钉"和"松动、断裂、相容性"为检索词进行检索。选择内容与骨折内固定治疗相关的文章,同一领域文献则选择近期发表在权威杂志的文章。初检得到178篇文献,根据纳入标准选择密切相关的24篇进行回顾分析。结果与结论:随着原材料工业和生物医学的进步,骨科内固定器械的发展迅速。目前绝大多数的医疗机构应用的骨科内固定钢板螺钉的生物相容性和刚度都是相当好的,但不同部位、类型的骨折所选择内固定的材料也不尽相同,这些材料的抗弯曲性、轴向、横向、抗旋转稳定性以及骨折固定后并发症和相容性均不同。骨折生物学固定由于极大地减少了对骨折处软组织的损伤及植骨率,缩短了骨折愈合时间,可显著降低骨折不愈合、再骨折和感染的发生率。

Biological internal fixation of the fracture and performance analysis of the internal fixation materials

BACKGROUND:In recent years,the focus of internal fixation for the fracture has developed from rigidity,stability and anatomic reduction to biological fixation which can preserve soft tissue blood supply,relatively stable and had anatomical axis arrangement.OBJECTIVE:To summarize the clinical characteristics of various materials for fracture fixation,and to analyze the biocompatibility after fixation device implantation.METHODS:A computer-based online retrieval of CNKI database and VIP database from January 1990 to November 2011 was conducted for articles addressing fracture internal fixation materials,by screening the key words of "fracture,internal fixation,plates,screws" in title and "loose,breakage,compatibility" in abstract.Documents related with fracture fixation treatment were involved,and those published in recent years or in authorized journals were preferred in the same field.After preliminary retrieval,178 literatures were screened out and 24 of them were involved in the retrospective analysis according to inclusion criteria.RESULTS AND CONCLUSION:With the advanced progress on raw materials industry and biomedicine,internal fixation devices are rapidly developing.The vast majority of current orthopedic internal fixation plates and screws used in medical institutions show very good biocompatibility and stiffness.However,fixation materials in different parts and different types of fracture alter,thus resulting in different bending resistance,axial,lateral and anti-rotational stability,as well as complications and compatibility after fixation.Biological fixation for the fracture can greatly reduce the injury at soft tissue and rate of bone graft,thereby shortening fracture healing time and significantly reducing the incidence of fracture non-union,second fracture and infection.