骨盆并髋臼骨折内固定材料的生物相容性

背景：骨盆骨折合并髋臼骨折多由高能量暴力伤所致，常伴严重并发症，往往需要外科内固定治疗。 目的：探讨骨盆骨折合并髋臼骨折内固定治疗以及材料的生物相容性。 方法：以“骨盆骨折，髋臼骨折，内固定，材料；pelvis fracture，acetabulum fracture，internal fixators，materials”为关键词，应用计算机检索2005至2014年万方数据库、清华知网数据库和PubMed数据库，选取有关骨盆骨折合并髋臼骨折内固定治疗以及材料生物相容性研究的文献，同一领域文献选择权威杂志或发表时间为近期的文章，依据纳入排除标准选取29篇文献进行归纳分析。 结果与结论：对于骨盆骨折合并髋臼骨折临床多采用重建钢板或拉力螺钉内固定，常用于内固定的重建钢板材料是钛板，弹性模量接近骨的弹性模量，生物相容性好，可在置入前预先弯曲塑形，使之与骨折部位骨面相匹配。可吸收螺钉具有良好的组织相容性，无毒副反应，避免金属螺钉的电解与腐蚀，在内固定早期保持一定的强度，随着时间的推移骨折逐渐愈合，材料强度也缓慢降低，材料最终降解为水和二氧化碳，治疗效果满意。以三维重建技术定制钢板固定和微创内固定是目前骨折治疗的重大进展，临床应用前景广阔。  中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

Materials biocompatibility in the internal fixation of pelvic fracture combined with acetabular fracture

BACKGROUND:Pelvic fractures combined with acetabular fractures are mostly caused by high-energy violence, often accompanied by severe complications and high mortality, and surgical fixation is preferred in most cases. OBJECTIVE:To investigate the internal fixation of pelvic fracture combined with acetabular fracture and to analyze the material biocompatibility. METHODS:A computer-based search of Wanfang, CNKI and PubMed databases was performed for articles related to the internal fixation of pelvic fracture combined with acetabular fracture and material biocompatibility published from 2005 to 2014. The keywords were “pelvis fractures, acetabulum fractures, internal fixators, materials” in Chinese and English, respectively. Articles published in authoritative journals or recently were preferred, and finally 29 articles were enrolled in result analysis. RESULTS AND CONCLUSION:Steel plate reconstruction or screw internal fixation is often used for clinical treatment of pelvic fracture combined with acetabular fracture. Titanium plate is often chosen with similar elastic modulus to the bone and good biocompatibility. The titanium plate is pre-bended before implantation to match the bone surface of the fracture site. Absorbable screws have good histocompatibility and non-toxic side effects, which can avoid the electrolysis and corrosion of metal screws and maintain certain strength in early period of internal fixation; over time, the fracture is gradually healed, the material strength gradually decreases, and the material is finally degraded into water and carbon dioxide to achieve good clinical outcomes. It is difficult and high-risk for treatment of pelvic fracture combined with acetabular fractures, and active treatment and damage control are recommended as soon as possible. A reasonable treatment plan can be developed based on the type of fracture. Plate internal fixation and minimally invasive fixation developed by the three-dimensional reconstruction techniques show a great progress in fracture treatment, which have broad clinical application prospects.