聚乳酸骨釘骨板與骨斷裂面間於癒合過程中之交互作用

Interactions between Poly-L-lactic Acid Bone Plates/Screws and a Bone Fracture Interface During the Healing Process

柯文昌(Wen-Chang Ko) ； 楊正昌(Jen-Chang Yang) ； 王敦正(Dun-Jang Wang) ； 馮琮涵(Tsung-Han Fung) ； 陳立典(Lee-Diang Chan) ； 李憲坤(Hsien-Kun Lee) ； 李勝揚(Sheng-Yang Lee)

《中華牙醫學雜誌》 23卷3期 (2004/06) Pp. 189-200

https://doi.org/10.7105/CDJ.200406.0189

摘要

藉由標準化的下顎骨斷裂模式，觀察應用吸收性聚乳酸骨釘／骨板於骨斷裂面復位之固定後，生物組織及材料降解性質變化，並比較吸收性（聚乳酸）、非吸收性（鈦金屬）骨板與無固定三種狀況下骨斷面之癒合過程之差別。活體試驗模式選擇成年紐西蘭公兔，手術區域均為右下顎骨之骨體中段部份，製造一垂直於骨體長軸的標準化骨斷裂模式，分別以聚乳酸骨釘骨板及鈦金屬骨釘骨板作固定，另外以斷裂後不固定作為對照組。實驗動物依照0、l、4、8、12、16、26週共七個觀察時間點並以灌流犧牲，取樣觀察其骨髓及斷面之組織反應，及聚乳酸降解性質變化。物化性質變化測試方面包括質量與三點彎曲強度變化，以瞭解其降解強度變化與斷面癒合速度之關係。再以示差掃描熱卡計測量結晶度變化，及以膠質滲透層析儀測定分子量，觀察聚乳酸之體內降解變化曲線，藉以推測完全降解所需時間。

關鍵字

聚乳酸骨釘骨板 ； 聚乳酸 ； 生物可吸收性 ； 骨斷裂 ； 骨固定

並列摘要

The purpose of this study was to investigate interactions between a fracture and a fixation bone plate during bone healing. Male adult New Zealand rabbits were used as in this in vivo experiment, and the operation site was located in the mid-portion of the right mandible. A combination of a micro-saw and an ultra-thin osteotome was used to create a fracture gap vertical to the body of the mandible. Both a non-resorbable titanium plate/screw and a resorbable PLA plate/screw were implanted and evaluated under a standardized model of mandibular fracture and repair. Animals were sacrificed at the designated periods of 0, 1, 4, 8, 12, 16, and 26 weeks. The tissue histology around the fractue gap and the physicochemical changes of the PLLA fixation devices were evaluated. The interface of screw insertion and performance of the fracture gap of PLLA/tissue and titanium/tissue were evaluated by histological observations. Physical properties, which changed at different time intervals, including the weight loss, 3-point bending strength retention, crystallinity, and molecular weight, were investigated during in vivo degradation.

並列關鍵字

fixation plate ； poly-L-lactic acid ； resorbable material ； bone fracture ； bone fixation