Clinical and Metallurgical Study of Implant Failure

人體金屬植入物斷裂—其臨床與金屬研究

江清泉(Ching-Chung Jiang) ； 陳盈伶(Yinn-Ling Chen) ； 黃麗紅(Li-Hung Huang) ； 王正一(Cheng-Yi Wang) ； 陳弘毅(Hong-Yie Chen) ； 王文雄(Wen-Hsiung Wang) ； 韓毅雄(Yi-Shiong Hang)

《Journal of Orthopaedic Surgery Taiwan》 3卷2期 (1986/06) Pp. 44-49

摘要

台大醫院骨外科在過去五年中共收集了八個人體金屬植入物(metal implant)發生斷裂的病例。本研究係將開刀取出之斷裂骨板、骨釘做下列的研究:
一、金屬斷面之電子顯微鏡掃描(Jeol,JSM-35,JAPAN Scanning electron microscope)
二、金屬元素分析(Kevex 7000 USA E-DS. System)
三、金相分析
四、臨床x-光分析
臨床上這些骨釘的使用及放置都不正確。金屬的斷裂面發現有五個包涵物、一個裂隙及一個氣泡;這些缺陷都可能造成應力集中的現象而引起斷裂。鈷鉻合金之斷裂面顯示為脆性斷裂，鈦合金則為展性斷裂，不銹斷之斷裂多為疲勞斷裂，人體金屬植入物斷裂的原因有許多，除了手術不當之因素外，金屬本身之缺陷也是一個重要的因素。

並列摘要

Eight fractured implants(2 plates, 2 neufeld nail-plates, 2 Jewett’s nails, 1 knowles’ pin and 1 Huckstep’s nail) were studied. Clinically, most of these implants were not placed correctly. The cobalt-chromium plate showed brittle failure while the Ti-6A1-4V Huckstep’s nail showed ductile failure. All the other stainless steel implants showed fastigue failure. There were 5 inclusions, 1 crack and 1 bubble on the fractured surface of the implant. Stress concentration may develop at the fractured surface of the implant. Stress concentration may develop at the sites of these defects, leading to the failure of the implants. The implant failure was multifactorial.

並列關鍵字

implant failure ； metallurgical study ； SEM ； fatigue failure