Novel intramedullary-fixation technique for long bone fragility fractures using bioresorbable materials.
Almost all of the currently available fracture fixation devices for metaphyseal fragility fractures are made of hard metals, which carry a high risk of implant-related complications such as implant cutout in severely osteoporotic patients. We developed a novel fracture fixation technique (intramedul...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2014-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC4128718?pdf=render |
| _version_ | 1819096156526870528 |
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| author | Takanobu Nishizuka Toshikazu Kurahashi Tatsuya Hara Hitoshi Hirata Toshihiro Kasuga |
| author_facet | Takanobu Nishizuka Toshikazu Kurahashi Tatsuya Hara Hitoshi Hirata Toshihiro Kasuga |
| author_sort | Takanobu Nishizuka |
| collection | DOAJ |
| description | Almost all of the currently available fracture fixation devices for metaphyseal fragility fractures are made of hard metals, which carry a high risk of implant-related complications such as implant cutout in severely osteoporotic patients. We developed a novel fracture fixation technique (intramedullary-fixation with biodegradable materials; IM-BM) for severely weakened long bones using three different non-metallic biomaterials, a poly(l-lactide) (PLLA) woven tube, a nonwoven polyhydroxyalkanoates (PHA) fiber mat, and an injectable calcium phosphate cement (CPC). The purpose of this work was to evaluate the feasibility of IM-BM with mechanical testing as well as with an animal experiment. To perform mechanical testing, we fixed two longitudinal acrylic pipes with four different methods, and used them for a three-point bending test (N = 5). The three-point bending test revealed that the average fracture energy for the IM-BM group (PLLA + CPC + PHA) was 3 times greater than that of PLLA + CPC group, and 60 to 200 times greater than that of CPC + PHA group and CPC group. Using an osteoporotic rabbit distal femur incomplete fracture model, sixteen rabbits were randomly allocated into four experimental groups (IM-BM group, PLLA + CPC group, CPC group, Kirschner wire (K-wire) group). No rabbit in the IM-BM group suffered fracture displacement even under full weight bearing. In contrast, two rabbits in the PLLA + CPC group, three rabbits in the CPC group, and three rabbits in the K-wire group suffered fracture displacement within the first postoperative week. The present work demonstrated that IM-BM was strong enough to reinforce and stabilize incomplete fractures with both mechanical testing and an animal experiment even in the distal thigh, where bone is exposed to the highest bending and torsional stresses in the body. IM-BM can be one treatment option for those with severe osteoporosis. |
| first_indexed | 2024-12-21T23:54:43Z |
| format | Article |
| id | doaj.art-b3a7b357770b4406a3e1489bafb6047a |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-21T23:54:43Z |
| publishDate | 2014-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-b3a7b357770b4406a3e1489bafb6047a2022-12-21T18:45:50ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-0198e10460310.1371/journal.pone.0104603Novel intramedullary-fixation technique for long bone fragility fractures using bioresorbable materials.Takanobu NishizukaToshikazu KurahashiTatsuya HaraHitoshi HirataToshihiro KasugaAlmost all of the currently available fracture fixation devices for metaphyseal fragility fractures are made of hard metals, which carry a high risk of implant-related complications such as implant cutout in severely osteoporotic patients. We developed a novel fracture fixation technique (intramedullary-fixation with biodegradable materials; IM-BM) for severely weakened long bones using three different non-metallic biomaterials, a poly(l-lactide) (PLLA) woven tube, a nonwoven polyhydroxyalkanoates (PHA) fiber mat, and an injectable calcium phosphate cement (CPC). The purpose of this work was to evaluate the feasibility of IM-BM with mechanical testing as well as with an animal experiment. To perform mechanical testing, we fixed two longitudinal acrylic pipes with four different methods, and used them for a three-point bending test (N = 5). The three-point bending test revealed that the average fracture energy for the IM-BM group (PLLA + CPC + PHA) was 3 times greater than that of PLLA + CPC group, and 60 to 200 times greater than that of CPC + PHA group and CPC group. Using an osteoporotic rabbit distal femur incomplete fracture model, sixteen rabbits were randomly allocated into four experimental groups (IM-BM group, PLLA + CPC group, CPC group, Kirschner wire (K-wire) group). No rabbit in the IM-BM group suffered fracture displacement even under full weight bearing. In contrast, two rabbits in the PLLA + CPC group, three rabbits in the CPC group, and three rabbits in the K-wire group suffered fracture displacement within the first postoperative week. The present work demonstrated that IM-BM was strong enough to reinforce and stabilize incomplete fractures with both mechanical testing and an animal experiment even in the distal thigh, where bone is exposed to the highest bending and torsional stresses in the body. IM-BM can be one treatment option for those with severe osteoporosis.http://europepmc.org/articles/PMC4128718?pdf=render |
| spellingShingle | Takanobu Nishizuka Toshikazu Kurahashi Tatsuya Hara Hitoshi Hirata Toshihiro Kasuga Novel intramedullary-fixation technique for long bone fragility fractures using bioresorbable materials. PLoS ONE |
| title | Novel intramedullary-fixation technique for long bone fragility fractures using bioresorbable materials. |
| title_full | Novel intramedullary-fixation technique for long bone fragility fractures using bioresorbable materials. |
| title_fullStr | Novel intramedullary-fixation technique for long bone fragility fractures using bioresorbable materials. |
| title_full_unstemmed | Novel intramedullary-fixation technique for long bone fragility fractures using bioresorbable materials. |
| title_short | Novel intramedullary-fixation technique for long bone fragility fractures using bioresorbable materials. |
| title_sort | novel intramedullary fixation technique for long bone fragility fractures using bioresorbable materials |
| url | http://europepmc.org/articles/PMC4128718?pdf=render |
| work_keys_str_mv | AT takanobunishizuka novelintramedullaryfixationtechniqueforlongbonefragilityfracturesusingbioresorbablematerials AT toshikazukurahashi novelintramedullaryfixationtechniqueforlongbonefragilityfracturesusingbioresorbablematerials AT tatsuyahara novelintramedullaryfixationtechniqueforlongbonefragilityfracturesusingbioresorbablematerials AT hitoshihirata novelintramedullaryfixationtechniqueforlongbonefragilityfracturesusingbioresorbablematerials AT toshihirokasuga novelintramedullaryfixationtechniqueforlongbonefragilityfracturesusingbioresorbablematerials |