Osteosynthesis and Trauma Care 2002; 10(1): 43-46
DOI: 10.1055/s-2002-30629
Original Articles

© Georg Thieme Verlag Stuttgart · New York

The Biodegradable Intramedullar Nail

Biomechanical Results and Tissue Response 4 Years after Implantation in SheepS. J. Rhemrev1 , M. vd Elst2 , M. Segers1 , C. P. A. T. Klein3 , F. C. Bakker1 , P. Patka1 , H. J. Th. M. Haarman1
  • 1Department of Surgery, Free University Hospital, Amsterdam, The Netherlands
  • 2Department of Surgery, Reinier de Graaf Groep, Delft, The Netherlands
  • 3Department of Medical Science, University of Groningen, The Netherlands
Further Information

Publication History

Publication Date:
17 May 2002 (online)

Abstract

The conventional metal intramedullar nail has considerable drawbacks. A second operation is often needed to remove the nail after fracture healing. The stress-shield phenomenon can cause impaired fracture healing, and there is the possibility of infection, allergic reaction and corrosion.
To avoid these problems a biodegradable interlocking nail was developed. Ideally, the biodegradable intramedullar nail will lose its strength gradually during a controlled degradation pattern and the load on the fractured bone will gradually shift from implant to bone.
The results of a long term follow up study (4 years) in an animal model using adult sheep are presented in this paper.
A self-reinforced polylactide intramedullar nail was used for the fixation of an artificially made femoral fracture.
The following parameters were subject of investigation: clinical fracture healing, radiological results, mechanical properties of the bones and local and regional histological response.
Macroscopically some shortening and angulation of the fractured femora was observed. The clinical healing was unimpaired and the mechanical tests were excellent in four sheep. Histological analysis showed a mild tissue response and a partial degradation of the implant.

Zusammenfassung

Im Folgenden werden die Resultate einer tierexperimentellen Langzeitstudie beschrieben, wobei ein so genannter „selfreinforced” Polylaktat-Marknagel benutzt wurde bei der Stabilisierung von künstlich bei Schafen zugebrachten Oberschenkelbrüchen.
Bei den nach vier Jahren obduzierten Schafen wurden die folgenden Parameter analysiert: Frakturheilung, Radiologiebefunde, mechanische Knocheneigenschaften und die lokale sowie regionale Gewebereaktion.
Makroskopisch beobachteten wir eine gewisse Verkürzung sowie eine Angulation der stabilisierten Femora. Die klinisch beurteilte Knochenheilung war uneingeschränkt und mechanische Tests waren exzellent. Die histologische Analyse wies eine milde Knochengewebereaktion auf sowie eine partielle Degradierung des Implantats.

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Dr. S. J. Rhemrev

Department of Surgery

Free University Hospital

De Boelelaan 1117

1007 MB Amsterdam

The Netherlands

Email: S.RhemRev@vumc.nl