不同材料动力髋螺钉置入治疗股骨转子间骨折的生物相容性比较

Biocompatibility comparison between different dynamic hip screws for femoral intertrochanteric fractures

背景:动力髋螺钉置入治疗股骨转子间骨折选择不锈钢还是钛合金材料一直无明确定论。目的:比较不锈钢动力髋螺钉和钛合金动力髋螺钉置入治疗股骨转子间骨折的生物相容性。方法:2003-07/2009-10收治股骨转子间骨折86例,分别用不锈钢动力髋螺钉和钛合金动力髋螺钉治疗各43例,两组患者在性别、年龄、致伤原因、骨折分型等方面基本相同,不锈钢动力髋螺采用00Cr18Ni14Mo3不锈钢,钛合金动力髋螺钉采用Ti6A14V钛合金,比较两组固定后的并发症、髋关节功能的恢复情况,取钉时大体观察植入物周围软组织炎症反应、增生及纤维囊壁情况。结果与结论:两组固定后并发症、髋关节功能的恢复方面差异无显著性意义,但在取钉时大体观察内固定周围软组织炎症反应、增生及纤维囊壁情况,不锈钢动力髋螺钉组明显多于钛合金动力髋螺钉组(P<0.01)。提示钛合金动力髋螺钉的生物相容性好于不锈钢动力髋螺钉,可作为永久性置入材料。

BACKGROUND：There has been no clear conclusion about the better selection of materials with good biocompatibility between stainless steel and titanium alloy dynamic hip screw for the treatment of intertrochanteric fracture of the femur.OBJECTIVE：To compare the biocompatibility between stainless steel and titanium alloy dynamic hip screw implantation in the treatment of intertrochanteric fracture of femur.METHODS：A total of 86 patients with femoral intertrochanteric fracture were selected from July 2003 to October 2009,and treated with stainless steel dynamic hip screw（n=43） and titanium alloy dynamic hip screw（n=43）.Two groups were matched in terms of gender,age,cause of injury,and fracture type.00Cr18Ni14Mo3 stainless steel was used in stainless steel dynamic hip screw group and Ti6A14V titanium alloy in the titanium alloy dynamic hip screw group.Differences in postoperative complications and recovery of hip joint function were compared between two groups,and soft tissue inflammatory reaction,hyperplasia and fibrous capsule wall surrounding the implants were observed.RESULTS AND CONCLUSION：There were no significant differences between two groups in the postoperative complications and recovery of hip joint function,but the stainless steel dynamic hip screw group was worse than the titanium alloy dynamic hip screw group in the soft tissue inflammatory reaction,hyperplasia and fibrous capsule wall surrounding the implants when removing the screws（P 0.01）.Results indicated that biocompatibility of titanium alloy dynamic hip screw was better than the stainless steel dynamic hip screw and can be used as a permanent implant material.