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DOI: 10.1055/s-2002-30629
© Georg Thieme Verlag Stuttgart · New York
The Biodegradable Intramedullar Nail
Biomechanical Results and Tissue Response 4 Years after Implantation in SheepPublikationsverlauf
Publikationsdatum:
17. Mai 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.
Key words
Intramedullar osteosynthese - Biodegradable - Polylactid acid
Schlüsselwörter
Intramedulläre Knochenstabilisierung - Polylaktat - Biologisch abbaubar
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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