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A Novel Biodegradable Polycaprolactone Fixator for Osteosynthesis Surgery of Rib Fracture: In Vitro and in Vivo Study

Department of Orthopedic Surgery, Musculoskeletal Research Center, Chang Gung Memorial Hospital, Tao-Yuan 33305, Taiwan
Department of Mechanical Engineering, Chang Gung University, Tao-Yuan 33302, Taiwan
Author to whom correspondence should be addressed.
Academic Editors: Aldo R. Boccaccini, Jung Kwon (John) Oh and Juergen Stampfl
Materials 2015, 8(11), 7714-7722;
Received: 16 August 2015 / Revised: 19 October 2015 / Accepted: 5 November 2015 / Published: 13 November 2015
(This article belongs to the Section Biomaterials)
Osteosynthesis surgery for rib fractures is controversial and challenging. This study developed a noval poly(ε-caprolactone) (PCL)-based biodegradable “cable-tie” fixator for osteosynthesis surgery for rib fractures. A biodegradable fixator specifically for fractured ribs was designed and fabricated by a micro-injection molding machine in our laboratory. The fixator has three belts that could be passed through matching holes individually. The locking mechanism allows the belt movement to move in only one direction. To examine the in vitro biomechanical performance, ribs 3–7 from four fresh New Zealand rabbits were employed. The load to failure and stress-strain curve was compared in the three-point bending test among native ribs, titanium plate-fixed ribs, and PCL fixator-fixed ribs. In the in vivo animal study, the sixth ribs of New Zealand rabbits were osteotomized and osteosynthesis surgery was performed using the PCL fixator. Outcomes were assessed by monthly X-ray examinations, a final micro-computed tomography (CT) scan, and histological analysis. The experimental results suggested that the ribs fixed with the PCL fixator were significantly less stiff than those fixed with titanium plates (p < 0.05). All ribs fixed with the PCL fixators exhibited union. The bridging callus was confirmed by gross, radiographic micro-three-dimensional (3D) CT, and histological examinations. In addition, there was no significant inflammatory response of the osteotomized ribs or the PCL-rib interface during application. The novel PCL fixator developed in this work achieves satisfactory results in osteosynthesis surgery for rib fractures, and may provide potential applications in other orthopedic surgeries. View Full-Text
Keywords: polycaprolactone; rib fracture; osteosynthesis; internal fixation polycaprolactone; rib fracture; osteosynthesis; internal fixation
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Yu, Y.-H.; Fan, C.-L.; Hsu, Y.-H.; Chou, Y.-C.; Ueng, S.W.N.; Liu, S.-J. A Novel Biodegradable Polycaprolactone Fixator for Osteosynthesis Surgery of Rib Fracture: In Vitro and in Vivo Study. Materials 2015, 8, 7714-7722.

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