课题背景：解放军第二军医大学附属长海医院骨科张春才教授设计了镍钛聚髌器，利用记忆合金的特点，使其在使用时产生多方向的持续向心抓髌聚合力，从而固定住严重粉碎的髌骨。

应用要点：镍钛聚髌器置入后使骨折端获得可靠的固定，形成了骨折端的持续性成骨力值，为从分子生物学的角度认识骨折愈合奠定了基础。

术语解析：记忆性压应力和生理性应力结合形成骨折端持续性生理性成骨力值，在骨折愈合过程中持续存在，不因骨折线的吸收而消失，持续刺激骨折端组织形成与分化，有效促进骨折愈合，降低了骨折延迟愈合、骨不连的发生率。

摘要
目的：镍钛聚髌器在人体温度下产生的固定和加压作用为持续不断的，使出现吸收的骨折端继续紧密对合。回顾性分析生理性成骨力值概念在镍钛聚髌器治疗髌骨骨折中的应用。
方法：①选择解放军第二军医大学长海医院2003-01/2006-01应用镍钛聚髌器治疗髌骨骨折患者106例，其中男75例，女31例；年龄16~72岁，平均年龄39.3岁。伤后至手术时间3 h~7 d，全部为闭合性骨折。②西脉产聚髌器由镍钛记忆合金材料制成，由5个功能爪枝和1个连结爪枝的功能腰部组成，分为大、中、小3个型号。根据其结构为奥-马互逆的特性使其在体温驱动下，功能爪可从5~9个方面对髌骨产生持续、稳定、立体、向心的加压聚合力。记忆合金还具有良好的组织相容性，是理想的人体生物功能材料。③术后2，4，8周及5个月时复查X射线片。并对膝关节功能进行评价。
结果：106例患者平均随访23个月（11~50个月），X射线片示髌骨关节面达到解剖复位者96例，患膝功能平均3.3周达到90°，平均6.9周屈、伸功能达到健侧水平，按Bostman临床评分系统，优99例，良7例，优良率100％。术后未见聚髌器松动、断裂等材料反应。无炎症、排异等宿主反应。
结论：镍钛聚髌器使骨折端获得可靠的固定，同时使生理性应力在骨愈合的过程中持续通过骨折端，可以获得良好的骨愈合和功能水平。
关键词：镍钛聚髌器；髌骨骨折；成骨力值；骨折固定术；医学植入体

刘欣伟，苏佳灿，张春才，禹宝庆，纪方，许硕贵，傅青格，牛云飞，管华鹏，陈育岳.生理性成骨力值概念在镍钛聚髌器置入治疗髌骨骨折的应用：106例回顾[J].中国组织工程研究与临床康复，2008，12(17):3225-3228
[www.zglckf.com/zglckf/ejournal/upfiles/08-17/17k-3225(ps).pdf]

Nickel-titanium patellar concentrator for the treatment of patellar fracture based on concept of physiological osteogenic stress: A retrospective analysis of 106 cases

Abstract

AIM:Nickel-titanium patellar concentrator (NT-PC) can maintain fixation and pressure under human temperature, and keep fracture sites closely apposed. This study analyzed the treatment of patellar fracture using NT-PC based on the concept of physiological osteogenic stress.
METHODS: 106 patients with patellar fracture who were treated by NT-PC in Changhai Hospital of Second Military Medical University of Chinese PLA between January 2003 and January 2006 were selected, including 75 males and 31 females, with an average age of 39.3 years (range, 16-72 years). All fracture was closed fracture within 3 hours to 7 days before surgery. ②PC was made of Nickel and Titanium memory alloy by Seemine, Gansu. It consisted of 5 concentrator hooks and 1 device connecting hook stem, and was classified into large, middle and small types. The concentrator hooks produced sustained, stable, three-dimensional and centripetal compression on patella from 5-9 directions. Moreover, the good histocompatibility of memory alloy made it possible to become ideal biomaterial for human body. ③X-ray examination was performed to evaluate knee joint function 2, 4, 8 weeks and 5 months after surgery.
RESULTS: 106 cases were averagely followed up for 23 months (range, 11-50 months). Radiograph showed that 96 cases obtained anatomic reduction of facies articularis patellae, and the fractured knee function was improved (90 °) after average 3.3 weeks, flexion and extension function restored to normal extent at average 6.9 weeks. According to Bostman scoring system, 99 cases were excellent, and 7 were good. The excellent and good rate was 100%. PC loosening and breakage were not found postoperatively. No inflammation or rejection responses were found.
CONCLUSION: NT-PC can fix bone fragments reliably and provide continuous compression axially during fracture union, and accordingly promote the union of fractures.

Liu XW, Su JC, Zhang CC, Yu BQ, Ji F, Xu SG, Fu QG, Niu YF, Guan HP, Chen YY.Nickel-titanium patellar concentrator for the treatment of patellar fracture based on concept of physiological osteogenic stress: A retrospective analysis of 106 cases. Zhongguo Zuzhi Gongcheng Yanjiu yu Linchuang Kangfu 2008;12(17):3225-3228(China)
[www.zglckf.com/zglckf/ejournal/upfiles/08-17/17k-3225(ps).pdf]