WO2015043496A1 - Bone injury repair and fixation instrument and method of manufacturing same - Google Patents
Bone injury repair and fixation instrument and method of manufacturing same Download PDFInfo
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- WO2015043496A1 WO2015043496A1 PCT/CN2014/087498 CN2014087498W WO2015043496A1 WO 2015043496 A1 WO2015043496 A1 WO 2015043496A1 CN 2014087498 W CN2014087498 W CN 2014087498W WO 2015043496 A1 WO2015043496 A1 WO 2015043496A1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L31/00—Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
- A61L31/04—Macromolecular materials
- A61L31/06—Macromolecular materials obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds
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- the invention relates to the field of medical devices. More specifically, the present invention relates to a bone injury repair fixation device and a method of preparing the same.
- Bone trauma is a common disease in surgical surgery. With the aging of the population structure, the development of transportation and manufacturing, and the increasing environmental pollution, the number of patients requiring bone repair due to bone trauma is rising. The lesions and injuries of bone tissue directly affect people's quality of life, so the repair of bone tissue has always been a medical research topic of great concern. Implantation of artificial materials into the body to repair or replace lesions and damage bone tissue is the main clinical treatment.
- bone bones, spikes, bone screws, bone plates, etc. are often used to join together damaged bone tissue to promote bone tissue regeneration and recovery.
- These bone nails, spikes, bone screws and bone plates are generally made of a metallic material such as stainless steel, nickel titanium alloy, ceramic or polymeric material.
- Absorbable polymer materials have received extensive attention in recent years, such as the successful application of polylactic acid, polyglycolide and their copolymers in fracture fixation systems.
- These orthopedic fixation devices come in different shapes and sizes to provide special features.
- the bone screw fixation is usually inserted into a screw hole previously drilled in the bone to be repaired.
- Bone nails or spikes differ from bone screws in that they have no threads and nuts and are often used to increase the stiffness of the bone rather than providing compression.
- the role of the bone plate is to tightly bond the bone or other parts of the bone together.
- the bone plate is usually fixed using bone screws.
- An anchor is used as an attachment for stitching.
- Metal, ceramic and polymeric bone fixation devices are not without problems.
- Medical metal materials mainly include stainless steel, cobalt, chromium, nickel-based alloys, titanium alloys, and precious metals such as gold and platinum. Its biggest advantages: high strength, mature technology, low cost, easy to change shape Adapts to the contours of the bone and is easy to store. However, it also has significant defects: the mechanical compatibility and the tissue compatibility of the metal material and the bone tissue are poor, and the mismatch of the mechanical properties will lead to uneven stress distribution, which will cause the relative movement of the implant and the bone to cause loosening and dislocation.
- Inorganic non-metallic materials are mainly a series of calcium phosphate-based bioceramics (including ⁇ -tricalcium phosphate, ⁇ -tricalcium phosphate, tetracalcium phosphate, etc.), hydroxyapatite (HA), bioglass and wollastonite.
- Biomedical inorganic non-metallic materials have excellent biological activity, but have defects of large brittleness and poor wear resistance.
- Medical polymer materials are divided into two kinds of natural polymer materials and synthetic polymer materials.
- natural polymer materials mainly include polysaccharides and proteins. Commonly used are: chitosan and collagen; synthetic polymer materials. According to the structural characteristics of the main chain, it is divided into polyesters, polyanhydrides, polyamides, polyphosphates, etc. Commonly used are polyglycolide (polyglycolic acid, PGA), polylactide (polylactic acid, polylactic acid). Acid, PLA), poly- ⁇ -hydroxybutyrate (PHB), copolymers and complexes thereof, and the like are generally linear polymers. Polymer materials have incomparable flexibility between metallic materials and inorganic non-metallic materials.
- U.S. Patent No. 4,539,981 is incorporated herein by reference.
- the apparatus is made of an L-lactide polymer having an intrinsic viscosity of 4.5 or more and a very high molecular weight.
- the polymer contains less than 2% unreacted monomer and is polymerized at selected monomer to catalyst ratios and temperature conditions.
- the device is absorbed by the body and does not need to be removed after the bone has healed.
- US Patent No. 4,655,777 is directed to a method of making a biodegradable prosthesis, and its use in bone plates and orthopedic devices, wherein the prosthesis is made of a composite of biodegradable polymers reinforced with absorbable fibers.
- the fibers include ceramic powder, beta-TCP, CaAl, biodegradable glass, CMP, especially calcium phosphate fibers.
- the invention aims to combine the advantages of both ceramic and polymeric materials while eliminating the drawbacks (brittleness and strength) of both.
- U.S. Patent No. 5,108,755 discloses biodegradable composites suitable for use as a building material for implantable medical devices.
- the composite is made of a biodegradable substrate (e.g., polyorthoester) and a biodegradable reinforcing material (e.g., calcium metaphosphate (CSM) fiber.
- CSM calcium metaphosphate
- U.S. Patent No. 7,378,144 B2 is directed to an oriented polymer implantable device and a method of making the same, the device comprising an implantable tissue or a bone fixation device. Since the degree of polymer orientation is related to physical properties (e.g., strength, elasticity, etc.), the invention achieves higher strength by providing a higher degree of polymer orientation.
- the above patents or applications are based on linear degradable polymer materials, especially polylactic acid or its copolymers, or further processing these materials, such as orientation to enhance the mechanical properties of the materials, to prepare degradable bone nails, bone screws, Fixing parts such as bone plates.
- the main problem is that the bone nail plate prepared by these materials is not strong enough, is easy to break, and the degradation time is too long.
- the material used for preparing the bone repair system is a cross-linked degradable polymer (polymer) material having a three-dimensional crosslinked network structure, so that it has higher mechanical strength than a linear polymer material (for example, polylactic acid). And toughness, easy to store, and can avoid breakage, to ensure the stability of the bone wound site in the early stage of healing.
- the material has a controlled degradation rate, which can be matched with the rate of bone tissue repair, avoiding delayed occlusion caused by delayed stress in the late healing, which is beneficial to the repair of bone tissue. Reconstruction, speed up its clinical healing, and can control the degradation rate of orthopedic products according to the needs of different parts and different products.
- the fracture and bone damage fixing member of the present invention can be designed as an orthopedic fixing member made of a standard metal or polymer material, and different structures are designed on the basis of the above, and the material for preparing the fixing member of the present invention is cross-linked type. Degradation of polymer materials.
- the present invention relates to a bone injury repair and fixation device, characterized in that the device uses a cross-linked biodegradable polymer material, the polymer material is a monomer homopolymer, and a plurality of single substances.
- the copolymer of the body, or a blend of 2 to 3 kinds of the homopolymers and copolymers, has a three-dimensional crosslinked network structure.
- the monomer for preparing the crosslinked degradable polymer material is a left-handed milk Acid, D-lactic acid, lactide, ⁇ -caprolactone, salicylic acid, carbonate, amino acids and derivatives thereof.
- the proportion of comonomer is between 95:5 and 50:50.
- the invention also relates to a bone nail having the features of the bone injury repair fixation device described above.
- the invention further relates to a bone screw comprising a nail cap, a screw, a thread and a tip having the features of the bone injury repair fixation device described above.
- the present invention also relates to a bone plate or a holder comprising a body and a fixing hole provided in the body, which has the features of the above-described bone damage repairing and fixation device.
- the present invention also relates to a method for preparing the above-described bone damage repair and fixation device, comprising performing a cross-linking treatment before, during, or after the molding process.
- the forming process is injection molding, injection molding - laser cutting molding, hot pressing - laser cutting molding, extrusion molding or extrusion-laser cutting molding.
- the crosslinking treatment employs ultraviolet crosslinking, thermal reaction crosslinking, chemical reaction crosslinking, and/or physical crosslinking.
- a three-dimensional network crosslinked copolymer is formed by introducing a crosslinkable group at the terminal group of the polymer material, by ultraviolet crosslinking or thermal reaction crosslinking.
- the crosslinkable group is a methacrylic acid containing a double bond, an acrylic acid containing a double bond, anthracene, cinnamic acid or coumarin.
- a crosslinking agent is added to the polymer material, and the crosslinking agent chemically reacts with the terminal group of the polymer material to form a three-dimensional network crosslinked copolymer after heating.
- the cross-linking agent is multi-armed, for example, by a 2-arm linear, 3-arm or 4-arm star prepolymer, preferably a 3-arm or 4-arm star prepolymer, which is cross-linked.
- the terminal group contains a reactive group such as an isocyanate, an epoxy group or the like.
- the crosslinking agent is multi-armed, and the terminal group contains a crosslinkable group of an unsaturated olefin, which can itself undergo a crosslinking reaction to form a three-dimensional network structure, which is irradiated by heating or ultraviolet light, and the high
- the molecular material forms a semi-interpenetrating network structure.
- the fixing device formed of a degradable polymer material is subjected to radiation crosslinking, and the radiation crosslinking is selected from electron beam crosslinking and gamma ray crosslinking.
- TMAIC trimethylallyl isocyanurate
- an orientation force is applied to the polymer melt to orient the molecular material, so that the crosslinked polymer has higher mechanical properties.
- the fixing means is heated and stretched after the forming to orient the molecular material, and the applied temperature is between the glass transition temperature and the melting point of the polymer.
- the degradable polymer material comprises L-polylactic acid, racemic polylactic acid, polyglycolic acid, poly- ⁇ -caprolactone, polytrimethylene carbonate, polydioxanone, polyamino acid derivative. a carbonate or polyorthoester degradable polymer material, a blend of any two or three kinds of degradable polymer materials, a synthetic monomer of the above degradable polymer material and a small amount of a second monomer Copolymer.
- the copolymerization mode between the degradable materials includes, but is not limited to, graft copolymerization, block copolymerization, random copolymerization, and the like.
- the monomers of the three copolymerization methods include, but are not limited to, L-lactic acid, D-lactic acid, glycolic acid (glycolic acid), and ⁇ -. Two or more of ester, salicylic acid, carbonate, amino acid and derivatives thereof.
- the polymer material has a molecular weight of 5,000 to 1.2 million and an intrinsic viscosity of 0.1 to 9.0 dl/g.
- an initiator and a catalyst are usually added in the synthesis of a linear or star-degradable polymer.
- the linear prepolymer is synthesized from an initiator containing two hydroxyl groups
- the star prepolymer is synthesized from an initiator containing three or four hydroxyl groups.
- the initiator includes, but is not limited to, an initiator containing two hydroxyl groups, such as ethylene glycol, 1,4-butanediol, n-decanediol, tripropylene glycol, triethylene glycol, triethylene glycol dimethyl Acrylate, triethylene glycol dimethyl ether, triethylene glycol mono-11-decyl undecyl ether, triethylene glycol monobutyl ether, triethylene glycol methyl ether methacrylate, molecular weight 100- 10,000 polyethylene glycol (PEG), polytetrahydrofuran diol (pTHF) having a molecular weight of 100-10,000, polycaprolactone diol (PCL) having a molecular weight of 100-10,000, etc.; an initiator containing three hydroxyl groups, such as Polycaprolactone triol (molecular weight 300,900), trihydroxy polyoxypropylene ether, 1,2,3-heptanetriol, 1,2,6-hexanetriol, tri
- the number average molecular weight of the star (polylactic acid copolymer) prepolymer can be controlled by the relative content of the initiator and the second monomer, and the number The average molecular weight is controlled between 5,000 and 100,000, preferably between 5,000 and 50,000, and then a crosslinkable reactive group is introduced.
- the degradation rate of the synthetic degradable polymeric material is determined by the relative ratio of the first monomer to the second monomer, and the second monomer is between 5-50%.
- the synthetic methods of the degradable polymer material include, but are not limited to, a ring-opening polymerization method, a direct polycondensation method, and the like.
- the ring-opening polymerization is a ring-shaped monomer which is polymerized by ring-opening under the action of an initiator or a catalyst; the polycondensation method means that a bifunctional or polyfunctional monomer is formed by repeated condensation reaction.
- Molecular reactions include melt polycondensation, solution polycondensation, interfacial polycondensation, solid phase polycondensation, and the like.
- the bone screw for fracture and bone injury repair fixation consists of a nail cap, a screw, a thread and a nail tip.
- the shape and size of the bone screw can be referred to the AISF standard for bone screws or moderately modified.
- Thread diameter (mm) Nut diameter (mm) Nail diameter (mm) Thread part minimum diameter (mm) Pitch (mm) 1.5 full thread 3.0 1.0 1.25 2.0 full thread 4.0 1.5 1.25 2.7 full thread 5.0 2.5 1.9 1.25 3.5 full thread 6.0 2.5 2.4 1.25 4.0 part thread 6.0 2.5 1.9 1.75 4.0 full thread 6.0 2.5 1.9 1.75 4.5 part thread 8.0 3.0 3.0 1.75 4.5 full thread 8.0 3.0 3.0 1.75 6.5 full thread 8.0 3.0 3.0 1.75
- the diameter of the shank is between 2-6mm, the minimum diameter of the thread is between 1-6mm, the pitch is chosen to be between 1-3mm, preferably 1.25mm or 1.75mm, as shown in Figure 2.
- the shank portion can be designed as a partially threaded structure as shown in Figure 1 (middle).
- the length of the thread occupies 40-80% of the entire shank, wherein the shank or threaded portion can be selected with a microporous knot This is conducive to the growth of bone cells and is well integrated with the degradable bone screws.
- the size of the nut is between 1 and 12 mm, preferably between 3 and 8 mm.
- the nut can be selected in various forms in Figure 3.
- the upper end of the nut can be provided with a cross recess structure, and the middle of the groove can be perforated for easy integration with the suture.
- the present invention also includes bone nails which may be smooth or barbed to prevent displacement (as shown in Figure 4).
- the diameter of the bone nail is between 2 and 8 mm, preferably between 2 and 5 mm.
- the present invention also includes a bone plate having a variety of shapes. As shown in FIG. 5, the bone plate has a corresponding hole for the bone nail and the bone screw.
- the present invention provides a bone injury repair and fixation device and a preparation method thereof.
- the device comprises a bone nail, a bone screw, a bone plate or a fixing frame.
- the crosslinked polymer material has higher mechanical strength, is easy to store, and is not easily broken. Thereby ensuring the stability of the bone wound site in the early stage of healing; and because the monomer composition and ratio are adjustable, the material has a controllable degradation rate, which matches the rate of bone tissue repair, and solves the stress occlusion caused by the late healing period. Delayed fracture; due to its good degradability and biocompatibility, it avoids secondary surgery, reduces patient pain and inflammation, and accelerates clinical healing.
- Figure 1 shows a bone-fixing bone screw, full thread of the screw, partial thread of the screw, micro-hole of the screw;
- Figure 2 is the thread size
- Figure 3 shows the shape of a bone screw cap
- Figure 4 is a barbed nail and a barb without a barb
- Figure 5 illustrates the design and shape of various bone plates
- Figure 6 is a schematic diagram of the synthesis of a degradable crosslinker.
- Synthesis 3 liter glass reactor was vacuum dried at 80 ° C for 1 hour before polymerization, 2000 g of L-lactide, 100 g of glycolide and 14 g of 1,2,6 under nitrogen protection. - Glycerol was added to the reactor and dried under vacuum at 60 ° C for 1 hour. Then, 2 g of stannous octoate was added, the temperature was raised to 140 ° C, and the reaction was maintained at 140 ° C for 3 hours to obtain a star polylactic acid prepolymer having a number average molecular weight of 20,000 (see Reaction Formula 1).
- the molecular weight of the star polylactic acid copolymer prepolymer is controlled by the relative amounts of the initiator and the monomer, and the number average molecular weight is controlled between 5,000 and 50,000.
- the molecular weight of the star polylactic acid copolymer prepolymer reaches the experimental design requirements, 48 g (0.32 mol) of methacrylic anhydride and 0.6 g (300 ppm) of the free radical inhibitor p-hydroxyanisole are directly added dropwise.
- the reaction was carried out at ° C for 2 hours to form a crosslinkable star polymer (see Reaction Scheme 2). After the reaction was completed, the temperature was lowered to 60 ° C. 5 L of ethyl acetate was added to the reactor to dissolve the prepolymer, and then slowly poured. In a mixture of n-hexane and ethanol, precipitation and drying yield a prepolymer product.
- Reaction formula 1 Formation of a 3-arm star polymer prepolymer
- Reaction Formula 2 Formation of a 3-arm star crosslinkable prepolymer with a crosslinkable reactive group
- (b) or the obtained crosslinkable prepolymer with reactive groups and the linear degradable polymer material are mixed in a certain ratio to be processed into the fracture and bone damage fixation system such as bone nail and bone plate described above.
- Bone block, bone rod, etc. irradiated under ultraviolet light in the 200-400nm band, and the temperature is controlled between 35-65 ° C, and the cross-linking reaction is carried out for 5-30 min to obtain a product;
- a cyclic monomer or a cyclic comonomer such as L-lactide and ⁇ -caprolactone (L-LA/ ⁇ -CL molar ratio of 95/5) is obtained by a ring-opening polymerization method.
- Synthetic star degradable polymer copolymer as a prepolymer including 2, 3 or 4 arm linear or star polymers, preferably a star polymer with 3 or 4 arms to facilitate Cross-linking reaction), such as a tetrahydroxy polymer.
- the number average molecular weight of the tetrahydroxy polymer is controlled between 500 and 100,000.
- the isocyanate is then introduced at the end of the tetrahydroxy polymer by polycondensation, and the remaining isocyanate is removed by polymer precipitation washing to ensure that no isocyanate residue is present, thereby synthesizing the crosslinker.
- the proportion of the crosslinking agent in the mixture is between 10% and 80%, and an appropriate amount can be added.
- the (for example, 0.1 mol%) catalyst, such as dibutyltin dilaurate, is then prepared by injection extrusion or injection molding to obtain bone nails, bone screws, bone plates and the like.
- the apparatus to be prepared may be subjected to a suitable heat treatment for completion of the crosslinking reaction, thereby obtaining a polymer article having a three-dimensional crosslinked network structure.
- the prepolymer or the prepolymer and the blend of the above Example 1 are thoroughly mixed, heated and melted between two glasses, and a PTFE-cut frame film is placed between the glass to control the thickness of the sheet.
- the composite sheet was prepared by cross-linking polymerization by heating or UV light irradiation, and the mechanical properties and thermal properties of the polymer are shown in Table 1 below.
- the degradation rate experiment was carried out in a constant temperature oscillating degrader. A sample of a certain size and weight was placed in a pH 7 buffer solution, and the bath temperature was controlled at 37 °C. The samples were taken out at regular intervals and weighed, so that the weight loss (%) of the samples was measured.
- PLGA L-lactide and glycolide copolymer
- PLGA (95/5) indicates that the ratio of polymerized L-lactic acid to glycolide is 95:5, and so on;
- PLLA poly-L-lactic acid
- PDLLA poly- lactic acid
- P(L-LA70-DL-LA30)-TERA represents that the ratio of the polymerized L-lactide L-LA to the racemic lactide DL-LA is 70:30, and the initiator is pentaerythritol;
- pTHF250 polytetrahydrofuran diol having a molecular weight of 250;
- PCL polycaprolactone diol
- PCL500 and PCL540 represent polycaprolactone diols having molecular weights of 500 and 540, respectively;
- PLGA(85/15)-tetra-20K-PLA32 wherein PLGA(85/15)-tetra-15K represents a molecular weight of 20kk of crosslinker with 4 arms of isocyanate, and a polymer which is cross-linked with it It is PLA polylactic acid and its intrinsic viscosity is 3.2dL/g.
- PEG600 and PEG1000 represent polyethylene glycols having molecular weights of 600 and 1000, respectively;
- PLGA(85/15)-PCL trio1900 indicates that the ratio of the polymerized L-lactide to glycolide is 85:15, the initiator is polycaprolactone triol, and the molecular weight is 900;
- P(DL-LA/ ⁇ -CL 90/10)-PCL 540 indicates that the ratio of the polymerized racemic lactide DL-LA to caprolactone ⁇ -CL is 90:10, and the initiator is polycaprolactone a triol having a molecular weight of 540;
- PLGA(85/15)-PC500 wherein the ratio of polymerized L-lactide to glycolide is 85:15, the initiator is polycarbonate diol, and the molecular weight is 500;
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Abstract
A bone injury repair fixation instrument and a method of manufacturing same. A crosslinked biodegradable polymer material is adopted for the instrument. The polymer material is a homopolymer of monomers, a copolymer of multiple monomers or a blend of 2 or 3 kinds of the homopolymer and copolymer, and has a three-dimensional crosslinked network structure. The instrument comprises a bone nail, a bone screw, a bone plate or a fixing support, and has great mechanical performance, structural stability, controllable degradation speed, and excellent biocompatibility.
Description
本发明涉及医疗器械领域。更具体而言,本发明涉及一种骨损伤修复固定器械及其制备方法。The invention relates to the field of medical devices. More specifically, the present invention relates to a bone injury repair fixation device and a method of preparing the same.
骨创伤是外科临床常见的疾病。随着人口结构的老龄化、交通和制造业的发展、环境污染的日益严重,由于骨创伤需要使用骨修复的患者数量在不断攀升。骨组织的病变和损伤直接影响着人们的生活质量,故骨组织的修复一直以来都是人们非常关注的医学研究课题。采用人工材料植入体内修复或替代病变及损伤骨组织是临床上主要的治疗方法。Bone trauma is a common disease in surgical surgery. With the aging of the population structure, the development of transportation and manufacturing, and the increasing environmental pollution, the number of patients requiring bone repair due to bone trauma is rising. The lesions and injuries of bone tissue directly affect people's quality of life, so the repair of bone tissue has always been a medical research topic of great concern. Implantation of artificial materials into the body to repair or replace lesions and damage bone tissue is the main clinical treatment.
在修复骨折、骨断裂或其他类型的骨修复过程中,通常是使用骨钉、钉状物、骨螺钉、骨板等将损坏的骨组织接合在一起,促使骨组织重新生长和康复。这些骨钉、钉状物、骨螺钉和骨板一般是由金属材料,比如不锈钢、镍钛合金、陶瓷或者高分子材料制备的。可吸收的高分子材料在近年来获得了广泛的关注,例如聚乳酸、聚乙交酯及其共聚物在骨折固定系统中获得成功的应用。这些骨科固定器件有不同的形状和大小,以便提供特殊的功能。骨螺钉固定件通常是插入事先在被修复骨里钻造的螺丝孔里面。骨钉或钉状物区别于骨螺钉在于没有螺纹和螺帽,通常被用在提高骨的坚硬性而不是提供压缩功能。骨板的作用是将骨或骨的其他部分紧密地结合在一起。骨板通常是使用骨螺钉固定的。固定架(anchor)被用作缝合的附件使用。In the repair of fractures, bone fractures or other types of bone repair, bone bones, spikes, bone screws, bone plates, etc. are often used to join together damaged bone tissue to promote bone tissue regeneration and recovery. These bone nails, spikes, bone screws and bone plates are generally made of a metallic material such as stainless steel, nickel titanium alloy, ceramic or polymeric material. Absorbable polymer materials have received extensive attention in recent years, such as the successful application of polylactic acid, polyglycolide and their copolymers in fracture fixation systems. These orthopedic fixation devices come in different shapes and sizes to provide special features. The bone screw fixation is usually inserted into a screw hole previously drilled in the bone to be repaired. Bone nails or spikes differ from bone screws in that they have no threads and nuts and are often used to increase the stiffness of the bone rather than providing compression. The role of the bone plate is to tightly bond the bone or other parts of the bone together. The bone plate is usually fixed using bone screws. An anchor is used as an attachment for stitching.
金属、陶瓷和高分子材料骨固定装置不是没有问题的。医用金属材料主要有不锈钢、钴、铬、镍基合金、钛合金,以及贵金属金、铂等。其最大的优点:强度高,工艺成熟,成本较低,方便改变形状以
适应骨的外形轮廓,而且易于保存。但其也存在显著的缺陷:金属材料与骨组织的机械相容性和组织相容性差,机械性能的不匹配将导致应力分布不均匀,会使植入体与骨产生相对运动引起松动和脱位,易造成骨质疏松、骨吸收或骨萎缩且又易出现二次骨折;组织相容性差,缺乏足够的机械应力刺激易导致初期骨愈合延迟。金属内固定物比如金属钉和骨螺钉通常在使用后需经二次手术取出,再次给病人造成巨大的痛苦。对病人造成二次创伤同时也使得被修复骨支撑力减弱。Metal, ceramic and polymeric bone fixation devices are not without problems. Medical metal materials mainly include stainless steel, cobalt, chromium, nickel-based alloys, titanium alloys, and precious metals such as gold and platinum. Its biggest advantages: high strength, mature technology, low cost, easy to change shape
Adapts to the contours of the bone and is easy to store. However, it also has significant defects: the mechanical compatibility and the tissue compatibility of the metal material and the bone tissue are poor, and the mismatch of the mechanical properties will lead to uneven stress distribution, which will cause the relative movement of the implant and the bone to cause loosening and dislocation. It is easy to cause osteoporosis, bone resorption or bone atrophy and is prone to secondary fractures; poor histocompatibility, lack of sufficient mechanical stress stimulation may lead to delayed initial bone healing. Metal internal fixations such as metal nails and bone screws are usually removed after a second operation after use, again causing great pain to the patient. The second trauma to the patient also reduces the support of the repaired bone.
无机非金属材料主要是一系列磷酸钙基生物陶瓷(包括α-磷酸三钙、β-磷酸三钙、磷酸氧四钙等)、羟基磷灰石(HA)、生物玻璃和硅灰石等。生物医用的无机非金属材料具有优异的生物活性,但存在脆性大和耐磨性差的缺陷。Inorganic non-metallic materials are mainly a series of calcium phosphate-based bioceramics (including α-tricalcium phosphate, β-tricalcium phosphate, tetracalcium phosphate, etc.), hydroxyapatite (HA), bioglass and wollastonite. Biomedical inorganic non-metallic materials have excellent biological activity, but have defects of large brittleness and poor wear resistance.
医用高分子材料又分为天然高分子材料和合成高分子材料两种,其中天然高分子材料主要有多糖类和蛋白质两大类,常用的有:壳聚糖和胶原蛋白;合成高分子材料按主链结构特征分为聚酯类、聚酸酐类、聚酰胺类、聚磷酯类等,常用的有聚乙交酯(聚羟基乙酸,polyglycolicacid,PGA)、聚丙交酯(聚乳酸,polylactic acid,PLA)、聚-β-羟丁酸(poly-β-hydroxybutyrate,PHB)及它们的共聚物和复合物等,一般都为线性聚合物。高分子材料有着金属材料和无机非金属材料不可比拟的柔韧性。自1965年始,人们已经尝试用可降解高分子材料代替传统的金属材料作骨折内固定装置。随着可降解内固定物应用于骨折治疗,临床已显示出明显的优越性,其特点主要表现在:操作简单,具有植骨及诱导成骨作用,当材料降解失去强度的同时,应力逐渐转移至愈合的骨组织,避免了应力遮挡。无金属的腐蚀反应,不干扰放射影像。内固定材料可降解物被组织吸收,无需第二次手术,减少患者痛苦,总体费用低;无明显排异反应及感染,愈合相对较快。但在应用过程中,也出现了一些缺点,比如固定件的机械强度低,生物活性差,易磨损,储存困难,降解速率不可控,完全吸收时间过长,且存在断裂问题,术后需要牢靠有效的外固定,如石膏外固定,时间也
相对较长。对某些部位不适合,如张力较大的部位,其治疗骨折适应症有限,主要包括关节内骨折,松质骨骨折,管状骨骨折,截骨术,关节融合术等。Medical polymer materials are divided into two kinds of natural polymer materials and synthetic polymer materials. Among them, natural polymer materials mainly include polysaccharides and proteins. Commonly used are: chitosan and collagen; synthetic polymer materials. According to the structural characteristics of the main chain, it is divided into polyesters, polyanhydrides, polyamides, polyphosphates, etc. Commonly used are polyglycolide (polyglycolic acid, PGA), polylactide (polylactic acid, polylactic acid). Acid, PLA), poly-β-hydroxybutyrate (PHB), copolymers and complexes thereof, and the like are generally linear polymers. Polymer materials have incomparable flexibility between metallic materials and inorganic non-metallic materials. Since 1965, attempts have been made to replace traditional metal materials with biodegradable polymer materials for fracture internal fixation. With the application of degradable internal fixation in the treatment of fractures, clinical advantages have been shown. The main features are: simple operation, bone grafting and osteogenic induction. When the material loses strength, the stress gradually shifts. To the healing of the bone tissue, stress shielding is avoided. No metal corrosion reaction, does not interfere with radiographic images. The internal fixation material degradable material is absorbed by the tissue, no need for a second operation, reducing the patient's pain, the overall cost is low; no obvious rejection and infection, and the healing is relatively fast. However, in the application process, some shortcomings have also appeared, such as low mechanical strength of the fixing member, poor biological activity, easy wear and tear, difficulty in storage, uncontrollable degradation rate, excessive absorption time, and fracture problem. Effective external fixation, such as plaster fixation, time
Relatively long. It is not suitable for some parts, such as the part with large tension, which has limited fracture indications, including intra-articular fractures, cancellous bone fractures, tubular bone fractures, osteotomy, and arthrodesis.
美国专利No.4,539,981涉及一种可吸收内骨固定装置。该装置由特性粘度4.5以上、分子量非常高的L-丙交酯聚合物制成。该聚合物含有低于2%未反应的单体,并在选择的单体与催化剂比和温度条件下聚合。该装置可被人体吸收,并在骨愈合后无需取出。U.S. Patent No. 4,539,981 is incorporated herein by reference. The apparatus is made of an L-lactide polymer having an intrinsic viscosity of 4.5 or more and a very high molecular weight. The polymer contains less than 2% unreacted monomer and is polymerized at selected monomer to catalyst ratios and temperature conditions. The device is absorbed by the body and does not need to be removed after the bone has healed.
欧洲专利申请No.0,266,146 A2涉及一种可吸收抗断裂骨板,该骨板有助于内固定,并由可被人体吸收的材料(例如,如美国专利4,539,981中公开的聚丙交酯聚合物)制成。European Patent Application No. 0,266,146 A2, which is incorporated herein incorporated by reference in its entirety in its entire entire entire entire entire entire entire entire entire entire entire entire entire entire entire entire portion production.
美国专利No.4,655,777涉及一种制备生物可降解假体的方法,及其在骨板和整形外科装置中的应用,其中该假体由以可吸收纤维加强的生物可降解聚合物的复合体制成,所述纤维包括陶瓷粉末,β-TCP,CaAl,生物可降解玻璃,CMP,尤其是磷酸钙纤维。该发明旨在组合陶瓷材料和聚合物材料两者的优点,同时消除两者的缺陷(脆性和强度)。US Patent No. 4,655,777 is directed to a method of making a biodegradable prosthesis, and its use in bone plates and orthopedic devices, wherein the prosthesis is made of a composite of biodegradable polymers reinforced with absorbable fibers. The fibers include ceramic powder, beta-TCP, CaAl, biodegradable glass, CMP, especially calcium phosphate fibers. The invention aims to combine the advantages of both ceramic and polymeric materials while eliminating the drawbacks (brittleness and strength) of both.
美国专利No.5,108,755公开生物可降解复合体,适于用作可植入医疗器械的构建材料。该复合体由生物可降解基材(例如聚原酸酯)和生物可降解加强材料(例如偏磷酸钙钠(CSM)纤维制成。该发明旨在平衡复合体的强度和生物降解性。U.S. Patent No. 5,108,755 discloses biodegradable composites suitable for use as a building material for implantable medical devices. The composite is made of a biodegradable substrate (e.g., polyorthoester) and a biodegradable reinforcing material (e.g., calcium metaphosphate (CSM) fiber. This invention is intended to balance the strength and biodegradability of the composite.
美国专利No.7378144 B2涉及一种取向的聚合物可植入装置及其制备方法,所述装置包括可植入组织或骨固定装置。由于聚合物取向程度与物理性质(例如强度,弹性等)相关,通过提供较高程度的聚合物取向,该发明实现较高的强度。
U.S. Patent No. 7,378,144 B2 is directed to an oriented polymer implantable device and a method of making the same, the device comprising an implantable tissue or a bone fixation device. Since the degree of polymer orientation is related to physical properties (e.g., strength, elasticity, etc.), the invention achieves higher strength by providing a higher degree of polymer orientation.
上述专利或申请都是以线型可降解高分子材料尤其是聚乳酸或其共聚物为材料或将这些材料进一步加工,比如取向以增强材料的力学性能,来制备可降解骨钉,骨螺钉,骨板等固定件。主要问题是以这些材料制备的骨钉骨板等强度不够,容易断裂,降解时间过长等。The above patents or applications are based on linear degradable polymer materials, especially polylactic acid or its copolymers, or further processing these materials, such as orientation to enhance the mechanical properties of the materials, to prepare degradable bone nails, bone screws, Fixing parts such as bone plates. The main problem is that the bone nail plate prepared by these materials is not strong enough, is easy to break, and the degradation time is too long.
为了弥补上述骨损伤固定系统的不足,开发具有优异生物相容性,高机械强度,和降解可控的骨损伤固定系统势在必行。In order to make up for the above-mentioned deficiencies of the bone injury fixation system, it is imperative to develop a bone injury fixation system with excellent biocompatibility, high mechanical strength, and controllable degradation.
发明内容Summary of the invention
本发明的目的是设计一套用于固定修复骨折和骨损伤的可降解医疗器械,包括骨钉,骨螺钉,骨板,固定架,以及其制作方法。其中用于制备骨修复系统的材料是交联型可降解高分子(聚合物)材料,其具有三维交联网络结构,故其具有比线性高分子材料(比如,聚乳酸)更高的机械强度和韧性,容易储存,且可避免断裂,保证骨创伤部位在愈合初期的稳定性。此外,由于聚合物的单体组分和比例可调,使得材料具有可控的降解速率,可与骨组织修复的速率相匹配,避免愈合后期应力遮挡导致延迟性骨折,利于骨组织的修复与重建,加快其临床愈合,并且能够根据不同部位、不同产品的需求来控制调节骨科产品的降解速率。It is an object of the present invention to design a set of degradable medical devices for the fixation of fractures and bone injuries, including bone nails, bone screws, bone plates, fixation frames, and methods of making the same. The material used for preparing the bone repair system is a cross-linked degradable polymer (polymer) material having a three-dimensional crosslinked network structure, so that it has higher mechanical strength than a linear polymer material (for example, polylactic acid). And toughness, easy to store, and can avoid breakage, to ensure the stability of the bone wound site in the early stage of healing. In addition, due to the adjustable monomer composition and ratio of the polymer, the material has a controlled degradation rate, which can be matched with the rate of bone tissue repair, avoiding delayed occlusion caused by delayed stress in the late healing, which is beneficial to the repair of bone tissue. Reconstruction, speed up its clinical healing, and can control the degradation rate of orthopedic products according to the needs of different parts and different products.
本发明的骨折和骨损伤固定件可以设计成目前标准的金属或者高分子材料制作的骨科固定件,在此基础上设计出不同的结构,而且本发明制备这些固定件的材料是交联型可降解高分子材料。The fracture and bone damage fixing member of the present invention can be designed as an orthopedic fixing member made of a standard metal or polymer material, and different structures are designed on the basis of the above, and the material for preparing the fixing member of the present invention is cross-linked type. Degradation of polymer materials.
具体而言,本发明涉及一种骨损伤修复固定器械,其特征在于所述器械采用交联型生物可降解高分子材料,所述高分子材料为一种单体的均聚物,多种单体的共聚物,或2~3种所述均聚物、共聚物的共混物,具有三维交联网络结构。Specifically, the present invention relates to a bone injury repair and fixation device, characterized in that the device uses a cross-linked biodegradable polymer material, the polymer material is a monomer homopolymer, and a plurality of single substances. The copolymer of the body, or a blend of 2 to 3 kinds of the homopolymers and copolymers, has a three-dimensional crosslinked network structure.
根据本发明,制备所述交联型可降解高分子材料的单体为左旋乳
酸、右旋乳酸、丙交酯、ε-己内酯、水杨酸、碳酸酯、氨基酸及其衍生物。According to the present invention, the monomer for preparing the crosslinked degradable polymer material is a left-handed milk
Acid, D-lactic acid, lactide, ε-caprolactone, salicylic acid, carbonate, amino acids and derivatives thereof.
根据本发明,所述共聚单体的比例在95∶5-50∶50之间。According to the invention, the proportion of comonomer is between 95:5 and 50:50.
本发明还涉及一种骨钉,其具有上述骨损伤修复固定器械的特征。The invention also relates to a bone nail having the features of the bone injury repair fixation device described above.
本发明还涉及一种骨螺钉,包括钉帽、螺杆、螺纹和顶尖,其具有上述骨损伤修复固定器械的特征。The invention further relates to a bone screw comprising a nail cap, a screw, a thread and a tip having the features of the bone injury repair fixation device described above.
本发明还涉及一种骨板或固定架,包括本体及在本体上设置的固定孔,其具有上述骨损伤修复固定器械的特征。The present invention also relates to a bone plate or a holder comprising a body and a fixing hole provided in the body, which has the features of the above-described bone damage repairing and fixation device.
本发明还涉及一种上述骨损伤修复固定器械的制备方法,包括在成型加工前、成型加工中或成型加工后,进行交联处理。The present invention also relates to a method for preparing the above-described bone damage repair and fixation device, comprising performing a cross-linking treatment before, during, or after the molding process.
根据本发明,所述成型加工采用注塑成型、注塑-激光切割成型、热压-激光切割成型、挤出成型或挤出-激光切割成型。According to the invention, the forming process is injection molding, injection molding - laser cutting molding, hot pressing - laser cutting molding, extrusion molding or extrusion-laser cutting molding.
根据本发明,所述交联处理采用紫外交联、热反应交联、化学反应交联和/或物理交联。According to the present invention, the crosslinking treatment employs ultraviolet crosslinking, thermal reaction crosslinking, chemical reaction crosslinking, and/or physical crosslinking.
根据本发明,通过在所述高分子材料末端基引入可交联基团,利用紫外交联或热反应交联的方式,形成三维网状交联共聚物。According to the present invention, a three-dimensional network crosslinked copolymer is formed by introducing a crosslinkable group at the terminal group of the polymer material, by ultraviolet crosslinking or thermal reaction crosslinking.
根据本发明,所述可交联基团为含有双键的甲基丙烯酸、含有双键的丙烯酸、蒽(anthracene)、肉桂酸或香豆素(coumarin)。According to the invention, the crosslinkable group is a methacrylic acid containing a double bond, an acrylic acid containing a double bond, anthracene, cinnamic acid or coumarin.
根据本发明,所述高分子材料中加入交联剂,交联剂与所述高分子材料末端基发生化学反应,经过加热,形成三维网状交联共聚物。
According to the invention, a crosslinking agent is added to the polymer material, and the crosslinking agent chemically reacts with the terminal group of the polymer material to form a three-dimensional network crosslinked copolymer after heating.
根据本发明,所述交联剂是多手臂的,例如,由2臂线型、3臂或4臂星形预聚体,优选3臂或4臂星形预聚体,经交联处理而成,末端基含有活性基团,例如异氰酸酯、环氧基团等。According to the invention, the cross-linking agent is multi-armed, for example, by a 2-arm linear, 3-arm or 4-arm star prepolymer, preferably a 3-arm or 4-arm star prepolymer, which is cross-linked. The terminal group contains a reactive group such as an isocyanate, an epoxy group or the like.
根据本发明,所述交联剂是多手臂的,末端基含有不饱和烯烃的可交联基团,自身能发生交联反应形成三维网状结构,通过加热或紫外灯照射,与所述高分子材料形成半互穿网络结构。According to the present invention, the crosslinking agent is multi-armed, and the terminal group contains a crosslinkable group of an unsaturated olefin, which can itself undergo a crosslinking reaction to form a three-dimensional network structure, which is irradiated by heating or ultraviolet light, and the high The molecular material forms a semi-interpenetrating network structure.
根据本发明,将可降解高分子材料形成的所述固定器械进行辐射交联,而辐射交联选自电子束交联和伽马射线交联。According to the present invention, the fixing device formed of a degradable polymer material is subjected to radiation crosslinking, and the radiation crosslinking is selected from electron beam crosslinking and gamma ray crosslinking.
根据本发明,所述可降解高分子材料中加入少量,例如,0.5-5.0%的三烯丙基异氰脲酸酯或者三甲基烯丙基异氰脲酸酯(TMAIC)以促进交联反应。According to the present invention, a small amount, for example, 0.5-5.0% of triallyl isocyanurate or trimethylallyl isocyanurate (TMAIC) is added to the degradable polymer material to promote crosslinking. reaction.
根据本发明,在所述成型加工时,对聚合物熔体施加取向力,使所述高分子材料分子取向,使得交联型聚合物拥有更高的力学性能。According to the present invention, at the time of the molding process, an orientation force is applied to the polymer melt to orient the molecular material, so that the crosslinked polymer has higher mechanical properties.
根据本发明,在所述加工成型后对所述固定器械加温拉伸使所述高分子材料分子取向,所加温度在聚合物的玻璃化转变温度和熔点之间。According to the present invention, the fixing means is heated and stretched after the forming to orient the molecular material, and the applied temperature is between the glass transition temperature and the melting point of the polymer.
根据本发明,所述可降解高分子材料包括左旋聚乳酸、消旋聚乳酸、聚羟基乙酸、聚ε-己内酯、聚三亚甲基碳酸酯、聚对二氧环己酮、聚氨基酸衍生碳酸酯、聚原酸酯可降解高分子材料中的一种,上述任何两种或三种可降解高分子材料的共混物,上述可降解高分子材料的合成单体与少量第二单体的共聚物。所述可降解材料之间的共聚方式包括但不限于接枝共聚、嵌段共聚和无规共聚等。三种共聚方式的单体都包括但不仅限于左旋乳酸、右旋乳酸、羟基乙酸(乙醇酸)、ε-己内
酯、水杨酸、碳酸酯、氨基酸及其衍生物等中的两种或两种以上。所述高分子材料的分子量在5,000到120万之间,特性粘度在0.1到9.0dl/g之间。According to the present invention, the degradable polymer material comprises L-polylactic acid, racemic polylactic acid, polyglycolic acid, poly-ε-caprolactone, polytrimethylene carbonate, polydioxanone, polyamino acid derivative. a carbonate or polyorthoester degradable polymer material, a blend of any two or three kinds of degradable polymer materials, a synthetic monomer of the above degradable polymer material and a small amount of a second monomer Copolymer. The copolymerization mode between the degradable materials includes, but is not limited to, graft copolymerization, block copolymerization, random copolymerization, and the like. The monomers of the three copolymerization methods include, but are not limited to, L-lactic acid, D-lactic acid, glycolic acid (glycolic acid), and ε-.
Two or more of ester, salicylic acid, carbonate, amino acid and derivatives thereof. The polymer material has a molecular weight of 5,000 to 1.2 million and an intrinsic viscosity of 0.1 to 9.0 dl/g.
根据本发明,在合成线型或星形可降解聚合物时,通常会加入引发剂和催化剂。由含有两个羟基的引发剂合成线型预聚体,而由含有三个或四个羟基的引发剂合成星形预聚体。所述引发剂包括但不限于含有两个羟基的引发剂,如乙二醇,1,4-丁二醇,正十烷二醇,三丙二醇,三乙二醇,三乙二醇二甲基丙烯酸酯,三乙二醇二甲醚,三乙二醇单-11-巯基十一烷基醚,三乙二醇单丁醚,三乙二醇甲基醚甲基丙烯酸酯,分子量为100-10,000的聚乙二醇(PEG),分子量为100-10,000的聚四氢呋喃二醇(pTHF),分子量为100-10,000的聚己内酯二醇(PCL)等;含有三个羟基的引发剂,如聚己内酯三醇(分子量300,900),三羟基聚氧化丙烯醚,1,2,3-庚三醇,1,2,6-己三醇,三羟甲基丙烷,3-甲基-1,3,5-戊三醇;含有四个羟基的引发剂,如季戊四醇,1,2,7,8-辛烷四醇,丙氧化季戊四醇,双季戊四醇。所述催化剂包括但不限于辛酸亚锡和二月桂酸二丁基锡。催化剂的含量在万分之一到千分之五之间,最好在万分之一到千分之一之间。According to the present invention, an initiator and a catalyst are usually added in the synthesis of a linear or star-degradable polymer. The linear prepolymer is synthesized from an initiator containing two hydroxyl groups, and the star prepolymer is synthesized from an initiator containing three or four hydroxyl groups. The initiator includes, but is not limited to, an initiator containing two hydroxyl groups, such as ethylene glycol, 1,4-butanediol, n-decanediol, tripropylene glycol, triethylene glycol, triethylene glycol dimethyl Acrylate, triethylene glycol dimethyl ether, triethylene glycol mono-11-decyl undecyl ether, triethylene glycol monobutyl ether, triethylene glycol methyl ether methacrylate, molecular weight 100- 10,000 polyethylene glycol (PEG), polytetrahydrofuran diol (pTHF) having a molecular weight of 100-10,000, polycaprolactone diol (PCL) having a molecular weight of 100-10,000, etc.; an initiator containing three hydroxyl groups, such as Polycaprolactone triol (molecular weight 300,900), trihydroxy polyoxypropylene ether, 1,2,3-heptanetriol, 1,2,6-hexanetriol, trimethylolpropane, 3-methyl -1,3,5-pentanetriol; an initiator containing four hydroxyl groups, such as pentaerythritol, 1,2,7,8-octanetetraol, pentaerythritol propoxide, dipentaerythritol. The catalyst includes, but is not limited to, stannous octoate and dibutyltin dilaurate. The catalyst is present in an amount between one ten thousandth to five thousandths, preferably between one ten thousandth and one thousandth.
在可降解高分子材料末端基引入可交联基团的情况下,通过引发剂和第二单体的相对含量可控制星形(聚乳酸共聚物)预聚体的数均分子量,并将数均分子量控制在5,000到10万之间,最好在5,000和5万之间,然后引入可交联活性基团。In the case where a crosslinkable group is introduced to the terminal group of the degradable polymer material, the number average molecular weight of the star (polylactic acid copolymer) prepolymer can be controlled by the relative content of the initiator and the second monomer, and the number The average molecular weight is controlled between 5,000 and 100,000, preferably between 5,000 and 50,000, and then a crosslinkable reactive group is introduced.
合成的可降解高分子材料的降解速率由第一单体和第二单体的相对比率决定,第二单体在5-50%之间。The degradation rate of the synthetic degradable polymeric material is determined by the relative ratio of the first monomer to the second monomer, and the second monomer is between 5-50%.
可降解高分子材料的合成方法包括但不限于开环聚合法、直接缩聚法等。开环聚合是环状单体在引发剂或催化剂作用下开环后聚合;缩聚法是指双官能团或多官能团单体之间通过重复的缩合反应生成高
分子的反应,包括熔融缩聚、溶液缩聚、界面缩聚、固相缩聚等。The synthetic methods of the degradable polymer material include, but are not limited to, a ring-opening polymerization method, a direct polycondensation method, and the like. The ring-opening polymerization is a ring-shaped monomer which is polymerized by ring-opening under the action of an initiator or a catalyst; the polycondensation method means that a bifunctional or polyfunctional monomer is formed by repeated condensation reaction.
Molecular reactions include melt polycondensation, solution polycondensation, interfacial polycondensation, solid phase polycondensation, and the like.
有关交联型聚合物和交联剂的制备,可参见2013年2月28日提交的专利申请号201310064472.9、发明名称“改性聚乳酸可降解支架及其制备方法”,2012年10月9日提交的专利申请号201210380863.7、发明名称“生物可降解的交联型聚合物及其制备方法”,以及2012年10月9日提交的专利申请号201210380316.9、发明名称“可降解的血管支架及其制备方法”。上述这些申请在此引作参考,其发明内容全部并入本申请。For the preparation of cross-linking polymers and cross-linking agents, see Patent Application No. 201310064472.9, filed on February 28, 2013, entitled "Modified Polylactic Acid Degradable Stents and Preparation Methods", October 9, 2012 U.S. Patent Application No. 201210380863.7, entitled "Biodegradable Crosslinked Polymer and Process for Its Preparation", and Patent Application No. 201210380316.9, filed on Oct. 9, 2012, entitled "Degradable Vascular Stent and Preparation thereof" method". The above-identified applications are incorporated herein by reference.
如图1所示,用于骨折和骨损伤修复固定作用的骨螺钉由钉帽,螺杆,螺纹和钉尖组成。骨螺钉的形状和大小可以参照AISF关于骨螺钉的标准或者做适度的更改。As shown in Figure 1, the bone screw for fracture and bone injury repair fixation consists of a nail cap, a screw, a thread and a nail tip. The shape and size of the bone screw can be referred to the AISF standard for bone screws or moderately modified.
表1.骨螺钉的尺寸Table 1. Dimensions of bone screws
螺纹直径(mm)Thread diameter (mm) | 螺帽直径(mm)Nut diameter (mm) | 钉杆直径(mm)Nail diameter (mm) | 螺纹部最小直径(mm)Thread part minimum diameter (mm) | 螺距(mm)Pitch (mm) |
1.5全螺纹1.5 full thread | 3.03.0 | 1.01.0 | 1.251.25 | |
2.0全螺纹2.0 full thread | 4.04.0 | 1.51.5 | 1.251.25 | |
2.7全螺纹2.7 full thread | 5.05.0 | 2.52.5 | 1.91.9 | 1.251.25 |
3.5全螺纹3.5 full thread | 6.06.0 | 2.52.5 | 2.42.4 | 1.251.25 |
4.0部分螺纹4.0 part thread | 6.06.0 | 2.52.5 | 1.91.9 | 1.751.75 |
4.0全螺纹4.0 full thread | 6.06.0 | 2.52.5 | 1.91.9 | 1.751.75 |
4.5部分螺纹4.5 part thread | 8.08.0 | 3.03.0 | 3.03.0 | 1.751.75 |
4.5全螺纹4.5 full thread | 8.08.0 | 3.03.0 | 3.03.0 | 1.751.75 |
6.5全螺纹6.5 full thread | 8.08.0 | 3.03.0 | 3.03.0 | 1.751.75 |
钉杆的直径在2-6mm之间,螺纹部最小直径在1-6mm之间,螺距选择在1-3mm之间,最好选择1.25mm或者1.75mm,如图2所示。钉杆部分可以设计成部分螺纹结构,如图1(中)所示。螺纹的长度占整个钉杆的比例在40-80%之间,其中钉杆或螺纹部分可以选择带微孔结
构,这样有利于骨细胞生长并和可降解骨螺钉很好的结合成为一体。The diameter of the shank is between 2-6mm, the minimum diameter of the thread is between 1-6mm, the pitch is chosen to be between 1-3mm, preferably 1.25mm or 1.75mm, as shown in Figure 2. The shank portion can be designed as a partially threaded structure as shown in Figure 1 (middle). The length of the thread occupies 40-80% of the entire shank, wherein the shank or threaded portion can be selected with a microporous knot
This is conducive to the growth of bone cells and is well integrated with the degradable bone screws.
螺帽的尺寸在1-12毫米之间最好在3-8毫米之间。螺帽可以选择图3中的各种形式。螺帽上端可以带十字凹槽结构,凹槽中间可带孔,便于和缝合线结合。The size of the nut is between 1 and 12 mm, preferably between 3 and 8 mm. The nut can be selected in various forms in Figure 3. The upper end of the nut can be provided with a cross recess structure, and the middle of the groove can be perforated for easy integration with the suture.
本发明还包括骨钉,表面可以是光滑的,也可以是带倒刺的结构,以防止位移发生(如图4所示)。骨钉的直径在2-8mm之间,最好在2-5mm之间。The present invention also includes bone nails which may be smooth or barbed to prevent displacement (as shown in Figure 4). The diameter of the bone nail is between 2 and 8 mm, preferably between 2 and 5 mm.
本发明还包括骨板,骨板的形状具有多样性,如图5所示,骨板上面有配合骨钉、骨螺钉使用相对应的孔。The present invention also includes a bone plate having a variety of shapes. As shown in FIG. 5, the bone plate has a corresponding hole for the bone nail and the bone screw.
总之,本发明提供了一种骨损伤修复固定器械及其制备方法。所述器械包括骨钉,骨螺钉,骨板或固定架,与目前骨科产品所用的线性高分子材料相比,所述交联型聚合物材料具有更高的机械强度,容易储存,不易断裂,从而保证了骨创伤部位在愈合初期的稳定性;而且由于单体组分和比例可调,使得材料具有可控的降解速率,与骨组织修复的速率相匹配,解决了愈合后期应力遮挡导致的延迟性骨折;由于其聚合物材料具有良好的可降解性和生物相容性,避免了二次手术,减少了病人的痛苦和炎症的发生,加快了其临床愈合。In summary, the present invention provides a bone injury repair and fixation device and a preparation method thereof. The device comprises a bone nail, a bone screw, a bone plate or a fixing frame. Compared with the linear polymer material used in the current orthopedic products, the crosslinked polymer material has higher mechanical strength, is easy to store, and is not easily broken. Thereby ensuring the stability of the bone wound site in the early stage of healing; and because the monomer composition and ratio are adjustable, the material has a controllable degradation rate, which matches the rate of bone tissue repair, and solves the stress occlusion caused by the late healing period. Delayed fracture; due to its good degradability and biocompatibility, it avoids secondary surgery, reduces patient pain and inflammation, and accelerates clinical healing.
为了更清楚地描述本发明的技术方案,下面将结合附图作简要介绍。显而易见,这些附图仅是本申请记载的骨损伤修复固定器械的一些具体实施方式,但并不意图对其进行限定。In order to more clearly describe the technical solution of the present invention, a brief description will be made below with reference to the accompanying drawings. It is obvious that these drawings are only some specific embodiments of the bone injury repair and fixation device described in the present application, but are not intended to be limiting.
图1示出骨固定骨螺钉,螺杆全螺纹、螺杆部分螺纹、螺杆有微孔;Figure 1 shows a bone-fixing bone screw, full thread of the screw, partial thread of the screw, micro-hole of the screw;
图2为螺纹尺寸;Figure 2 is the thread size;
图3示出骨螺钉钉帽的形状;
Figure 3 shows the shape of a bone screw cap;
图4为带倒刺的骨钉和不带倒刺的骨钉;Figure 4 is a barbed nail and a barb without a barb;
图5示出各种骨板的设计和形状;以及Figure 5 illustrates the design and shape of various bone plates;
图6为可降解交联剂的合成示意图。Figure 6 is a schematic diagram of the synthesis of a degradable crosslinker.
为了进一步理解本发明,下面将结合实施例对本发明的优选方案进行描述。这些描述只是举例说明本发明的特征和优点,而非限制本发明的保护范围。In order to further understand the present invention, the preferred embodiments of the present invention will be described below in conjunction with the embodiments. These descriptions are only illustrative of the features and advantages of the invention and are not intended to limit the scope of the invention.
实施例1:3手臂星形聚乳酸共聚物预聚体的合成以及预聚体的官能化Example 1: Synthesis of 3-arm star polylactic acid copolymer prepolymer and functionalization of prepolymer
合成:聚合前将3升的玻璃反应釜在80℃下真空干燥1个小时,在氮气保护下将2000g左旋丙交酯(L-lactide),100g乙交酯(glycolide)和14g1,2,6-己三醇加入到反应器中,在60℃条件下真空干燥1小时。然后加入2g辛酸亚锡,将温度提高到140℃,并保持在140℃下反应3小时,得到数均分子量为20,000的星形聚乳酸预聚体(参见反应式1)。星形聚乳酸共聚物预聚体的分子量通过引发剂和单体的相对含量控制,数均分子量控制在5,000到50,000之间。当星形聚乳酸共聚物预聚体的分子量达到实验设计要求的时候,直接滴加48g(0.32mol)甲基丙烯酸酐和0.6g(300ppm)的自由基抑制剂对羟基苯甲醚,在150℃下反应2个小时形成可交联的星形聚合物(参见反应式2),反应结束后降温到60℃,往反应器中加入5L乙酸乙酯,使预聚体溶解,然后缓慢倒入正己烷和乙醇的混合液中,沉淀、干燥得到预聚体产物。
Synthesis: 3 liter glass reactor was vacuum dried at 80 ° C for 1 hour before polymerization, 2000 g of L-lactide, 100 g of glycolide and 14 g of 1,2,6 under nitrogen protection. - Glycerol was added to the reactor and dried under vacuum at 60 ° C for 1 hour. Then, 2 g of stannous octoate was added, the temperature was raised to 140 ° C, and the reaction was maintained at 140 ° C for 3 hours to obtain a star polylactic acid prepolymer having a number average molecular weight of 20,000 (see Reaction Formula 1). The molecular weight of the star polylactic acid copolymer prepolymer is controlled by the relative amounts of the initiator and the monomer, and the number average molecular weight is controlled between 5,000 and 50,000. When the molecular weight of the star polylactic acid copolymer prepolymer reaches the experimental design requirements, 48 g (0.32 mol) of methacrylic anhydride and 0.6 g (300 ppm) of the free radical inhibitor p-hydroxyanisole are directly added dropwise. The reaction was carried out at ° C for 2 hours to form a crosslinkable star polymer (see Reaction Scheme 2). After the reaction was completed, the temperature was lowered to 60 ° C. 5 L of ethyl acetate was added to the reactor to dissolve the prepolymer, and then slowly poured. In a mixture of n-hexane and ethanol, precipitation and drying yield a prepolymer product.
其中,x=3-300,y=1-100。Where x=3-300 and y=1-100.
为清楚起见,上述结构简化为:For the sake of clarity, the above structure is simplified to:
即,带有三个羟基(n=3)的可降解聚合物。That is, a degradable polymer having three hydroxyl groups (n = 3).
反应式1:形成带3手臂星形聚合物预聚体Reaction formula 1: Formation of a 3-arm star polymer prepolymer
反应式2:形成带可交联反应活性基团的3手臂的星形可交联预聚体Reaction Formula 2: Formation of a 3-arm star crosslinkable prepolymer with a crosslinkable reactive group
预聚体的交联与成型:Crosslinking and molding of prepolymers:
(a)将得到的带有活性基团的可交联预聚体加工成上面所描述的骨折和骨损伤固定系统如骨钉、骨板、骨块、骨棒等,在200-400nm波段的紫外灯下辐照,将温度控制在35-65℃之间,持续5-30min进行交联反应,得到产品;(a) processing the obtained crosslinkable prepolymer having a reactive group into a fracture and bone injury fixation system such as a bone nail, a bone plate, a bone block, a bone rod, etc., as described above, in the 200-400 nm band Irradiation under ultraviolet light, the temperature is controlled between 35-65 ° C, and the crosslinking reaction is carried out for 5-30 min to obtain a product;
(b)或者将得到的带有活性基团的可交联预聚体和线型可降解高分子材料按一定比例混合,加工成上面所描述的骨折和骨损伤固定系统如骨钉、骨板、骨块、骨棒等,在200-400nm波段的紫外灯下辐照,将温度控制在35-65℃之间,持续5-30min进行交联反应,得到产品;(b) or the obtained crosslinkable prepolymer with reactive groups and the linear degradable polymer material are mixed in a certain ratio to be processed into the fracture and bone damage fixation system such as bone nail and bone plate described above. Bone block, bone rod, etc., irradiated under ultraviolet light in the 200-400nm band, and the temperature is controlled between 35-65 ° C, and the cross-linking reaction is carried out for 5-30 min to obtain a product;
(c)或者将得到的带有活性基团的可交联预聚体先交联,然后在平板硫化机上于130-190℃,10-20MPa下加压10-30min,得到用于骨钉、骨板、骨块的材料,将此压制成型的材料经切割得到骨钉、骨板、骨块、骨棒等。(c) or cross-linking the obtained crosslinkable prepolymer having a reactive group, and then pressurizing on a flat vulcanizer at 130-190 ° C, 10-20 MPa for 10-30 min to obtain a bone nail, The material of the bone plate and the bone block is cut into the bone nail, the bone plate, the bone block, the bone rod and the like.
实施例2:交联剂合成Example 2: Synthesis of crosslinking agent
如图6所示,首先利用开环聚合的方法将环状单体或环状共聚单体,比如左旋丙交酯和ε-己内酯(L-LA/ε-CL摩尔比为95/5)合成星形可降解高分子共聚合物作为预聚体(包括2,3或4个手臂的线型或星形高分子,最好是有3个或4个手臂的星形高分子以利于交联反应),比如四羟基聚合物。所述四羟基聚合物的数均分子量控制在500到10万之间。接着通过缩聚,在四羟基聚合物的末端引入异氰酸酯,剩余的异氰酸酯通过聚合物沉淀洗涤的方法去除以保证没有异氰酸酯残留物的存在,从而合成得到交联剂。As shown in Fig. 6, first, a cyclic monomer or a cyclic comonomer such as L-lactide and ε-caprolactone (L-LA/ε-CL molar ratio of 95/5) is obtained by a ring-opening polymerization method. Synthetic star degradable polymer copolymer as a prepolymer (including 2, 3 or 4 arm linear or star polymers, preferably a star polymer with 3 or 4 arms to facilitate Cross-linking reaction), such as a tetrahydroxy polymer. The number average molecular weight of the tetrahydroxy polymer is controlled between 500 and 100,000. The isocyanate is then introduced at the end of the tetrahydroxy polymer by polycondensation, and the remaining isocyanate is removed by polymer precipitation washing to ensure that no isocyanate residue is present, thereby synthesizing the crosslinker.
将线型或多手臂的可降解聚合物(数均分子量在5万和120万之间,手臂数是2,3,4)和上述带有异氰酸酯末端基的可降解交联剂按一定比例混合。交联剂在混合物中的比例在10%-80%,可以加入适量
的(例如,0.1mol%)催化剂,例如二月桂酸二丁基锡,然后通过注射挤出或注射成型的方法制备得到骨钉,骨螺钉,骨板等。所制备的装置可以经过适当的热处理,以便交联反应的完成,从而得到具有三维交联网络结构的高分子制品。Mix linear or multi-arm degradable polymers (number average molecular weight between 50,000 and 1.2 million, number of arms is 2, 3, 4) and the above-mentioned degradable crosslinker with isocyanate end groups in a certain ratio . The proportion of the crosslinking agent in the mixture is between 10% and 80%, and an appropriate amount can be added.
The (for example, 0.1 mol%) catalyst, such as dibutyltin dilaurate, is then prepared by injection extrusion or injection molding to obtain bone nails, bone screws, bone plates and the like. The apparatus to be prepared may be subjected to a suitable heat treatment for completion of the crosslinking reaction, thereby obtaining a polymer article having a three-dimensional crosslinked network structure.
实施例3:性能测试Example 3: Performance test
将上述实施例1的预聚体或者预聚体和共混物充分混合,加热熔融在2个玻璃之间,在玻璃之间放入聚四氟乙烯切割的边框薄膜来控制板材的厚度,利用加热或UV光照射交联聚合制成标准板材,聚合物的机械性能和热性能如下表1所示。降解速率实验在恒温振荡降解器中进行,一定尺寸和重量的样品放在pH 7的缓冲溶液中,水浴温度控制在37℃。每隔一定期间取出样品干燥后称重,这样测出样品的失重率(weight loss wt%)。The prepolymer or the prepolymer and the blend of the above Example 1 are thoroughly mixed, heated and melted between two glasses, and a PTFE-cut frame film is placed between the glass to control the thickness of the sheet. The composite sheet was prepared by cross-linking polymerization by heating or UV light irradiation, and the mechanical properties and thermal properties of the polymer are shown in Table 1 below. The degradation rate experiment was carried out in a constant temperature oscillating degrader. A sample of a certain size and weight was placed in a pH 7 buffer solution, and the bath temperature was controlled at 37 °C. The samples were taken out at regular intervals and weighed, so that the weight loss (%) of the samples was measured.
表1:交联型可降解聚合物的力学和热行为Table 1: Mechanical and thermal behavior of crosslinked degradable polymers
注:Note:
PLGA:左旋丙交酯与乙交酯共聚物,PLGA(95/5)表示其中聚合的左旋乳酸与乙交酯之比为95∶5,其他以此类推;PLGA: L-lactide and glycolide copolymer, PLGA (95/5) indicates that the ratio of polymerized L-lactic acid to glycolide is 95:5, and so on;
PLLA:聚左旋乳酸;PLLA: poly-L-lactic acid;
PDLLA:聚消旋乳酸;PDLLA: poly- lactic acid;
P(L-LA70-DL-LA30)-TERA表示其中聚合的左旋丙交酯L-LA与消旋丙交酯DL-LA之比为70∶30,引发剂是季戊四醇;P(L-LA70-DL-LA30)-TERA represents that the ratio of the polymerized L-lactide L-LA to the racemic lactide DL-LA is 70:30, and the initiator is pentaerythritol;
pTHF250:分子量为250的聚四氢呋喃二醇;pTHF250: polytetrahydrofuran diol having a molecular weight of 250;
PCL:聚己内酯二醇,PCL500和PCL540分别表示分子量为500和540的聚己内酯二醇;PCL: polycaprolactone diol, PCL500 and PCL540 represent polycaprolactone diols having molecular weights of 500 and 540, respectively;
PLGA(85/15)-tetra-20K-PLA32:其中PLGA(85/15)-tetra-15K表示带4个手臂的异氰酸酯的交联剂的分子量为20k,与其共混发生交联反应的聚合物是PLA聚乳酸,特性粘度是3.2dL/g.PLGA(85/15)-tetra-20K-PLA32: wherein PLGA(85/15)-tetra-15K represents a molecular weight of 20kk of crosslinker with 4 arms of isocyanate, and a polymer which is cross-linked with it It is PLA polylactic acid and its intrinsic viscosity is 3.2dL/g.
PEG600和PEG1000表示分子量分别为600和1000的聚乙二醇;PEG600 and PEG1000 represent polyethylene glycols having molecular weights of 600 and 1000, respectively;
PLGA(85/15)-PCL trio1900:表示其中聚合的左旋丙交酯与乙交酯之比为85∶15,引发剂为聚己内酯三醇,分子量为900;PLGA(85/15)-PCL trio1900: indicates that the ratio of the polymerized L-lactide to glycolide is 85:15, the initiator is polycaprolactone triol, and the molecular weight is 900;
P(DL-LA/ε-CL 90/10)-PCL 540:表示其中聚合的消旋丙交酯DL-LA与己内酯ε-CL之比为90∶10,引发剂为聚己内酯三醇,分子量为540;P(DL-LA/ε-CL 90/10)-PCL 540: indicates that the ratio of the polymerized racemic lactide DL-LA to caprolactone ε-CL is 90:10, and the initiator is polycaprolactone a triol having a molecular weight of 540;
PLGA(85/15)-PC500:表示其中聚合的左旋丙交酯与乙交酯之比为85∶15,引发剂为聚碳酸酯二醇,分子量为500;PLGA(85/15)-PC500: wherein the ratio of polymerized L-lactide to glycolide is 85:15, the initiator is polycarbonate diol, and the molecular weight is 500;
ND:未测。ND: Not tested.
以上实施例的说明只是用于帮助理解本发明的核心思想。应当指出,对于本领域的普通技术人员而言,在不脱离本发明原理的前提下,还可以对本发明进行若干改进和修饰,但这些改进和修饰也落入本发明权利要求请求保护的范围内。
The above description of the embodiments is merely for helping to understand the core idea of the present invention. It should be noted that many modifications and variations of the present invention may be made without departing from the spirit and scope of the invention. .
Claims (19)
- 一种骨损伤修复固定器械,其特征在于所述器械采用交联型生物可降解高分子材料,所述高分子材料为一种单体的均聚物、多种单体的共聚物、或2~3种所述均聚物、共聚物的共混物,具有三维交联网络结构。A bone damage repairing and fixing device, characterized in that the device adopts a cross-linked biodegradable polymer material, wherein the polymer material is a monomer homopolymer, a copolymer of a plurality of monomers, or 2 ~3 kinds of the homopolymer, a blend of copolymers, having a three-dimensional crosslinked network structure.
- 如权利要求1所述的固定器械,其特征在于制备所述交联型可降解高分子材料的单体材料为左旋乳酸、右旋乳酸、丙交酯、ε-己内酯、水杨酸、碳酸酯、氨基酸及其衍生物。The fixing device according to claim 1, wherein the monomer material for preparing the crosslinked degradable polymer material is L-lactic acid, D-lactic acid, lactide, ε-caprolactone, salicylic acid, Carbonates, amino acids and their derivatives.
- 如权利要求1所述的固定器械,其特征在于所述共聚单体的比例在95∶5-50∶50之间。The fixation device of claim 1 wherein said comonomer ratio is between 95:5 and 50:50.
- 一种骨钉,其特征在于具有如权利要求1~3任一项所述的特征。A bone nail characterized by having the features of any one of claims 1 to 3.
- 一种骨螺钉,包括钉帽、螺杆、螺纹和顶尖,其特征在于还具有如权利要求1~3任一项所述的特征。A bone screw comprising a nail cap, a screw, a thread and a tip, characterized by further having the features of any of claims 1-3.
- 一种骨板或固定架,包括本体及在本体上设置的固定孔,其特征在于还具有如权利要求1~3任一项所述的特征。A bone plate or holder comprising a body and a fixing hole provided in the body, characterized by further having the features of any one of claims 1 to 3.
- 一种如权利要求1所述的骨损伤修复固定器械的制备方法,其特征在于在成型加工前、成型加工中或成型加工后,进行交联处理。A method of preparing a bone injury repair and fixation device according to claim 1, wherein the crosslinking treatment is performed before the molding process, during the molding process, or after the molding process.
- 如权利要求7所述的制备方法,其特征在于所述成型加工采用注塑成型、注塑-激光切割成型、热压-激光切割成型、挤出成型或挤出-激光切割成型。The production method according to claim 7, wherein the molding process is injection molding, injection molding-laser cutting molding, hot press-laser cutting molding, extrusion molding or extrusion-laser cutting molding.
- 如权利要求7所述的制备方法,其特征在于所述交联处理采用 紫外交联、热反应交联、化学反应交联和/或物理交联。The preparation method according to claim 7, wherein said crosslinking treatment is carried out UV crosslinking, thermal reaction crosslinking, chemical reaction crosslinking, and/or physical crosslinking.
- 如权利要求7所述的制备方法,其特征在于通过在所述高分子材料末端基引入可交联基团,利用紫外交联或热反应交联的方式,形成三维网状交联共聚物。The preparation method according to claim 7, wherein a three-dimensional network crosslinked copolymer is formed by introducing a crosslinkable group at the terminal group of the polymer material by ultraviolet crosslinking or thermal reaction crosslinking.
- 如权利要求10所述的制备方法,其特征在于所述可交联基团为含有双键的甲基丙烯酸,含有双键的丙烯酸,蒽,肉桂酸或香豆素。The process according to claim 10, wherein the crosslinkable group is methacrylic acid containing a double bond, acrylic acid, hydrazine, cinnamic acid or coumarin containing a double bond.
- 如权利要求7所述的制备方法,其特征在于在所述高分子材料中加入交联剂,交联剂与所述高分子材料末端基发生化学反应,经过加热,形成三维网状交联共聚物。The preparation method according to claim 7, wherein a crosslinking agent is added to the polymer material, and the crosslinking agent chemically reacts with the terminal group of the polymer material to form a three-dimensional network cross-linking copolymerization by heating. Things.
- 如权利要求12所述的制备方法,其特征在于所述交联剂是多手臂的,末端基含有活性基团。The process according to claim 12, wherein the crosslinking agent is multi-armed and the terminal group contains a reactive group.
- 如权利要求12所述的制备方法,其特征在于所述交联剂是多手臂的,末端基含有不饱和烯烃的可交联基团,自身能发生交联反应形成三维网状结构,通过加热或紫外灯照射,与所述高分子材料形成半互穿网络结构。The preparation method according to claim 12, wherein the crosslinking agent is multi-armed, and the terminal group contains a crosslinkable group of an unsaturated olefin, which can undergo cross-linking reaction to form a three-dimensional network structure, and is heated by heating. Or irradiated with a UV lamp to form a semi-interpenetrating network structure with the polymer material.
- 如权利要求7所述的制备方法,其特征在于将可降解高分子材料形成的所述固定器械进行辐射交联,辐射交联选自电子束交联和伽马射线交联。The preparation method according to claim 7, wherein the fixing device formed of the degradable polymer material is subjected to radiation crosslinking, and the radiation crosslinking is selected from electron beam crosslinking and gamma ray crosslinking.
- 如权利要求15所述的制备方法,其特征在于在所述可降解高分子材料中加入三烯丙基异氰脲酸酯或者三甲基烯丙基异氰脲酸酯以促进交联反应。The process according to claim 15, wherein triallyl isocyanurate or trimethylallyl isocyanurate is added to the degradable polymer material to promote a crosslinking reaction.
- 如权利要求7所述的制备方法,其特征在于所述共聚单体的 比例在95∶5-50∶50之间。The production method according to claim 7, wherein said comonomer The ratio is between 95:5 and 50:50.
- 如权利要求7~16任一项所述的制备方法,其特征在于在所述成型加工时,对聚合物熔体施加取向力,使所述高分子材料分子取向。The production method according to any one of claims 7 to 16, wherein an orientation force is applied to the polymer melt during the molding process to orient the molecular material.
- 如权利要求7~16任一项所述的制备方法,其特征在于在所述加工成型后对所述固定器械加温拉伸使所述高分子材料分子取向,所加温度在聚合物的玻璃化转变温度和熔点之间。 The preparation method according to any one of claims 7 to 16, characterized in that after the processing and molding, the fixing device is heated and stretched to orient the polymer material, and the temperature is applied to the glass of the polymer. Between the transition temperature and the melting point.
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