鈦合金骨板和骨釘常用於口腔及顏面骨骨折的內固定，雖然這是種很好的骨折治療方式，但仍有許多缺點。因此生物可分解材質的骨板及骨釘應用於顏面骨骨折，是一項很好的替代裝置。
糖尿病動物及人類的傷口容易癒合不良。
本研究的目的是在於比較糖尿病及正常的動物，其股骨骨折傷口應用鈦合金及生物可吸收性材質Poly Lactic-co-Glycolic Acid （PLGA）進行固定後，傷口癒合程度之比較。
結果顯示控制組的傷口癒合良好，傷口週圍沒有分泌物產生。以 PLGA固定的糖尿病鼠的傷口周圍則有瘻管形成，並伴隨著有膿及氣體的排出。控制組以PLGA固定的股骨其直徑大於以鈦合金固定的股骨，在正常的老鼠以PLGA固定股骨骨折，其骨折處大多數都會有彎曲的情形，並在骨折處附近有骨痂的形成。
在術後20天以PLGA固定股骨骨折的老鼠，控制組及實驗組兩者傷口皆未癒合，但以鈦合金固定股骨骨折的老鼠中，控制組可以發現在骨缺陷處有大量的新生骨形成。糖尿病鼠則大多數是形成纖維組織。
在術後40天，以PLGA固定股骨骨折的糖尿病鼠，其傷口癒合不良且伴隨大量纖維組織生成，同樣的在40天以鈦合金所固定的糖尿病鼠也是有大量的纖維組織在骨缺陷處形成。但在以PLGA固定股骨骨折的正常老鼠，則在傷口缺陷處發現大量的軟骨形成。大多數以PLGA固定骨折的正常老鼠會有股骨呈現彎曲的情形。
在術後40天以鈦合金固定股骨骨折的正常老鼠在骨缺陷癒合處及骨釘周圍則有板狀骨形成。
PLGA骨板與鈦合金骨板對照起來不管是正常或是糖尿病的老鼠，並不適合固定在股骨骨折，因為PLGA骨板強度較低及在老鼠身上較容易引起組織反應，這些結果也造成大量的纖維組織形成，並在PLGA的骨釘周圍影響骨骼的生成。

Titanium bone plates and screws are commonly used in oral and maxillofacial surgery for internal fixation. Although titanium plate is good for fixation of bone fractures, there are still somemany disadvantages of the material. Biodegradable materials are considered to be good alternatives for treatment of the facial bone fractures.
Poor wound healing in diabetic animals and human was well known.
The aims of the studies were to compare the strength and tissue reaction of the poly lactic-co-glycolic acid （PLGA） with titanium plates used as fixation material in fractured-femora of diabetic and normal animals.
The results of the studies show that the wounds of the control group healed quite well and there was no discharge around the wound. However, bullas formation was found in all the diabetic wounds fixed with PLGA. There was fistula with pus and gas discharge around the bullas. In the control group, the diameter of the PLGA-fixed femur was larger than the titanium-fixed femura. There was a large amount of callus formation around the PLGA-fixed fracture femur.
At the 20th day, the defects of both groups of the PLGA treated were not healed. A large amount of new bone formation in normal titanium-treated rats was found, while in diabetic rats, mainly a fibrous tissue reaction.
At the 40th day, the diabetic PLGA-fixed femora were poorly healed with a large amount of fibrous tissue. Similarly, after 40 days in the titanium-fixed femora of diabetic rats, extensive fibrosis of the defect was also present. In normal PLGA-fixed fractured femora, there was a large amount of cartilage present around the defect. Most of the normal PLGA-fixed fractured femora were distorted in shape.
At the 40th day, lamellar bone formation was found around the screw in normal titanium-fixed femora and the defect was healed.
In conclusion, the PLGA plate is not suitable for fixation in the fractured-femora of the rats in either normal or diabetic groups when compared with those from titanium plate treat groups. It is because of less strength of the PLGA plate and the material easily cause tissue reaction in the rat which result in the formation of large amount of fibrous tissue around the PLGA screw instead of bone.

中文摘要 1
關鍵字：PLGA、糖尿病 2
Abstract 3
Key words：PLGA、Diabetic 4
前言 5
材料和方法 8
結果 9
結果 10
術後20天以PLGA骨板固定之比較 10
術後20天以鈦合金骨板固定之比較 11
術後40天以PLGA骨板及鈦合金骨板應用於糖尿病老鼠股骨骨折之比較 11
術後40天以PLGA骨板及鈦合金骨板應用於對照組老鼠股骨骨折之比較 12
討論 13
外來物反應及降解 16
結論 19
參考文獻 20
附表 27
Tab 1：實驗組與對照組之血糖值比較圖 27
Tab 2：實驗組與對照組體重值變化表 28
Tab 3：在術後20天與40天實驗組與對照組血糖值變化表 31
Tab 4：老鼠分組方式 33
附圖 34
Fig 1 ：There was fistula formation with pus and gas discharge around the bullas.（2X） 34
Fig 2 ：The diameter of the PLGA-fixed femur was larger than the titanium-fixed femura.（2X） 35
Fig 3：Distorted PLGA-fixed femora of the normal rat, x-ray film.（10X） 36
Fig 4：40th days after the surgery, Normal-PLGA, cartilage around the wound.（10X） 37
Fig 5：20th days after the surgery, Normal-PLGA, defect not healed. （5X） 38
Fig 6：20th days after the surgery, DM-PLGA, fibrotic tissues around the defect.（5X） 39
Fig 7：20th days after the surgery, DM-PLGA, fibrotic tissues in the middle of defect, defect not healed.（10X） 40
Fig 8：20th days after the surgery, DM-PLGA, fibrotic tissues mixed with fibroblasts in the middle of defect.（40X） 41
Fig 9 : 20th days after the surgery, DM-PLGA, fibrotic tissues in the middle of defect, with bone destruction and osteogenesis near the original bone.（40X） 42
Fig 10：20th days after the surgery, DM-PLGA, fibrotic tissue around the screw. （5X） 43
Fig 11：20th days after the surgery, Normal-PLGA, defect not-healed woven bone, osteoblasts, osteoclasts, collagen network, cartilage-like tissue, new bone formation outside the original bone.（20X） 44
Fig 12：20th days after the surgery, Normal-PLGA, defect not-healed, woven bone, osteoblasts, osteoclasts, collagen network, cartilage-like tissue, new bone formation outside the original bone.（40X） 45
Fig 13：20th days after the surgery, Normal-PLGA, new bone mixed with original bone around the PLGA screw normal of nroaml rat.（5X） 46
Fig 14：20th days after the surgery, Normal-Titanium, new bone formation around the screw with osteoblasts, osteoclasts, woven bone, clear cut origional bone.（10X） 47
Fig 15：20th days after the surgery, Normal-Titanium, new bone, formation around the screw.（20X） 48
Fig 16：20th days after the surgery, DM-Titanium, mainly fibrotic tissues formation around the screw.（10X） 49
Fig 17：40th days after the surgery, DM-PLGA, fibrotic tissue around the original bone formation around the screw.（5X） 50
Fig 18：40th days after the surgery, DM-PLGA, fibrotic tissue, woven bone PMNs around the screw.（20X） 51
Fig 19：40th days after the surgery, DM-Titanium, woven bone osteoblasts, fibroblasts PMNs, fibrotic tissues at the defect.（10X） 52
Fig 20：40th days after the surgery, DM-Titanium, fibroblasts, PMNs around the screw.（10X） 53
Fig 21：40th days after the surgery, DM-Titanium, fibroblasts, PMNs around the screw.（20X） 54
Fig 22：40th days after the surgery, Normal-PLGA, cartilages around the defect.（10X） 55
Fig 23：40th days after the surgery, Normal-PLGA, cartilages mixed with bubbles around the defect and inside the femora.（10X） 56
Fig 24：40th days after the surgery, Normal-Titanium, wound healed at the cutting area. （2.5X） 57
Fig 25：40th days after the surgery, Normal-Titanium, lamellar bone around the screw.（20X） 58

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