Biodegradable
poly([D,L]-lactide-co-glycolide) (PLGA) nanofibrous membrane embedded with two
drug-to-
polymer weight ratios, namely 1:3 and 1:6, which comprised PLGA 180 mg,
lidocaine 20 mg,
vancomycin 20 mg, and
ceftazidime 20 mg, and PLGA 360 mg,
lidocaine 20 mg,
vancomycin 20 mg, and
ceftazidime 20 mg, respectively, was produced as an artificial periosteum in the treatment of segmental
femoral fractures. The nanofibrous membrane's drug release behavior was assessed in vitro using high-performance liquid chromatography and the disk-diffusion method. A femoral segmental fracture model with intramedullary
Kirschner-wire fixation was established for the in vivo rabbit activity study. Twenty-four rabbits were divided into two groups. Twelve rabbits in group A underwent
femoral fracture fixation only, and 12 rabbits in group B underwent
femoral fracture fixation and were administered the
drug-loaded nanofibers. Radiographs obtained at 2, 6, and 12 weeks postoperatively were used to assess the bone unions. The total activity counts in animal behavior cages were also examined to evaluate the clinical performance of the rabbits. After the animals were euthanized, both femoral shafts were harvested and assessed for their torque strengths and toughness. The daily in vitro release curve for
lidocaine showed that the nanofibers eluted effective levels of
lidocaine for longer than 3 weeks. The bioactivity studies of
vancomycin and
ceftazidime showed that both
antibiotics had effective and sustained bactericidal capacities for over 30 days. The findings from the in vivo animal activity study suggested that the rabbits with the artificial
drug-eluting periosteum exhibited statistically increased levels of activity and better clinical performance outcomes compared with the rabbits without the artificial periosteum. In conclusion, this artificial
drug-eluting periosteum may eventually be used for the treatment of
open fractures.