摘要
目的观察两种骨折固定方法救治海水浸泡开放性骨折的大体形态、组织病理学、影像学变化。方法取成年新西兰免50只,随机分为三组:对照组10只、A组20只、B组20只。于胫骨中段截骨制成开放性骨折动物模型。对照组伤口自然旷置3 h,A组和B组海水浸泡伤口3 h。随后对照组和A组行伤口清创、钢板螺钉内固定术;B组行伤口清创、外固定架固定、伤口开放换药、二期缝合。观察各组的伤口感染情况、骨折愈合的组织学、影像学变化和测定骨折断端骨痂的平均比灰度值。结果a)对照组感染1只(10%),A组感染15只(75%),B组感染5只(25%)。各组间结果有统计学差异(P<0.05)。b)术后45 d时各组间骨折断端组织愈合等级有统计学差异(P<0.05)。c)术后45d时各组间骨折部位骨痂的生长情况在影像学上表现为对照组大于B组大于A组。各组间骨愈合率对照组为100%,A组为66.7%,B组为93.3%。d)术后45d时骨折断端间骨痂的平均比灰度值对照组为8.1149±1.2043,A组为6.2268±1.4000,B组为6.5138±1.3045,各组间有统计学差异(P<0.05)。结论海水浸泡使开放性骨折伤口感染率增高;海水浸泡使开放性骨折断端骨痂形成不良率增高;骨外固定架与钢板内固定比较救治成功率提高。
Objective The purposes of this study is to explore which method,internal fixation or external fixation,is much efficacious in management of open fracture with seawater immersion by rabbbit model. Methods 50 New Zealand rabbits were divided into three groups randomly. There were 10 in control group,20 in group A,20 in group B. Osteotomy was conducted in the middle part of tibia. The animals of control group were exposed in the air for three hours and other animals of group A and B were fixed on the special shelf and immersed in seawater also for three hours. Wound debridement was given to each animal ,then the animals of control group and group A were given internal fixation,contemporary,the animals of group B were applied by external fixation,the wound was kept open- ing,then,closed secondly. Ultimately,infection rate, histopathology,radiology and the grayscale at fracture site were observed. Results 1. One wound was infected in the control group （10%）;15 wounds were infected in the group A （75%）;5 were infected in the group B（25%）. There was a significant statistical difference between each two groups （P〈0.05）. 2. At 45 days postoperatively,pathological grading of existent animals showed a significant difference statistically between each two groups （P〈0.05）. 3. At 45 days postoperatively,the osteotylus of existent animals at fracture site showed control group〉group B〉group A. the bone healing rate of existent animals at fracture site was 100Y00, 66. 7%, 93. 3% in control group A and group B respectively. 4. At 45 days postoperatively, the average grayscale of existent animals at fracture site was 8. 114 9±1. 204 3,6. 226 8±1. 400 and 6. 513 8±1. 304 5 in control group ,group A and group B,respectively. There was a significant difference statistically between each two groups（P 〈0.05）. Conclusion Wound infection rate was increased by seawater immersion,bone healing was affected by seawater immersion,external fixation was better than the internal fixation in management the open
出处
《实用骨科杂志》
2008年第10期595-599,共5页
Journal of Practical Orthopaedics
基金
全军"十五"计划指令性课题(01L011)
关键词
海水浸泡
开放性骨折
内固定
外固定架
感染
seawater immersion
open fracture
internal fixation
external fixation
infection
