摘要
目的：比较坚硬接骨板和应力松弛接骨板固定后板下皮质骨内微循环的变化。方法：２８只家兔的两侧胫骨分别以不锈钢接骨板（坚硬接骨板）和螺孔内衬有粘弹性垫圈的不锈钢接骨板（应力松弛接骨板）做固定，并定期进行微血管造影，术后处死取材观察。结果：两种接骨板置入后均造成板下皮质骨缺血，２～４周后来自髓腔侧的血管扩张并侵入缺血区，８～１２周缺血区基本消失，皮质骨内血管继续增生呈网状，两组间比较，差异无显著性意义。１６周后应力松弛接骨板侧微血管容量不再改变，而坚硬接骨板侧血管继续扩张，形成较多血窦，血管容量进一步增加，并与应力松弛接骨板侧出现统计学差异。上述早期改变与血循环损伤有关，后期两种接骨板的差别则与其应力遮挡率不同有关。结论：应力松弛接骨板可有效地减缓和减轻坚硬接骨板造成的微血管形态改变及血管容量增加，从而避免严重的骨吸收和骨力学强度下降。
bjective: To compare the effect of rigid and stressrelaxation plate on bone microcirculation. Methods: The tibiae of 28 rabbits were fixed with stainless steel plate (rigid plate,RP)on oneside and the other side with a similar plate in which viscose elastic washer was put between the screw and screw hole (stressrelaxation plate,SRP). Microangiography was used to observe the morphological and volume changes in microcirculation of cortical bone beneath RP and SRP at regular intervals after fixation. Results:Avascular necrosis could be seen in the cortical bone beneath both kind of plates. The micrangium risen from medullary side dilated and invading into the avascular zone at 2-4 weeks. The avascular zone disappeared while hyperplasia of micrangium net of the cortical bone continued developing at 8-12 weeks after fixation,but no significant difference could be found between the RP and SRP sides. 16 weeks post fixation,the microvascular volume of SRP side showed no further change,while the micrangium was continuously dilated and several blood sinuses were formed in the RP side with further increase of them icrocirculation volume which is statistically different from that of the SP side. The early stage of above changes is related with circulation damage,while in late stage,the difference in changes of microcirculation of the cortical bone beneath different plates,is closely related with different stress shielding rate of the two plates. Conclusion: The SRP can effectively reduce and lighten the morphological change of micrangium with increase of microcirculation volume and thus prevent severe bone absorption and lower mechanical property of the fixed bone.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
1998年第8期484-488,I002,共6页
Chinese Journal of Orthopaedics
基金
国家自然科学基金
关键词
接骨板
微循环
骨折固定术
内固定
应力松驰
Bones Microcirculation Fracture fixation,internal Angiography Stress,mechanical
