摘要
目的 探讨联合应用带血运骨膜管移植和骨充填物治疗兔桡骨长段缺损的效果。 方法 实验分两部分 ,分别选用幼兔和成年兔各 4 0只 ,根据填充物的不同分为 4组。将兔双侧桡骨干中段切除 3cm制成骨长段缺损模型 ,保留切骨段骨膜 ,重新复原缝合后作带血运骨膜管移植模型。左侧分别用自体骨、同种异体脱钙骨、磷酸三钙陶瓷和羟基磷灰石进行填充 ,右侧不行任何填充作为对照。观察 3个月。通过 X线片、骨强度、骨密度和组织学检查等方法 ,了解骨缺损的修复效果。 结果 幼兔术后 6周 ,所有实验组双侧的骨缺损均得到修复 ;术后 12周 ,磷酸三钙陶瓷和羟基磷灰石组桡骨抗弯曲强度较差 ,与自体骨组、同种异体脱钙骨组和对照侧比较具有统计学意义 (P<0 .0 5 ) ;骨愈合为膜内成骨和软骨成骨 ,以膜内成骨为主。成年兔 :各组实验侧骨缺损修复率分别为 :自体骨组 5 0 % ;同种异体脱钙骨组 4 0 % ;磷酸三钙陶瓷和羟基磷灰石组为 30 %。对照侧骨缺损修复率为 4 2 .5 %。 结论 幼兔单行带血运骨膜管移植或结合应用骨充填物均可有效修复骨长段缺损 ,但置换较慢的骨充填物不利于再生骨强度的恢复。成年兔带血运骨膜移植联合应用骨填充物不能有效修复骨长段缺损。
Objective To study the treatment efficacy of vascularized periosteum graft and bone filling material for long bone defect. Methods Forty young and forty adult rabbits were divided into four groups respectively according to the bone filling materials. A 3 cm long segment was removed from the middle part of the rabbit radius to make a bone defect model. The periosteum was reserved and restored to set up a vascularized tubulate periosteum graft. On the left side, autogenous bone graft, decalcified allograft, tricalcium phosphate, and hydroxyapatite were used to fill in the bone defect respectively; on the right side, no bone filling material was used as controls. The repairing effect of bone defect was evaluated by roentogenography, biomechanical, and histological methods. Results In young rabbits, bone defects on both sides healed in the 6th week after operation. The bending strength of radius in the tricalcium phosphate group and in the hydroxyapatite group were lower in the 12th week and there was significant difference when compared with autogenous bone graft group, decalcified allograft group and control group( P< 0.05). The repairing mechanism included intramembranous and endochondral ossification, and intramembranous ossification was prevalent. In the adult rabbits, the repairing rates of bone defect were 50% in the autogenous bone graft group, 40% in the decalcified allograft group, 30% in the tricalcium phosphate group and in the hydroxyapatite group and 42.5% in the control group, respectively.Conclusion In young rabbits, large bone defect can be repaired with vascularized tubulate periosteum graft with or without the combining use of bone filling materials. The bone filling material which will be substituted slowly is disadvantageous to the recovery of bone strength. In adult rabbits, vascularized tubulate periosteum graft combined with bone filling materials can not repair the large bone defect effectively.
出处
《中国修复重建外科杂志》
CAS
CSCD
2003年第1期9-12,共4页
Chinese Journal of Reparative and Reconstructive Surgery
