潘朝晖;赵玉祥;王大伟;栾兆新;

• 1:解放军第89医院全军创伤骨科研究所

摘要(Abstract)：

[目的]探讨建立新西兰大白兔20 mm长股骨骨缺损模型的可行性,比较切除和保留骨膜两种方法对该长度骨缺损愈合能力的影响。[方法]24只新西兰成年大白兔随机分切除和保留骨膜两组。右侧股骨外侧入路,9孔钢板置于股骨外侧,6枚螺钉固定。股骨中段20 mm双段截骨,切除骨膜组不分离骨膜,保留骨膜组截骨前先环形剥离骨膜保护,然后再原位缝合包绕骨缺损区。测量截骨髓腔直径,评估肢体功能恢复。分别于术后即刻、第4周和第12周拍X线片了解骨断端对位、内固定稳定及骨愈合情况;并于第4、12周取材行CT三维重建、组织学检查,了解骨愈合情况。[结果]切除骨膜组股骨髓腔直径(5.4±0.2)mm,保留骨膜组直径(5.3±0.6)mm,两组差异无统计学意义。所有动物耐受手术,伤口愈合好。第12周可正常负重行走。两组平均骨缺损长度20.7 mm,切除骨膜组股骨全长(10.1±0.5)cm,保留骨膜组股骨全长(10.2±0.5)cm,两组差异无统计学意义。除外切除骨膜组有1只动物在术后第12周出现远端螺钉松动现象,其余动物钢板螺钉位置良好,内固定稳定。术后第4周切除骨膜组截骨端少量斜行絮状骨痂,相向生长,表现为软骨化骨过程;保留骨膜组骨缺损被不规则骨痂连接,可辨认两端股骨皮质,表现为骨膜化骨过程。术后第12周切除骨膜组骨痂继续相向生长,骨端部分硬化,无骨性连接;保留骨膜组骨缺损被均匀新生骨连接,形状类似正常骨结构,不能辨认股骨切缘骨皮质。[结论]该模型具有可重复性和临床相关性,保留骨膜可促进20 mm股骨节段性骨缺损的愈合。

关键词(KeyWords)： 股骨骨折;大白兔;节段性骨缺损;骨膜

Abstract:

Keywords:

基金项目(Foundation): 军队“十二五”面上课题资助项目(编号:CWS11J245)

作者(Author): 潘朝晖;赵玉祥;王大伟;栾兆新;

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DOI:

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