摘要
目的:观察新型便携式外固定支架在兔胫骨骨折中的治疗效果。方法:选取实验用健康大白兔48只,随机均分为实验组和对照组,制造胫骨中段骨折模型。实验组应用新型便携式外固定支架,对照组应用传统外固定支架,两组均实施有限切开复位外固定术。X线检查比较术后骨折复位及愈合情况;取新生骨组织行组织学检查;并测定血清及骨组织中骨形态发生蛋白(BMP-7)、转化生长因子-β1(TGF-β1)及碱性成纤维细胞因子(bFGF)的变化。结果:两组治疗方式均能对骨折断端进行有效外固定;实验组和对照组术后复查X线,在相同时间点(4、8、12周)实验组骨折愈合更快;实验组HE染色显示骨折断端纤维连接、新生骨小梁、板层骨形成较早,骨塑型较快;在骨折愈合早期,实验组血清中BMP-7(185±9.6 vs 147±7.20,P=0.03)、TGF-β1(2555±104.7 vs 2142±94.7,P=0.04)及bFGF(104±8.3 vs 77±4.9,P=0.04)细胞因子浓度(pg/ml)高于对照组,且新生骨组织中可检测到BMP-7和TGF-β1蛋白的高表达。结论:新型便携式外固定支架在加强骨折固定、减小手术创伤、促进骨折断端愈合方面具有自身优势,在胫骨骨折中的治疗效果较好。
Objective：To perform a comparative test on newly designed simple external fixator and traditional external fixator in rabbit tibial fracture.Methods：48 healthy white rabbit were selected as experimental animals and divided into 2 groups randomly and equally.Midpiece oblique tibial fracture models were established and the reduction and fixation were carried out with external fixators.The newly designed simple external fixator was used in the test group while control group was treated with traditional external fixator.X-ray was performed to check the tibial fracture reduction and healing.Neonatal bone tissues were harvested to carry out tissue assay.the expression of BMP-7,TGF-β1,bFGF in serum and fracture callus was tested.Results：Anatomical reduction and fixation could be observed in both groups.X-ray showed a better fracture recovery in the test groups at the same observation time points.HE staining exhibited more rapid formation of fibrous connection,new trabeculae and lamellar bone.In the early stages of fracture healing,the serum levels of BMP-7（185±9.6 vs 147±7.20,P=0.03）,TGF-β1（2555±104.7 vs 2142±94.7,P=0.04）,bFGF（104±8.3 vs 77±4.9,P=0.04）in the test group were higher than the controls.BMP-7 and TGF-β1 proteins exhibited higher expression either in the fracture callus on post-operative week 2.Conclusion：Our newly designed simple external fixator possesses merits of high-strength fixation,less surgical trauma in promoting fracture healing.
作者
陈喆
毕龙
姬权磊
高嘉锴
杨大钊
邓岳
裴富强
袁志
Chen Zhe;Bi Long;Ji Quanlei(Department of Orthopedics, Xijing Hospital, The Air Force Military Medical University （Xi＇an 710032)
出处
《陕西医学杂志》
CAS
2018年第6期690-692,697,共4页
Shaanxi Medical Journal
基金
国家自然科学基金资助项目(81371982)
关键词
胫骨
骨折固定术
外固定器
骨折愈合
骨形态发生蛋白质类
转化生长因子Β1
兔
Tibia Fracture fixation External fixators Fracture healing Bone morphogenetic proteins Transforming growth factor betal Rabbits
