自控微动带锁髓内钉对山羊骨折愈合的影响

Influence of the fixation with auto-control micro-movement intramedullary interlocking nail mode on fracture healing in goats

目的:观察自控微动带锁髓内钉(AMLN)内固定对骨折愈合的影响。方法:对16只山羊两侧股骨干横断截骨,分别采用AMLN和Gross-Kempf(GK)钉固定,术后7、14、28和56d分批处死,行组织学观察和生物化学测量。结果:(1)AMLN钉固定组骨外膜骨痂,桥梁骨痂能早期加速形成,并逐渐形成连接骨痂和封闭骨痂,使皮质骨松化,骨痂不断长入,骨折修复与塑形提早实现,明显优于GK钉固定。不同愈合期骨痂的定量分析表明,两者具有显著差异(P<0.05)。(2)AMLN钉固定组的骨痂胶原、不溶性胶原、钙、磷含量均高于GK钉固定组(P<0.05)。结论:AMLN钉固定符合“弹性固定准则”,骨折端间歇生理性动应力的产生与传导,较好解决了应力遮挡与应力传导的平衡问题,骨折边愈合边塑形,加速了骨折愈合进程。

AIM： To investigate the effect of auto -control micro -movement locking nail （AMLN） on experimental fracture healing. METHODS： 32 goats with a transverse osteotomy of the femoral shafts （ 16 matched pairs） were fixed intramedullary with AMLN and Gross - Kempf （GK）, respectively. The follow - up time was 7, 14, 28 and 56 days, histological and biochemical analysis were done. RESULTS： （ 1 ） Histological observation and quantitative analysis of calluses reveahd that AMLN promoted the growth of bridge calluses and periosteum calluses. In that way the facture healing and remodeling process came along ahead of time that was much better than traditional GK nail fixation. The significant difference between them was observed （ P 〈0. 05）. （2） The content of the total collagen, insoluble collagen, calcium and phosphate in the AMLN fixed group were higher than those in the GK nail fixed group （ P〈0.05 ）. CONCLUSIONS： The design of AMLN accords well .with the plastic fixation theory. The generation and conduct of the intermittent physical stress between the fractural parts could resolve the balance problem between stress conduct and stress protection. The fracture end could heal and remodeling at the same time which speed up the fractural healing process.