同种异体皮质骨板重建股骨压力侧骨皮质缺损的实验研究

Experimental Studies on Reconstructing Compression Side Femoral Cortical Bone Defect with Allogeneic Cortical Bone Plate

目的探讨同种异体皮质骨板重建压力侧骨皮质缺损的可行性及效果。方法24只成年山羊,制作压力侧骨皮质缺损动物模型。随机分两组,实验组12只:行异体骨板、钢板固定结合植骨;对照组12只:仅行钢板固定结合植骨。于术后4、8、12周进行影像学观察,生物力学测试和组织学检查。结果术后实验组内固定位置均良好,对照组4例发生螺钉松动、钢板断裂等内固定失效现象。12周时实验组髓腔再通,异体皮质骨与宿主骨融合;对照组仍可见不均匀骨痂影。各时间点两组标本的抗扭转、抗压缩刚度比较具有非常显著性差异(P<0.01)。组织学检查按Lane等评分标准评分,有非常显著性差异(P<0.01)。结论同种异体皮质骨板能够结构性重建骨皮质缺损区,恢复其承载功能,有效防止内固定失败,促进骨折愈合。

Objective To explore the feasibility and effect of reconstructing compression side femoral cortical bone defect with allegeneic cortical bone plate. Methods 24 adult goats were divided into two groups randomly, 12 animals respectively in experiment group and control group. At 4、 8、 12 weeks postoperatively, all animals were made X - ray exam, and then sacrificed. The left sides of femur were taken as specimens for biomeehanieal test and histopathologieal examination. Results Loosening or breakage of plates or screws were found for four animals in the control group, while the instruments were in the right site in experiment group. 12 weeks the medullary cavity appeared again, the allogeneic cortical bone linked with host bone, fracture area repaired completely. While irregulary bone callus was existing in control group. Betweeen experiment group and control group, distinct difference （P 〈 0.01 ） were found in hardscale of vertical compression, torsion at post - operatively immediately 4, 8 and 12 weeks. According to Lane standard, there were distinct difference in the histopathological examination （P 〈 0.01 ）. Conclusion Allogeneic cortical bone plates associated with steel plate can rebuild the cortical bone defect structurally and recovery the function of load bearing, and it is a valid means to accelerate bone union and prevent the failure of fixations.