α-氰基丙烯酸正辛酯粘接兔胫骨横断骨折的实验研究

An experimental study on the adhesive effect of octyl-α-cyanoacrylate on rabbit tibial transverse fracture

目的:通过用α-氰基丙烯酸正辛酯在新西兰大白兔体内粘接固定胫骨中段横断骨折,观察其对骨折愈合的影响、在体内降解的速度,研究α-氰基丙烯酸正辛酯粘接固定骨折的疗效。方法:在新西兰大白兔的胫骨中段制成横断骨折模型,实验组用2.5mm克氏针髓腔内固定,断端间用α-氰基丙烯酸正辛酯粘接固定,对照组单纯用2.5mm克氏针髓腔内固定,术后分别于2、4、6、8、10、12周处死取材,通过大体观察、X线片和组织学检查观察断端骨折愈合情况、胶体残留情况。结果:α-氰基丙烯酸正辛酯粘接固定新西兰大白兔胫骨骨折后,对骨折愈合无明显影响。大体观察、X线片检查和组织学检查发现,术后2周实验组和对照组骨折线清晰,断端可见纤维软组织连接,骨折断端周围可见软组织粘连,未见骨痂生长,断端间被粘连的软组织包裹;X线片可见骨折线清晰,未见骨痂影像。4周实验组和对照组可见少量的骨痂形成,X线片可见骨折线略显模糊。8周实验组和对照组可见明显外骨痂形成,骨折线部分消失,10周和12周实验组和对照组骨折线完全消失,伴有明显外骨痂形成,骨折愈合;胶体在体内4周时纤维细胞和软骨细胞逐渐长入,6周时可见被软骨细胞和纤维细胞包裹,8周时材料降解破碎,被纤维细胞和软骨细胞包裹,材料逐渐吸收并可见软骨化骨。结论:在粘接固定兔胫骨骨折时,胶体置入体内后,α-氰基丙烯酸正辛酯在体内2周即开始降解,软骨细胞和纤维细胞逐渐长入降解的区域,并逐渐包裹材料,8周时材料降解破碎,10～12周完全降解消失,未形成板障效应,不影响骨折愈合。

Objective To explore the efficacy of octyl-α-cyanoacrylate adhesive on sticking fracture through observing healing of rabbit tibial transverse fracture following the use of octyl-α-cyanoacrylate. Methods A rabbit model of transverse fracture at the middle portion of tibia was established. In the experimental group, fixation was performed internally with Kirschner wires of 2.5 mm and octyl-α-cyanoacrylate was applied to stick the broken ends, while wires alone were used in the control group. Healing of the broken end was observed grossly, by X-ray and histological examination on weeks 2, 4, 6, 8, 10, and 12 after fixation. Results Fracture healing was not influenced markedly after octyl-α-cyanoacrylate was applied to stick the broken ends of the rabbit tibia. Two weeks following fixation in both group, fracture line was clear with no scar formation on X-ray and the broken ends were connected by fiber tissues. On week 4, scanty scar was formed and the fracture line became slight blur. The fracture line disappeared partially on week 8 and completely from week 10 with significant sear formation, revealing fracture healing. Fibroeytes and ehondroeytes gradually infiltrated into the adhesive on week 4. The adhesive was covered by fibroeytes and ehondroeytes on week 6, degraded and fragmented on week 8, and then absorded slowly. Conclusions The oetyl-α-eyanoaerylate adhesive used for sticking rabbit tibial fracture degrades on week 2 after being applied, fragments on week 8, and disappears completely from weeks 10 to 12 with no formation of plate blockage. It has no adverse effect on fracture healing.