不锈钢与钛合金材料组合固定骨折的实验研究

Experimental study on the combining application of stainless steel and titanium alloy in the internal fixation of rabbits' fractures

目的评价不锈钢、钛合金材料制成的钢板、螺钉单独或组合固定骨折后周围组织反应的差别,及对骨折愈合的影响。方法新西兰大白兔一侧胫骨中段处截骨,用不锈钢、钛合金材料制成的钢板、螺钉单独或组合固定。动物随机分为A、B、C、D组。A组为钛板+钛钉组,B组为不锈钢板+不锈钢钉组,C组为钛板+不锈钢钉组,D组为不锈钢板+钛钉组。术后进行组织学、免疫组织化学和放射学检查。结果术后2周,各组内固定周围炎性细胞的数量、包膜厚度、增殖细胞核抗原(PCNA)阳性表达率无显著性差异。术后4、8、12周,A、C组与B、D组之间有显著性差异,A组与C组、B组与D组之间无显著性差异。骨折部位X线片显示不同组合对骨折愈合无明显影响。结论不锈钢与钛合金组合固定骨折,在术后12周不会引起严重组织反应,不会影响骨折愈合。

Objective To investigate the application of different combinations of plates and screws made of stainless steel （SST） or Ti-6AL-4V （Ti） in the internal fixation of rabbits＇ fractures, their influences on the reactions of the surrounding tissues as well as on the healing of fractures obscrved. Methods The experimental New Zealand rabbits with tibia fracture were randomly divided into four groups： A, 13, C and D. They were fixed with the different combinations of plates and Mews made of stainless steel or Ti-6AL-4V respectively： group A with the combination of Ti plates and Ti screws; group B with the combination of SST plates and SST screws; group C with the combination of Ti plates and SST screws; and group D with the combination of SST plates and Ti screws. After the operation, they were also observed histologically, immunohistochemically and radiographieally. Results With an analysis of the quantity of inflammatory cells, the thickness of fibrous capsule and the positive rate of proliferating cell nuclear antigens （PCNA） of the surrounding tissues, it shows that after 2 weeks of the operation, there were no significant differences among the four groups; after 4, 8, and 12 weeks of the operation, there were significant differences between group A, C and group B, D; but there were no significant differences between group A and C and between group 13 and D. The radiographs of the fractures show that the different combinations of internal fixation materials do not have an obvious influence on the healing of the rabbits＇ fractures. Conclusions The combining application of stainless-steel and titanium alloy in the internal fixation of rabbits＇ fractures does not cause scrious tissue reactions and does not affect the healing within 12 weeks after the operation.