骨痂在不同内固定骨折愈合过程中的差异

Difference of Bony Callus in Union of Fracture with Various Internal Fixation

目的观察不同内固定对兔股骨骨折愈合过程中骨痂的差异。方法取新西兰大白兔27只,建立大白兔股骨中段骨折模型,随机分为3组,每组9只。分别为股骨中段骨折保留骨膜,同时使用钢板内固定组(Ⅰ组)、股骨中段骨折骨膜剥离同时使用钢板内固定组(Ⅱ组)、股骨中段骨折骨膜保留但去除骨髓同时使用髓内钉固定组(Ⅲ组)。各组在不同时段拍X线片,观察骨折愈合情况,取骨折愈合部位测量其骨痂直径,观察骨折愈合中骨痂的差异。结果(1)X线片显示,Ⅲ组在相同时段有大量的骨痂生成,Ⅰ组、Ⅱ组在相同时段显示骨痂生成量少;(2)Ⅰ组与Ⅱ组骨痂直径不存在差异(F=5.14,P>0.05),Ⅰ组和Ⅲ组、Ⅱ组和Ⅲ组骨痂直径存在差异(F=3.15,3.30,P<0.05),有统计学意义。结论髓内钉固定组在骨折愈合过程中骨痂生成多,利于骨痂的钙化以及早期的功能锻炼和负重;骨痂多利于骨折愈合的判断。

Objective To observe the difference of bony callus in union of fracture of rabbits＇femur fracture with various internal fixation. Methods Twenty - seven New Zealand white rabbits were randomly divi- ed into 3 groups with 9 rabbits in each group to build the animal model of right mid - femur fracture. Group Ⅰ was reserved periosteum with mid - femur fracture and taken plate internal fixation. In group Ⅱ, the periosteum was stripped and the mid - femur fracture was taken plate internal fixation. Group m was reserved periosteum but removed marrow and the mid - femur fracture was taken intramedullary nail fixation. Each group was taken X - ray at different stages to observe the union of fracture. The diameter of bony callus in the location of fracture union was measured to observe the difference of bony callus in the union of fracture. Results （ 1 ） The X - ray film indicated that there were lots of formation of bony callus at the same stage in group m, while it was little in group Ⅰ and Ⅱ. （ 2 ） There was no difference in diameter of bony callus between group Ⅰ and group Ⅱ（ F = 5.14,5.23 ,P 〉 0.05 ）, but the differences were found between group Ⅰ and m, group Ⅱ and Ⅲ with statistical significance （ F = 3. 15, 3.30, P 〈 0.05 ）. Conclusions Group with intramedullary nail fixation has plenty formation of bony callus, which benefits the calcification of bony callus and helps early functional practice and weight loading. The plenty bony callus helps to the identification of fracture healing.