坐骨神经和T_(10)椎体部脊髓损伤对大鼠股骨干骨折早期骨痂生成的影响

Effect of sciatic nerve and T_(10) spinal cord injuries on early callus generation in rats with femoral shaft fracture

背景:神经因素在骨折愈合过程中具有调解作用,但其具体机制不明,实验进一步观察了外周神经和中枢神经在骨折愈合过程中的作用。目的:探讨失神经(坐骨神经和T10椎体部脊髓损伤)支配对Wistar大鼠股骨干骨折早期骨痂生成的影响。方法:建立Wistar大鼠单侧股骨中段开放性横行骨折动物模型,然后分别进行同侧坐骨神经横断和或T10椎体部脊髓开放性横断,并设仅行骨折建模者为对照组。所有大鼠分别于建模后14和28d后处死并于骨折部位取材,进行影像学测量及标本新生骨痂组织学观察。结果与结论:建模14和28d后,骨痂影像学测量结果均显示,坐骨神经横断组骨折愈合最快,对照组其次,T10椎体部脊髓横断组最慢,3组间差异均有显著性意义(P<0.05);股骨标本骨痂组织学观察显示:对照组骨痂较成熟,坐骨神经横断组和T10椎体部脊髓横断组均生成不成熟骨痂。实验以此推断周围神经损伤加速骨折愈合,中枢神经损伤则延缓骨折愈合,失神经支配下骨痂的构成有明显缺陷,完整的神经支配是骨折愈合的必要条件。

BACKGROUND： Neural factors have mediation role on fracture healing. But the exact mechanism has been unknown. This study is designed to further observe the effect of peripheral nerve and central nervous system on the fracture healing course. OBJECTIVE： To study the effect of nerve loss （sciatic nerve and T10 spinal cord） on early callus generation in rats with femoral shaft fracture. METHODS： Wistar rats were prepared for open hemi-femur middle fracture models, and were made the ipsilateral sciatic nerve transaction （SNT） and / or spinal cord transection at the T10 level （T10ST）. All rats were executed 14 and 28 days after operation, then the samples of fracture site was drawn, which were used for radiologic measurements and microscope histology observation of the new bony callus. RESULTS AND CONCLUSION： At 14 and 28 days after modeling, the bony callus imaging measurement results showed that the fracture healing of the SNT group was the fastest, and the T10ST group was slowest. The differences among the 3 groups had significance （P 〈 0.05）; the histology observation showed that the bony callus was more mature in the control group, but there were immature bony callus in the SNT group and T10ST group. Peripheral nerve injury can accelerate the course of bone fracture healing, but the central nervous system injury will delayed the course. There are significant deficiencies to the construction of bony callus under the denervation state. Nerve is a necessary condition for fracture healing.