模拟一次加压延长治疗先天性胫骨假关节的实验研究

Animal experiment study on treatment of congenital pseudoarthrosis of the tibia using combined bone distraction and compression with auto iliac grafting

目的：通过动物实验模拟采用自制改进 Ｉｌｉｚａｒｏｖ 长骨固定延长器，通过一次手术对假关节施行切除、少量髓芯植骨、加压固定延长治疗先天性胫骨假关节，寻求促进假关节愈合的最佳方式。方法：２０只绵羊随机分为 Ａ、 Ｂ 两组，每组１０只。于胫骨结节下约１ ｃｍ 处横行截骨，自中、下１／３部截除胫骨全长２０％ 的骨段，安装外固定器。 Ａ 组取髂骨于短缩截骨处行髓芯植骨。 Ｂ 组为空白对照组。术后行组织学、生物力学及放射线影像学分析。结果： Ａ 组短缩截骨处骨愈合情况在各项分析中均优于 Ｂ 组。结论：采用自制改进 Ｉｌｉｚａｒｏｖ 长骨固定延长器，通过一次手术对假关节施行切除、少量髓芯植骨、加压固定，能更好地促进假关节愈合。

Objective:15 patients with congenital pseudoarthrosis of the tibia (CPT) were treated successfully,using Ilizarov apparatus and core auto iliac grafting.The union rate was greatly increased.We designed the following animal experiment to prove the result.Methods:20 sheep were freely divided into 2 groups,with 10 in each group.Group A was done with core auto iliac grafting and group B served as blank control.X ray film was taken and the proportion of the callus area to the whole tibia area was figured out.The experiment of biomechanics was done to observe the relation between pressure and displacement.The histological tests were made to know the situation of osteogenesis.Results:The proportion of the area of callus to the area of the whole tibia in group A was bigger than that in group B.The change of displacement in group A was more evident than that in group B under the same changing pressure.Siuation of osteogenesis in group A was better than that in group B.Conclusion:This animal experiment has proved that treatment of CPT using Ilizarov apparatus with core auto iliac grafting has increased the union rate of CPT than the similar method.