间断拔针对大白兔股骨颈骨折愈合影响的实验研究

Research of drawing out the screws intermittently to prevent the femoral head necrosis

目的探讨间断拔针对股骨颈骨折愈合的影响。方法取新西兰大白兔9只,建立模型:双侧股骨颈骨折后,以3枚克氏针固定。随机取样的一侧为实验侧,分别于术后4、6、8w各拔1枚克氏针;另一侧为对照侧,术后8w时3枚克氏针一起拔出。模型建立后随机分为A、B、C组,于术后8w处死取材进行组织学观察。期间行X线检查、核素骨显像对比两侧愈合情况有无差别。结果骨同位素显像血流相及血池相显示A、B组实验侧动脉灌注及静脉回流较对照侧通畅,静态相显示实验侧血运优于对照侧。组织学观察结果显示:在血管生成、编织骨生成、坏死骨清除等阶段实验侧均较对照侧提前。结论应用间断拔针法治疗股骨颈骨折,可改善股骨头血运,加快股骨颈骨折愈合。

Abstract： Objective To study the effect of drawing out the screws intermittently on the healing of femoral neck fracture. Methods Nine healthy rabbits with matured skeleton were used to make the model of femoral neck fracture fixed with three compression Kirschner wires. One side was selected randomly to be the experimental side and the three wires were drawn out respectively at 4, 6, 8 weeks after the opera tion. The other side was the central side and the three wires were divided into A, B, C groups, which were sacrificed when it was 8 weeks after the operation. We compared the experimental side with the control side with X-ray, ingle photon emission computerized tomography （SPECT） and microscopic inspection. Res- ults The data of SPECT appeared： the blood flow in better than the control side in group A, B. There was microscopic inspection showed： the generation of new the artery and the vein of the experimental side was no difference between the two sides in group C. The blood capillary and interlaced bone in the experimentside were more rapid than the control side. The clearance of necrosis bone were accelerated. Conclusion Drawing out wire intermittently can improve head and reduce the ratio of femoral head necrosis. chips in the e the blood flow xperiment side of the femoral