同种异体皮质骨板重建压力侧骨皮质缺损的实验研究

Allogeneic cortical bone plate in the reconstruction of bone cortical defect of pressure side

目的在建立山羊动物模型基础上,探讨同种异体皮质骨板重建压力侧骨皮质缺损的特点,为临床治疗提供依据。方法将16只成年山羊随机分成两组,制作压力侧骨皮质缺损的动物模型,8只行植骨、骨板、钢板固定作为实验组,另8只行植骨、钢板固定作为对照组。3周、9周后取标本,进行生物力学测试,测试标本的抗扭转、抗压缩刚度数据。随后标本制作病理切片,观察组织病理学变化。结果对照组3只动物内固定术后失效,骨折端移位。实验组动物均愈合良好。病理结果显示实验、对照组3周纤维愈合,9周时基本达到骨性愈合。生物力学测试结果显示:术后0周、术后3周标本的抗扭转、抗压缩刚度两两比较差异具有统计学意义,9周后差异无统计学意义。结论同种异体皮质骨板能够为骨皮质缺损区提供可靠的初始固定稳定性,预防钢板内固定术失效,给骨缺损愈合提供稳定的力学环境。

Objective To investigate the characteristics of using allogeneic cortical bone plate in the reconstruction of bone cortical defect of pressure side through goat model, and to provide basis for clinical treatment. Methods Sixteen adult goats were randomly divided into group A （n=8, treated by bone graft, bone board, and plate fixation） and group B （n=8, treated by bone graft and plate fixation）, Specimens were collected three weeks and nine weeks later for biomechanical test. Data of anti-twist and anti-compression were tested. Then pathological section was made to observe histopathological changes. Results In the control group, 3 cases had displacement of the fractured part after internal fixation, while all the goats in the study group healed well. The pathologic result showed goats in the two groups achived fiber healing 3 weeks after treatment and basic bone union 9 weeks after treatment. Biomechanical test showed that the anti-twist and anti-compression properties showed statistically significant difference between the two groups three weeks after treatment, and showed no statistically significant difference nine weeks after treatment. Conclusion Alloganeic cortical bone plate can provide initial fixation stability for bone cortical defect, and prevent failure of plate fixation, thus provide a stable mechanical environment for the healing of bone defects.