不同自体移植物防止骺板损伤后骨桥形成的实验研究

Comparison of different autografts in the prevention of bone bridge formation after physeal injury

目的 比较在骺板损伤后分别将自体脂肪 ,游离骺板 ,带肌瓣骺板作为移植物来防止骨桥形成 ,减小畸形发生的效果。方法 将 32只未成熟家兔随机分为 4组 ,以A、B、C、D组表示 ,将A D组家兔左胫骨近端外侧骺板造成人为缺损 ,A组缺损旷置 ,B、C、D组分别以自体脂肪 ,游离腓骨骺板 ,带肌瓣腓骨骺板作为移植物填塞缺损。术后 12周处死 ,双下肢拍X线片和CT扫描。并对胫骨缺损处进行组织学观察。结果 只有D组 (带肌瓣骺板作为移植物组 )家兔发生的胫骨畸形较轻 ,与A组 (缺损旷置组 )在统计学上差异有显著性意义。结论 自体脂肪作为移植物不能完全避免骨桥的发生 ;带肌瓣骺板移植较游离骺板易于存活 ,有一定临床应用前景 ;

Objective To compare the effects of autologous fat, free physis, and physis with muscle flap acting as autografts in preventing bone bridge formation and minimizing deformity.Methods 32 skeletally immature rabbits were divided into 4 groups randomly, and designated A, B, C and D. An artificial defect was created in the lateral proximal left tibia physis in groups A, B, C and D. Nothing, autologous fat, free fibular physis, fibular physis with peroneus longus muscle flap were respectively inserted into the defects of group A, B, C and D. The animals were sacrificed 12 weeks after surgery. Radiographs and CT scans were taken of both legs. Sections through the proximal tibia were made for histological study.Results Only the rabbits in group D (fibular physis autografted with muscle flap group) had less limb length discrepancy and angular deformity. The difference between group D and A ( Non-graft group) was statistically significant. Conclusions Autologous fat could not prevent the formation of bone bridge completely; physis autografted with muscle flap was more liable to survive than free physis and had a clinical potential in the future; physis could, to some degree, regenerate after injury.