矩形髓内钉对实验性骨折局部微循环的影响

The Effect to Fracture-site Microcirculation of Rectangle-shaped Intramedullary Nail on Experimental Fracture Healing

目的 :探讨矩形髓内钉 (RIN )对骨折愈合过程中骨折局部微循环的影响。方法 :运用兔胫骨骨折内固定模型 ,通过微血管墨汁造影、组织切片观察等方法对RIN等不同内固定后骨折局部微循环的变化进行了动态对比研究。结果 :骨折早期 ,各组皮质骨血容量均锐减 ,RIN、END组以内 1/2、SPL组以外 1/2的减少明显。术后 7d ,血容量明显恢复 ,各组均超过正常值。术后 14d血容量扩增至最高峰 ,约为正常值的 6倍。之后血容量渐渐降低 ,术后 84d接近正常。同组相比术后 2 8d骨痂血管最丰富 ;同期相比RIN组骨痂血管最丰富 ,END组次之 ,SPL组最少 ,组间差异显著。结论 :RIN对骨折局部微循环影响小 ,有利于骨折愈合。

Objective:To explore the effect to fracture-site microcirculation of rectangle-shaped intramedullary nail (RIN)on fracture healing.Methods:65 New Zealand rabbits with tibial fracture were internal fixed by RIN,Ender's nails(END)and stainless steel plates(SPL)respectively,and the rabbits were killed at different time.The changes of fracture-site microcirculation in different internal fixation were measured dynamically by using prepared Chinese ink microarteriography and tissue slice examination.Result:At early stage cortical bone bloodvolume of each group were all greatly decreased.In group RIN and group END,the decreases of cortical bone blood-volume were mostly at inner half,but in group SPL it was mostly at outer half.At seven days after operation,a pronounced increase in cortical bone blood-volume occurred,with a peak at fourteen days,which was about six times the nomal control value,then decreased gradually and approached normal at eighty-four days.The distribution of callus microangium was the most affuence at twenty-eight days in a group,and dropped off with the prolongation after operation.At the same time,the distribution of callus microangium in group RIN was the most affluence,and there was a significant difference between two groups.Conclusion:The effect to fracture-site microcirculation and their recovery time of RIN group is less than those of SPL group,which are beneficial to fracture healing.