手术修复石膏外固定治疗兔髌骨-髌腱连接点断裂的愈合效果

Healing effect of plaster external fixation in surgical repair of rabbit patella-patellar tendon junction fracture

目的探讨石膏外固定对兔髌骨-髌腱连接点断裂修复术后愈合的影响。方法48只新荫兰大白兔按随机数字法分为实验组（n=24）和对照组（n=24），建立兔右侧髌骨-髌腱连接点断裂动物模型，然后行髌骨-髌腱连接点断裂修复术。术后实验组管型石膏固定右侧膝关节3周，对照组不进行膝关节制动。术后2、4、8周，每组分别选取实验动物8只，免疫组化法检测两组兔右侧髌骨-髌腱连接点组织的巨噬细胞表达并进行吸光度值（A值）分析。结果术后2周、4周、8周免疫组化检测显示，对照组巨噬细胞阳性染色的4值均显著高于实验组（术后2周：110．51±19．84比76．39±13．27，术后4周：85．72±21．60比51．76±10．35，术后8周：54．32±8．15比37．63±6．07，均P〈O．01），且两组巨噬细胞阳性染色的4值均随时间延长而逐渐降低（均P〈O．01）。结论石膏外固定可以抑制术后髌骨-髌腱连接部位巨噬细胞聚集，促进损伤愈合。

Objective To investigate the healing effect of plaster external fixation in surgical repair of rabbit patella-patellar tendon junction fracture. Methods Forty-eight New Zealand white rabbits were randomly divided into the experimental group （n=24） and control group （n=24）. The rabbit models with right patella-patellar tendon junction fracture were established, and underwent repair of patella-patellar tendon junction fracture. After the operation, tubular plaster was applied in the experimental group to fix the right knee joint for 3 weeks, while no knee joint was immobilized in the control group. At 2, 4, 8 weeks after the operation, 8 experimental animals were included from each group, and immunohistochemistry was used to determine the macrophage expression in the rabbit right patella-patellar tendon junction tissues of the two groups for absorbance value （A value） analysis. Results At 2, 4, 8 weeks after the operation, immunohistochemistl7 showed that the A value of macrophage positive staining in the control group was significantly higher than that in the experimental group （2 weeks after the operation ： 110.51±19.84 vs 76.39±13.27, 4 weeks after the operation： 85.72±21.60 vs 51.76±10.35, 8 weeks after the operation： 54.32±8.15 vs 37.63±6.07, all P〈0.01 ）. The A values of macrophage positive staining in both groups were gradually decreased with the increasing time （all P〈0.01）. Conclusion Plaster external fixation can inhibit postoperative naaerophage accumulation in patella-patellar tendon junction, and promote fracture healing.