动态应力钢板与普通应力钢板对羊股骨干骨折愈合影响的实验研究

Effect of Dynamic Stress Steel Plate and Ordinary Stress Plate on the Healing of Femoral Shaft Fracture

目的:研究动态应力钢板与普通应力钢板对羊股骨干骨折愈合的影响。方法:择取24只山羊建造股骨干骨折模型,成功后随即分为动态应力钢板组(CO组)和普通应力钢板组(AO组),前者用CO钢板固定,后者用AO钢板固定,分别在术后1,2及3周取出造模股骨,进行免疫组化实验、RT-PCR实验观测Ⅰ型胶原蛋白的表达、电镜下观测成纤维细胞。结果:苏木精-伊红染色显示在1周后与3周后的时间节点上未能检测到Ⅰ型胶原蛋白的mRNA的表达;2周后CO组Ⅰ型胶原蛋白的mRNA的表达优于AO组。RT-PCR结果示普AO组的Ⅰ型胶原蛋白表达在1周后要强于CO组;在2和3周后要弱于CO组。电镜下观察1周后AO组同CO组一样出现细胞核周围胞质增多,但是超微结构中没有线粒体出现,胶质纤丝的排列稀疏,总体上成纤维细胞没有CO组活跃;2周后AO组细胞质的含量、核糖体、线粒体的数量均少于CO组;3周后CO组细胞不再生长,成纤维细胞转变为纤维细胞,AO组纵切面的细胞增生,细胞间充质增加。结论:应用动态应力钢板内固定治疗山羊股骨干骨折可以促进骨折断端血肿的机化吸收,加速成骨细胞的增长,减少骨折愈合的时间。

Objective：To study the effect of dynamic stress plate and common stress plate on the healing of femoral shaft fracture.Methods：Twenty-four goats were chosen to build the femoral fracture model,after the success of randomly divided into dynamic stress plate group（Chinese osteosynthesis,CO group）and normal group（Association for the study of internal fixation,AO group）,the former fixed with CO steel,the latter with AO plate fixation.The femur of the goats＇ model was taken out at 1,2,and 3 weeks after the operation,and the expression of type Ⅰ collagen was observed by immunohistochemistry and RT-PCR experiment.The fibroblasts were observed under the electron microscope.Results：HE staining showed that the expression of mRNA of type Ⅰ collagen was not detected after 1 weeks and 3 weeks later.After 2 weeks,the expression of type Ⅰ collagen mRNA in group CO was better than that in AO group.RT-PCR results showed that the expression of type Ⅰ collagen in group AO was stronger than that in group CO at one-week point;and at 2 and 3-week point,the expression of collagen was weaker than that in group CO.At one-week point,AO group with CO group appeared around the nucleus cytoplasm increased and observed under electron microscope,but no mitochondria ultrastructure,sparse glial filament,the fibroblasts were not active in CO group;At 2-week point,the number of content of AO group of cytoplasmic ribosomes,mitochondria were less than CO group.After 3 weeks,the cells in group CO was no longer grew,and fibroblasts were transformed into fibroblasts.In group AO,cell proliferation and cell mesenchyme increased on the longitudinal side.Conclusion：The application of dynamic stress plate fixation in the treatment of goat femoral shaft fracture can promote the absorption of fracture and hematoma,accelerate the growth of osteoblasts,and reduce the time of fracture healing.