可滑动钢板跨骨骺固定对骺生长的影响

Effect of fixation with sliding plate cross epiphysis on the epiphyseal growth

[目的]评价可滑动钢板跨骨骺固定对兔骺板生长的影响,为临床应用提供依据。[方法]5周龄日本大耳白兔32只随机分4组,每组8只。于右侧股骨远端骺板线上方3~5 mm截骨,跨骺板可滑动接骨板固定,左股骨远端骺板未行处理,设为正常对照。分别于术后2、4、6和8周处死动物,测量股骨长度、股骨远端骨骺厚度,行HE和Masson三色染组织学观察。[结果]随着术后时间推移两侧股骨长度、股骨骺板厚度和肥大软骨细胞计数均增加,不同时间点间差异有统计学意义(P<0.05)。术后2~8周钢板侧股骨长度、股骨骺板厚度和肥大软骨细胞计数小于对照侧,术后2~6周时两侧间差异无统计学意义(P>0.05),但术后8周时,两侧间差异有统计学意义(P<0.05)。[结论]可滑动钢板跨骺板固定早期,可滑动孔产生滑动作用,未对骺板生长发育产生显著影响,但随可滑动孔螺钉到达末端,后期会限制骺板生长。

[Objective]To evaluate the effect of fixation with sliding plate cross epiphysis on the epiphyseal growth to provide bases for clinical application.[Methods]A total of 32 Japanese white rabbits aged 5 weeks were randomly divided into 4 groups with 8 animals in each group.After osteotomy conducted at 3~5 mm above the distal femoral epiphysis,the right femur was fixed with a sliding plate cross the epiphysis,by contrast,the left femur kept intact as normal control.The animals were sacrificed at 2,4,6 and 8 weeks respectively after operation to measure the total femoral length and the thickness of epiphysis,and used for histological observation by HE and Masson tricolor stains.[Results]As time went postoperatively,the total femoral length,the thickness of epiphysis and the counts of hypertrophic cartilage cells in the epiphysis significantly increased on both sides,with statistical differences among different time points after operation(P<0.05).From 2 weeks to 8 weeks,the plate side proved less than the normal control side regarding the total femoral length,the thickness of epiphysis and the counts of hypertrophic cartilage cells,which were of no statistical significances at 2,4 and 6 weeks(P>0.05),whereas statistical significances at 8 weeks postoperatively(P<0.05).[Conclusion]This fixation with sliding plate cross epiphysis is not interfere epiphyseal growth at early stage due to sliding role,but inhibit epiphyseal growth as sliding role vanished.