钢板与聚乙烯板互锁组合固定治疗股骨远端粉碎性骨折的实验研究

An experimental study of treatment of comminuted distal femur fracture with locked double-plating

目的探讨股骨远端粉碎性骨折治疗的新方法,促进功能恢复,减少并发症。方法健康成年杂种犬16只,随机自身对照,制作双侧股骨远端粉碎性骨折模型(AO/ ASIF C2型)。实验侧股骨远端采用钢板与高分子聚乙烯板互锁组合固定(双板固定),对照侧仅用钢板固定(单板固定),术后3、6、9、12周分别进行活体负重、X线摄片及组织学观察。结果双板固定实验侧负重时间、骨痂生成的数量与质量、骨痂塑形情况及骨折愈合时间均优于单板固定对照侧,聚乙烯板下炎性细胞稍多于钢板下。结论双板固定是治疗股骨远端粉碎性骨折的较理想方法,具有一定的临床应用前景。

Objective To explore new techniques for the treatment of comminuted distal femoral fractures to promote functional restoration and reduce the complications of the fracture. Methods Sixteen adult canines were selected for this study, and the experimental and control hindlimb for each canine were randomly determined. Distal comminuted fracture (AO/ASIF Type C2) was induced in both sides of the canine's femurs, and one side was fixed with the double plates (steel plate and polyethylene plate), whereas the other with a single steel plate. By the end of 3, 6, 9 and 12 weeks respectively after surgery, 4 of the dogs were used for weight-bearing observation and radiological and histological examination of the limbs. Results In comparison with dogs in single plate group, double plate fixation resulted in earlier recovery of weight bearing, more abundant and better callus, finer callus moulding and quicker healing. There were slightly more inflammatory cells, however, in the tissues under the polyethylene than those under the steel plate. Conclusion Locked double-plate internal fixation is an excellent alternative for treating comminuted fractures of the distal femur, and may have its potential use in clinical settings.