兔胫骨干骺端截骨延长术骨膜成骨作用的实验研究  

A study on periosteal and endosteal osteogenesis in metaphysiotomy lengthening of the tibia in immature rabbits

作　　者：周建明[1] 李起鸿[1] 赵媛莉[1] 

机构地区：[1]第三军医大学西南医院骨科,630038

出　　处：《第三军医大学学报》1993年第5期418-421,共4页Journal of Third Military Medical University

摘　　要：本实验对45只大耳白兔行左胫骨干骺端截骨延长术。动物被分成3组。其中A组保留骨内外膜;B组环形切除截骨端上下部分骨外膜;C组截骨后刮除截骨端上下部分骨髓及内膜组织。所有动物延长速度为1mm/d。结果发现A组延长区新骨形成和塑形快,质量好,愈合后新骨的力学性能强;B组延长区新骨形成慢,新骨的力学性能差;C组延长早期成骨受一定影响,后期新骨的组织形态与力学性能均接近A组。骨膜随缓慢牵拉同步增长,成骨十分活跃,未发生骨膜撕裂。同时,截骨术和机械牵拉可刺激和加速骨膜的成骨作用。作者认为:完整的骨膜套可为两骨端和骨膜向延长区成骨和新骨连接提供贴附生长的限制性支架,对于延长区成骨具有重要意义。在延长区骨愈合过程中,骨外膜成骨作用比骨内膜成骨作用重要。The histological and biomechanical aspects of the osteogenesis in metaphysioto-my lengthening of the tibia were observed in 45 immature rabbits,which were divided into 3 groups as follows:(1)Group A:After metaphysiotomy,the periosteum and endosteum of the transected boneends were well-preserved.(2)Group B:After metaphysiotomy,the periosteum about 0.7 cm in width on the 2 bone ends was circumcised.Then the 2 bone ends were aligned without disturbing the endosteum.(3)Group C:After metaphysiotomy,a part of the bone marrow and endosteum in the 2 bone ends wwere removed.Then the 2 bone edns were well aligned and the periosteum was sutured up.In all the experimental animals,the tibia was lengthened by 1mm/day.It was found that in Group A,the formation and remodelling of the new bone in the lengthened area occurred quite early after metaphysiotomy and the new bone was good in its biomechanical quality;in Group B,the formation of new bone was retarded and the biomechanical quality of the new bone was not satisfactory;and in Group C,new bone formation was sluggish in the early stage after metaphysiotomy but it wwas active in the late stage,and the neww bone formed was similar to that of Group A in its histological morphology and biomechanical quality.The periosteum could grow synchronously with the slow traction without any tearing.In addition,osteotomy and mechanical traction could stimulate and accelerate periosteal osteogenesis.It is believed that an intact periosteal cuff is of significance in the osteogenesis of the lengthened area since it serves as a restriction framework for the adherent growing of the connection between the new bones of the 2 bone ends and periosteal osteogenesis plays a more important role than endosteal osteogenesis in the bony healing of the lengthened area.

关 键 词：骨增长 骨膜 骨发生 截骨术 

分 类 号：R687.31[医药卫生—骨科学]