骨外膜剥离对实验性骨折愈合的影响─—超微结构研究  

Effects of periosteal stripping on experimental frac-ture healing -An ultra-structural.observation

作　　者：季鸣[1] 顾云五[1] 刘杰文[1] 

机构地区：[1]天津医院创伤骨科

出　　处：《中华骨科杂志》1994年第8期498-501,T003,共5页Chinese Journal of Orthopaedics

摘　　要：本文采用雄性健康家兔的双前肢制备桡骨标准骨折，一侧剥离骨外膜而另一侧不剥离作为对照。分别于骨折后第３、７、１４、２１、２８天各处死一组动物。电镜下观察。结果表明，在双侧骨折处均有典型的炎症反应，纤维软骨骨痂形成及原始骨性骨痂形成等骨折愈合的基本表现，各期中细胞活力，胶原基质合成和钙盐沉积过程基本上与其它文献报道相同。但在骨膜剥离侧观察到①成软骨细胞及软骨细胞较多。②出现不尚于一般成纤维细胞的肌纤维母细胞，其胞浆中含有平滑肌纤维束，具有收缩功能，可合成并分泌胶原及蛋白多糖，参与骨痴形成并使其强度增加；因而使骨折处胶原纤维合成增加，这种细胞可能来源于未分化间充质细胞。③成骨细胞出现稍晚，因而钙盐沉积慢于对照侧。由此可见，骨外膜剥离可削弱骨折愈合能力。AbstractStandardized radial fractures were produced in bila-teral forelegs of 20 rabbits.Periosteal stripping was per-formed on the unilateral sides. The animals were sacrificedat 3、7、14、21 and 28 days after surgery.Specimens wereobtained from the fracture sites and prepared for electronmicroscopic examination. The basic healing courses weresimilar;however,over the side with the periosteumstripped,some outstanding features were noted .1.Theer.were much more cartilaginous calli because of a largernumber of chondroblasts and chondrocytes;2.myofibrob-lasts were abundant,which in contrast from fibroblasts,some unstriated fibers were observed in the cytoplasm;3.there were special fat cells which formed collagen togetherwith myofibroblasts;4.the deposition of calcium appearedlate and slow.These findings indicated that,fracture heal-ing was interfered unfavourably by periosteal stripping as a result of cellular and vascular injury.

关 键 词：骨外膜 剥离 超微结构 骨折 愈合 

分 类 号：R683.02[医药卫生—骨科学]