管状骨髓腔内骨整合式纯钛种植体与骨组织界面的整合状态  

Osseointegrated titanium screw implants for tubular medullary cavity implantation

作　　者：周志强[1] 韩岩[1] 卢丙仑[1] 郭树忠[1] 

机构地区：[1]解放军第四军医大学西京医院全军整形外科研究所,陕西省西安市710032

出　　处：《中国临床康复》2006年第25期124-126,i0006,共4页Chinese Journal of Clinical Rehabilitation

基　　金：解放军第四军医大学西京医院医疗新技术;新业务资助项目~~

摘　　要：目的:自行设计管状骨髓腔内骨整合式纯钛螺旋状种植体组件,通过动物实验,观察种植体-骨组织界面的骨整合情况,为临床指缺损患者种植体式手指赝复体修复提供材料及依据。方法:实验于2005-08/12在第四军医大学西京医院整形外科实验室完成。采用国产纯钛制做螺旋形柱状种植体,根据成人正常掌骨和近节指骨及其髓腔的解剖学特点及临床应用的可行性,借鉴Bmnemark螺旋型种植体,自行开发研制纯钛种植体。选择新西兰大白兔10只,在麻醉显效后,胫骨髓腔内种植纯钛螺旋状种植体10枚,分别于术后2,4,8,12,16周各处死2只动物取材,X线摄片观察骨结合形成情况。结果:所有实验动物均进入结果分析,种植体无脱落。制备出掌指骨髓腔内骨整合式纯钛螺旋型种植体组件及配件。①X线观察结果:术后2周时,种植体与骨组织间可见到较明显透光间隙,种植体-骨界面未见骨小梁及新骨形成,术后4～6周,种植体与骨组织间透光间隙减小,可见种植体周围骨密度增高,种植体螺纹间新骨形成明显,术后8周,种植体与骨组织间已无明显透光间隙,均被高密度区替代,种植体周围骨密度增高,种植体螺纹间新骨形成明显,形成更完善的骨界面,界面骨成熟,术后12周与8周相比,变化不大。②大体及光镜观察结果:术后2周时,种植体与骨组织间为软组织界面,未见新骨生成;术后4～6周,种植体周围大量新生骨样组织形成;种植体周围及螺纹间新骨形成明显,形成骨性界面;术后12周与8周相比,骨性界面进一步形成。结论:该掌指骨髓腔内骨整合式纯钛螺旋状种植体组件,术后8周可以与周围骨组织形成完全骨结合。AIM： To design a type of osseointegrated screw implants of pure titanium in tubular medullary cavity, and observe the osscointegration between implants and interface of bone tissue through animal experiment, so as to provide materials and basis for clinical restoration of defected fingers with implanted prosthetic appliance. METHODS： The experiment was conducted in the laboratory of Plastic and Reconstructive Surgery, Xijing Hospital of Fourth Military Medical University from August to December 2005. Screw implants of made in Chinese were adopted. According to the anatomical characteristics and feasibility of clinical application of normal adult metacarpal, proximal phalanx and its medullary cavity as well as Bnmemark screw implants, implant of pure titanium was exploited and contrived by ourselves. Ten New Zealand rabbits were selected and implanted of 10 pieces of pure-titanium screw implants into the medullary cavity of tibia after being anesthetized. At the 2^th, 4^th, 8^th, 12^th , 16^th weeks after the operation, two rabbits were executed respectively, and formation of oaseointegration were observed by X-ray. RESULTS： All experimental animals were involved in the analysis of results, and there were no implants fell off. Components and accessories of osseointegrated screw implants were manufactured, which were made of pure titanium and used in metacarpal medullary cavity.（1）Results of X-ray： At 2 hours after operation, obvious lucent gap could be seen in the interface of implant-bone, in which there were no bone trabecular or new one formed. At 4-6 weeks after operation, the lucent gap in the interface of implant-bone diminished, and peripheral bone density of implants was enhanced with obvious new bone formation among screw implants. At the 8^th week after operation, there were no obvious lucent gap in the interface of bone-lmplant, which were substituted by high density, and peripheral bone density of implants was enhanced, new bond formation among fillets of implants were remarkable, interface

关 键 词：骨整合 骨内植入 X线 

分 类 号：R318[医药卫生—生物医学工程]