兔颧弓骨折骨缺损植骨临界值的确定  

Determination of a critical size defect in zygomatic arch fractures of rabbits

作　　者：张德辉[1] 张益[2] 段登辉[2] 昌红[3] 周经志[4] 

机构地区：[1]北京世纪坛医院口腔科,北京市100038 [2]北京大学口腔医学院口腔颌面外科,北京市100081 [3]北京世纪坛医院病理科,北京市100038 [4]北京世纪坛医院放射科,北京市100038

出　　处：《中国组织工程研究与临床康复》2007年第16期3131-3133,共3页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：目的:在新西兰白兔颧弓上制备不同的骨折骨缺损,以求得兔颧弓骨折骨缺损植骨临界值。方法:实验于2005-06/2006-12在首都医科大学动物实验室完成。①新西兰大白兔36只,采用随机数字表法分成1mm骨缺损组、3mm骨缺损组、5mm骨缺损组和7mm骨缺损组4组,每组9只。在兔一侧颧弓分别制备1,3,5,7mm骨折骨缺损。②于4,8,12周通过大体解剖学、X射线片、病理学观察骨折骨缺损愈合情况。结果:36只兔均进入结果分析。1mm骨缺损4周即骨愈合。3mm骨折骨缺损在术后8周大体观见骨折断端无动度,缺损界线模糊,X射线片显示缺损有较明显外骨痂,骨折局部骨桥连接,骨折线模糊,病理见骨折两断端间充满致密纤维结缔组织,出现少量淡红色骨基质,未见骨性桥接骨痂。12周大体观察见缺损完全愈合,骨密度完全一致,骨折线消失;X射线片显示骨折断端有骨痂连接;病理出现部分骨桥连接。5mm,7mm骨折骨缺损在术后4,12周内经大体观察、X射线片影像、病理检查均未见骨桥,呈现骨不连特征。结论:兔颧弓12周临界骨折骨缺损为5mm,即骨折骨缺损等于或大于5mm,则骨缺损必须植骨,否则骨不连。5mm亦可以作为颌骨临界骨折骨缺损值的参考。AIM： Different fracture bone defects are established on zygomatic arch of New Zealand rabbits to obtain the critical size fracture defect （CSFD） of the zygomatic arch. METHODS： The experiment was performed at the Animal Laboratory of Capital Medical University from June 2005 to December 2006. （1）Totally 36 New Zealand rabbits were selected and divided randomly into 1 mm bone defect group, 3 mm bone defect group, 5 mm bone defect group and 7 mm bone defect group with 9 in each group. Fracture defects were made on the zygomatic arch of 36 rabbits with the range of 1 mm, 3 mm, 5 mm and 7 mm. （2）Macroscopic anatomy, X radiographic and histopathlogical methods were used to examine bone defect healing at weeks 4, 8 and 12. RESULTS： Totally 36 rabbits were involved in the result analysis. Spontaneous bone healing achieved in 1 mm bone defect group by the end of the 4^th week. There were no range-of-motion and defect obfuscation by general observation, obviously external callus, local bone bridge connection, defect obfuscation by X-ray, feltwork connective tissue in broken ends, a small quantity of salmon pink bone matrix and no bone bridging osteotylus by pathological observation. Full healing of bone defect appeared by the end of the 12^th week by general observation, and bone density was the same and fracture line disappeared. X-ray showed that callus connection appeared in broken ends of fractured bone, and bone bridge connection appeared by pathological observation. No bone bridge, but bone nonunion appeared by general observation, X-ray and pathological test at weeks 4 and 12 after operation in 5 mm bone defect group and 7 mm bone defect group. CONCLUSION. CSFD is 5 mm for zygomatic arch of rabbits at week 12. Fracture bone defect controlled within the limitation of the CSFD can heal spontaneously without bone grafting.

关 键 词：颧骨骨折 植骨临界值 骨折愈合 组织构建 

分 类 号：R687.3[医药卫生—骨科学]