带肌瓣复合骨形态发生蛋白形成骨桥修复骨缺损  

Experimental Study on Vascular Muscle Flap as a Carrier of BMP to Repair Long Bone Defect

作　　者：裴国献[1] 杨润功[1] 魏宽海[1] 金丹[1] 

机构地区：[1]第一军医大学南方医院创伤骨科,广州510515

出　　处：《中国矫形外科杂志》2000年第2期156-159,共4页Orthopedic Journal of China

基　　金：国家自然科学基金!(基金编号 39870 881 )

摘　　要：目的 :探讨带血供肌瓣作为骨形态发生蛋白 (BMP)载体修复骨缺损的可行性。方法 :将新西兰大白兔前肢指深屈肌转位至桡骨下段 12mm骨缺损区 ,分带血供肌瓣复合BMP组和单纯BMP组进行观察检测。结果 :以带血供肌瓣复合BMP修复骨缺损 ,3周时肌瓣内可触及串珠状团块 ,有大量软骨细胞生成 ,沿肌间隙分布。 6周时骨桥已与宿主骨紧密结合 ,软骨溶解区有大量编织骨形成 ,已出现骨髓腔并与宿主骨髓腔再通 ,肌纤维被增殖的间充质细胞、软骨细胞及结缔组织所分割。新生骨湿重较单纯BMP组明显增高。结论 :带血供肌瓣可作为BMP的良好载体。Objective:To investigate the effect of vascular muscle flap as a carrier of bone morphogenetic protein (BMP) to repair long bone defect.Methods:20 forelimbs of 10 New Zealand white rabbits were divided into 2 groups randomly.12mm radius bone defect was made.Vascular muscle flap with BMP was implanted in one group and BMP alone was implanted in the other as control.Gross and histological observation,x-ray examination and wet bone weight measurement were carried out at 3 weeks and 6 weeks postoperatively.Results:In the group of vascular muscle flap combined with BMP,the bone defect was filled up with new bone tissue formed in the muscle flap at 3 weeks.The new bone tissue bridged the bone defect at 6 weeks.Histological examination showed that a large amount of cartilage was formed in the gaps of muscles at 3 weeks.The cartilage was absorbed and replaced by normal bone containing hematopoietic bone marrow at 6 weeks with obvious muscle cell atrophy.The wet bone weight of the new bone was 253.52±20.63 mg,which is significantly larger than that of the control group 172.22±13.95mg.Conclusion:Vascular muscle flap can be used as an effective carrier to keep BMP stable in the bone defect and provide target cells for bone formation as well.Muscle fibers can direct of new bone formation that was induced by BMP.Based on good blood supply and a large amount of target cells,the vascular muscle flap which was combined with BMP or other growth factors would play an important role in the therapy of bone defect.This study provide a new idea in the clinical repair of long bone defect.

关 键 词：带血供肌瓣 骨形态发生蛋白 骨桥 骨缺损 修复 

分 类 号：R687.3[医药卫生—骨科学]