骨膜瓣复合开窗异体骨移植修复大段骨缺损  

An experimental research on the repair of bone defect with allograft embedded by vascularized periosteum flap

作　　者：张大伟[1] 田清业 刘光军 王谦 杨磊 

机构地区：[1]潍坊医学院,潍坊261042 [2]解放军第八十九医院全军创伤骨科研究所,潍坊261042

出　　处：《骨科》2012年第2期72-76,共5页ORTHOPAEDICS

摘　　要：目的探讨带血管薄层皮质骨-骨膜瓣嵌入开窗的异体骨修复大段骨缺损的效果。方法将兔胫骨去抗原后制备异体骨标本,制作大段骨缺损动物模型,以带血管薄层皮质骨-骨膜瓣复合开窗的异体骨进行修复。术后观察骨缺损的X线影像,对移植物及其周围软组织行组织学和免疫组织化学观察。结果实验组骨缺损骨痂形成和改造塑形,新生血管长入骨缺损处,新骨形成和骨单位成熟较对照组早。结论以带血管薄层皮质骨-骨膜瓣嵌入开窗的异体骨修复大段骨缺损的手术方法优于以骨膜瓣直接包裹异体骨,缩短骨缺损修复的时间。Objective To study the effect of cortical windowing bone allograft embedded by vascularized thin cortex-periosteum flap to repair massive bone defect.Methods The adult rabbit model of massive tibial defect was established and reconstructed with allograft from de-antigenic rabbit tibia.In experimental group,the cortical windowing grafts were embedded by vascularized thin cortex-periosteum flap,while in other models using vascularized flap packing the allografts directly as the control group.X-ray examination was taken for each graft post-operatively.Histological observation（H-E stain） and immunohistochemical examination（VEGF） were done on the bone and the surrounding tissues.Results In the experimental group callus formation and transformation remodeling of the bone defects,neovascularization invasion into the defect,new bone formation and mature of the bone units were earlier than in the control group.Conclusion The healing model of bone allograft embedded by vascularized thin cortex-periosteum flap is a good way to repair massive bone defect,and it has significant advantages over the directly packing model.

关 键 词：骨膜 骨移植 血管内皮生长因子 

分 类 号：R687.3[医药卫生—骨科学]