新型动态加压交锁髓内针对骨折愈合的影响  

Effect of novel dynamic compressive interlocking intramedullary nail on fracture healing

作　　者：罗刚[1] 刁鑫伟[2] 李长青[1] 周跃[1] 

机构地区：[1]第三军医大学新桥医院骨科,重庆400037 [2]第三军医大学新桥医院病理科,重庆400037

出　　处：《第三军医大学学报》2012年第19期1989-1993,共5页Journal of Third Military Medical University

摘　　要：目的探讨新型动态加压交锁髓内针影响骨折愈合的组织学及骨痂内Ⅰ型胶原和骨钙素的表达变化。方法 2周岁青山羊15只,制作双侧股骨干中段横断骨折模型,实验侧以新型动态加压交锁髓内针固定,旨在骨折断端形成持续性动态压应力条件,对照侧以普通髓内针固定。于术后第7、14、30、60、90天在骨折愈合处取材,行组织病理学和RT-PCR等检测。结果组织学检测示实验组骨折间隙内软骨痂基质的钙化、软骨内成骨及编织骨的改建均快于对照组。RT-PCR检测示2组Ⅰ型胶原和骨钙素表达均在骨折术后上升,分别于术后14、30 d时相点达到峰值,实验组明显高于对照组(P<0.05)。结论新型动态加压交锁髓内针能够促进成骨细胞外基质的合成、分泌和软骨内成骨,从而有效加速骨折愈合过程。study the effect of novel dynamic compressive interlocking intramedullary nail on histology of fracture healing and expression of type I collagen and osteocalcin in callus. Methods Fifteen 2-years-old goats were included in this study. A bilateral middle femoral shaft transverse fracture model was established. Its experimental side was internally fixed with dynamic compressive intramedullary nails to produce continuous dynamic compressive stress and its opposite side was fixed with ordinary intramedullary nails. Samples were taken from the healed fracture on days 7, 14, 30, 60 and 90, respectively, after operation. The fracture healing was assessed by histopathology and RT-PCR, respectively, Results Histology examination showed that the calcification of cartilage matrix in the fracture space and the reconstruction of osteogenesis and woven bone within the cartilage were faster in the experimental side than in the opposite side. RT-PCR displayed that the expression levels of type I collagen and osteocalcin were higher after operation than before operation, reached their peak on days 14 and 30 after operation respectively, and were significantly higher in experimental group than in control group （P 〈 0.05 ）. Conclusion Novel dynamic compression intramedullary nail can effectively accelerate the healing of fractures by stimulating the bone extracellular matrix synthesis, secretion and formation of endochondrostosis.

关 键 词：交锁髓内针 骨折愈合 动态压应力 Ⅰ型胶原 骨钙素 

分 类 号：R-332[医药卫生] R683.05