国产多孔钽材料兔髌腱内植入形态学特点及生物相容性评价  

EFFECT OF ANTEROINFERIOR TIBIOFIBULAR LIGAMENT REPAIR AND POSTERIOR MALLEOLAR FRACTURE FIXATION ON SYNDESMOTIC STABILITY

作　　者：张振宇[1] 王伟[1] 李元城[2] 李成[1] 刘朋[1] 马静[3] 

机构地区：[1]锦州市中心医院骨科,辽宁锦州121000 [2]大连医科大学附属第一医院骨科 [3]锦州市中心医院神经内科,辽宁锦州121000

出　　处：《中国修复重建外科杂志》2014年第4期448-451,共4页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：国家科技部科技支撑课题资助项目（2012BAE06B03）

摘　　要：目的 通过将国产多孔钽材料植入兔髌腱内,观察其形态学变化并评价生物相容性,为其用于肌腱与骨之间界面固定提供实验依据。方法 成年新西兰大白兔48只,雌雄不限,体重2.5～3.0 kg;将大小为5 mm×5 mm×2 mm的多孔钽材料及多孔钛材料分别植入左、右侧髌腱,作为实验组及对照组。术后观察动物一般情况,2、4、8、12周取材行大体、组织学、扫描电镜及硬组织切片观察植入材料内髌腱组织长入情况。结果 术后实验动物均存活。大体观察实验组及对照组材料均与髌腱组织结合紧密,未见明显炎性反应。组织学观察示,两组植入材料周围均有包膜形成,且各时间点对照组包膜均较实验组疏松、厚,但两组包膜厚度比较差异均无统计学意义（P〉0.05）;随时间延长,两组包膜均逐渐变薄,组内各时间点间比较差异均有统计学意义（P〈0.05）。扫描电镜观察示随时间延长,两组材料孔隙中长入的肌腱纤维增多,但实验组多孔钽材料内部肌腱组织量多于对照组。硬组织切片示,实验组多孔钽-肌腱界面及钽孔隙内充满肌腱胶原纤维及小血管并逐渐向内部生长,与对照组相比无明显差异。结论 国产多孔钽材料具有良好生物相容性,多孔钽-肌腱界面之间可产生稳定牢固的连接,适用于肌腱-骨连接装置的重建。Objective To evaluate the biomechanical characteristics and effectiveness of repairing anteroinferior tibiofibular ligament and fixing the posterior malleolar fracture in reconstructing syndesmotic stability after ankle fracture of pronation-external rotation type （PER） stage IV. Methods Twenty-four normal lower extremity cadaver specimens were collected and made into intact ankle specimens. A MTS Bionix 858 test system was used to measure the maximum rotation of the foot under a static axial load of 150 N, internal rotation torque to the tibia at a rate of l~/second and 4 N＇m torque. Then a fracture of PER stage IV model was established in each specimen. Internal fixation of lower tibiofibular ligament union was performed by screws in group A, fixation of posterior malleolar fractures in group B, fixing posterior malleolar fracture combined with repairing anteroinferior tibiofibular ligament in group C （8 specimens each group）. Then the maximum rotation of the foot was measured under the same condition, and the syndesmotic stability was calculated. Between July 2009 and September 2012, 32 patients with ankle fracture of PER stage IV were treated. There were 19 males and 13 females with an average age of 35 years （range, 20-63 years）. The locations were the left ankle in 14 cases and the right ankle in 18 cases. The time from injury to admission was 3.5 hours on average （range, 1-72 hours）. Open reduction and plate compression internal fixation were performed in fibula, and medial maUeolus was fixed by conpression screws, then anteroinferior tibiofibular ligament was mended and posterior malleolar fracture was fixed by screws. Results The preservation rates of syndesmotic stability after repair were 46.2% ＋ 12.3%, 62.6% ＋ 10.7%, and 66.5% ＋ 12.6% in groups A, B, and C, respectively; groups B and C were significantly superior to group A （P 〈 0.05）, but no significant difference was found between groups B and C （P 〉 0.05）. All patients achieved wound healing by first intention, a

关 键 词：多孔钽 肌腱 - 骨连接装置 骨移植材料 髌腱 生物相容性 兔 

分 类 号：R589.2[医药卫生—内分泌]