兔桡骨骨缺损动物模型中骨缺损长度及缺损位置的影像学比较研究  

Computed tomography-based comparison of defect length and locality in a rabbit radial defect model

作　　者：李东亚[1] 郑欣[1] 邱旭升[1] 王晓波[1] 谢小肖 袁翰[1] 王昌俊[1] 陈一心[1] 

机构地区：[1]南京大学医学院附属鼓楼医院骨科,南京210008

出　　处：《中国矫形外科杂志》2014年第8期737-741,共5页Orthopedic Journal of China

基　　金：江苏省社会发展基金(编号:BE2011604);江苏省六大人才高峰项目(编号:2012-WS-092);江苏省博士后基金项目(编号:131024A);南京市青年卫生人才第一层次项目

摘　　要：[目的]通过CT影像学研究分析6个月龄新西兰兔桡骨大段骨缺损模型的合理缺损长度与缺损位置。[方法]选用健康6个月龄雄性新西兰兔24只,其中18只兔按骨缺损长度,分为1.0 cm组,1.5 cm组,2.0 cm组,依次记为A、B、C组,每组6只,双侧手术共计12侧。在全麻下行双侧桡骨中段骨缺损手术,分别于术后当日,术后4、8、12周行CT三维重建检查,应用Hedberg评分评估骨缺损愈合情况,术后12周处死实验兔,留取尺桡骨标本,行HE染色组织学分析缺损处新生骨情况;根据实验结果选择最佳缺损长度,以距尺骨鹰嘴远端3.0 cm为桡骨近段骨缺损的中心,完成D组6只兔双侧桡骨近段骨缺损实验,应用上述方法比较近段与中段缺损的骨愈合情况及术后并发症。[结果]术后2只实验兔因严重感染,予处死并及时补充。术后4周时,D组中2只实验兔出现单侧尺骨骨折,骨折一侧未计入统计。术后12周时,大体观察见,A组中11侧(91.7%)桡骨已经完全桥接并且塑形较完全,新生桡骨表面光滑。B组、D组完全桥接仅3侧,C组未见桥接,缺损断端已封闭,见少量成骨,缺损区域为纤维组织填充。CT断层图像见A组完全桥接的桡骨已形成髓腔再通,未桥接的骨缺损断端及缺损尺侧均见少量新骨生成;组织学结果示,A组缺损多已修复完成,髓腔再通,塑形完成,而其余三组多表现为断端封闭,缺损区域纤维组织填充;CT三维重建的Hedberg评分结果示B组(1.75±1.06)与A组(3.83±0.39)有统计学差异(P<0.05),而与C组(1.33±0.65)、D组(1.60±0.70)均无统计学差异(P>0.05)。[结论]6个月龄新西兰兔桡骨大段骨缺损模型的缺损长度选择1.5 cm较为合适,其中,缺损位置选择在桡骨中段或者近段均可。[ Objective ] To investigate the appropriate defect length and locality in a rabbit radial critical size defect model with computed tomography （CT） imaging analysis. [ Method ] Twenty-four healthy male New Zealand White rabbits （ age, 6 months） were included in this study. From these, 18 rabbits were divided based on their defect length into 1.0 cm （group A）, 1.5 cm （ group B）, and 2.0 cm （ group C） groups, with 6 rabbits with a total of 12 sides in each group. The rabbits underwent bilateral radial surgery. CT scans were taken immediately after the surgery ,and at 4 - week intervals. The healing of the bone de- fect was evaluated with hedberg scores using CT three-dimensional （3 - D） reconstruction. The rabbits were sacrificed 12 weeks postoperatively and the forearms were harvested for histological analysis to evaluate new bone formation. Based on the results of groups A, B, and C, we selected the best defect length, and performed surgery in group D （6 rabbits） on the proximal side of the radius. The defect center was selected 3.0 cm distal from the olecranon. Bone healing and postoperative complications were com- pared among the four groups. [ Result] Two rabbits were euthanized and replaced because of severe postoperative infection. Four weeks postoperatively, a unilateral ulnar fracture was observed in two rabbits in group D. Therefore, these two affected sides were not included in the analysis. Twelve weeks postoperatively, all rabbits were enthanized for a gross anatomical analysis. Eleven （91.7%） of the radial bones in group A were observed to have been bridged completely with a smooth surface. In contrast, onlythree had bridged completely in groups B and D, and none of the defects in group C was found to have a bridged callus. With the closure of both ends, the defect area was filled with fibrous tissue. Histological analysis showed that the bone de- fect in group A had been repaired perfectly, and the bone mar- row cavity was recanalized. However, the other three groups s

关 键 词：桡骨 大段骨缺损 缺损位置 缺损长度 

分 类 号：R687.3[医药卫生—骨科学]