兔胫骨干骺端骨膜外截骨对延长区成骨作用的影响  

Influence of metaphyseal osteotomy above the endosteum of rabbit tibia on osteogenesis at the osteotomy gap

作　　者：任志勇[1] 李涛[1] 张维彬[1] 王辉[1] 黄现峰[1] 魏长月[1] 

机构地区：[1]解放军第89医院全军创伤骨科研究所,山东潍坊261021

出　　处：《中国矫形外科杂志》2015年第2期150-155,共6页Orthopedic Journal of China

摘　　要：[目的]研究兔胫骨干骺端骨膜外截骨对延长区骨膜成骨作用的影响。[方法]取健康成年中国家兔48只随机分为两组,对照组:左胫骨干骺端骨膜下截骨。实验组:左胫骨干骺端骨膜外截骨。术后第7 d开始延长外固定架,分别于术后7、17、27、37 d拍摄X线片观察延长区成骨情况;同时段随机在两组动物活体取延长区再生骨组织,制作HE染色切片,光镜下观察组织学变化;术后17、27 d常规电镜取材、制片后透射电镜下观察延长区细胞内变化。比较两组间的差异。[结果]观察两组术后第7 d X线片,均可见外固定架延长后遗留一清晰的牵张间隙,随着时间的延长,牵张间隙内逐渐出现越来越多的新生骨组织,骨密度影像也由低向高逐渐增加,但肉眼观察在影像学上两组无显著差异。HE染色示各时段实验组较对照组均有更为明显的成骨现象,两组差异性随时间推移逐渐减小。透射电镜示术后17、27 d,在超显微细胞器水平上,实验组较对照组有更多的粗面内质网扩张、高尔基复合体及线粒体增生。两组差异性随时间推移逐渐减小。[结论]兔胫骨干骺端骨膜外截骨有利于骨膜早期活跃性成骨作用。[Objective]This work aimed to investigate the influence of metaphyseal osteotomy above the endosteum of rabbit tibia on osteogenesis at the osteotomy gap. [Method]Forty- eight healthy adult Chinese rabbits were randomly divided into the control group（ metaphyseal osteotomy under the endosteum of left tibia） and the experimental group（ metaphyseal osteotomy above the endosteum of left tibia）. The osteotomy site was distracted on the 7th day after osteotomy using an Ilizarov external fixator. X- ray pictures at the osteotomy gap at 7,17,27 and 37 days after the distracting were taken to observe the bone formation,and in the mean time,fresh bone tissue samples at the osteotomy gap were taken from the two groups for HE staining. Changes inside the cells at the osteotomy gap at 17 and 27 days were observed using a transmission electron microscope. Osteogenesis in the two groups was comparatively studied. [Result]A clear osteotomy gap could be found on the X- ray pictures after distracting. New bone tissues formed gradually at the osteotomy gap,and bone mineral density also increased with time. However,there was no significant difference between the two groups on the X- ray pictures. HE staining results showed more obvious osteogenesis phenomenon in the experimental group than in the control group after distracting,while the difference was gradually vanished. Electron microscopy results showed more dilated rough endoplasmic reticulum,more proliferation of Golgi complex and mitochondria in the experimental group than in the control group at 17 and 27 days,while the difference was also gradually vanished. [Conclusion]Metaphyseal osteotomy above the endosteum is benefit for the active osteogenesis of endosteum in the early stage.

关 键 词：截骨延长 骨膜 成骨作用 

分 类 号：R683.42[医药卫生—骨科学]