叩击式骨应力刺激仪促进山羊胫骨骨折愈合的实验研究  

Tibial fracture healing accelerated by rap-style bone stress simulator in goats

作　　者：张峰[1] 王江泽[1] 丁真奇[1] 叶永贤 陈卫[1] 沙漠[1] 黄国锋[1] 梁勃威[1] 庄泽民[1] 温路生[1] 

机构地区：[1]厦门大学附属东南医院,解放军第一七五医院全军骨科中心,福建省漳州市363000

出　　处：《中华创伤骨科杂志》2016年第1期66-73,共8页Chinese Journal of Orthopaedic Trauma

基　　金：国家自然科学基金[81371951（H0605）,81401783]

摘　　要：目的利用钢板螺丝钉内固定山羊胫骨骨折动物模型，探讨叩击式骨应力刺激仪施加不同强度、频率组合的无创式体外轴向应力刺激对骨折愈合的影响。方法选取健康成熟山羊72只建立胫骨骨折钢板螺丝钉内固定模型，随机分为4组（n=18），根据不同的应力参数使用无创性叩击式骨应力刺激仪进行体外轴向应力刺激：实验1组（350N、1．5Hz）、实验2组（200N、1Hz）、实验3组（50N、0．5Hz），并设立无应力刺激处理的空白对照组。术后第7天实验组即行应力刺激，2次／d，30min／次，持续6周。术后即刻、3、6及9周摄X线片，术后3、6、9周每个时间点各组处死6只动物，获取标本行大体观察、生物力学检测及组织学染色以评估骨折愈合情况。结果术后即刻、3、6、9周X线片示实验2组Lane-Sandhu X线评分均较其他组高，差异有统计学意义（P〈0．05）。生物力学测试显示术后3、6、9周实验2组的力学性能优于其他组，实验1和实验3组均优于空白对照组，差异均有统计学意义（P〈0．05）；术后6、9周实验1组与实验3组之间差异有统计学意义（P〈0．05），而术后3周差异无统计学意义（P〉0．05）。组织学HE及Masson染色均显示实验2组骨折处的骨痂量及修复重建速度较其他组好。术后3、6、9周实验2组的新生骨小梁密度及骨胶原蛋白含量百分比高于其他组，差异均有统计学意义（P〈0．05）；3个实验组与空白对照组比较差异均有统计学意义（P〈0．05）；实验3组与实验1组相比差异有统计学意义（P〈0．05）。结论叩击式骨应力刺激仪能够促进山羊胫骨骨折的愈合，体外轴向应力参数为200N、1．0Hz时较明显促进骨折愈合。Objective To observe the effects of axial stress of different magnitudes and vibrations on tibial fracture healing in goats. Methods Models of tibial fracture internally fixated by plate were built in 72 healthy goats. The models were then randomly divided into 4 groups which were subjected to axial stress of 4 sets of parameters implemented by a rap-style bone stress simulator： 350 N and 1.5 Hz （experimental group 1）, 200 N and 1.0 Hz （experimental group 2）, 50 N and 0. 5 Hz （experimental group 3） and zero stress simulation （control group）. The treatments started 7 days after operation, followed by twice per day for 30 minutes per time, and lasted for 6 weeks altogether. Tibial radiographs were taken for each goat on the first day, and at 3, 6 and 9 weeks after operation. Six goats out of each group were killed every 3 weeks for biomechanical and histological analyses to evaluate fracture healing. Results X-ray examinations showed the Lane-Sandhu X-ray score in experimental group 2 was significantly higher than in the other 3 groups on the first day, and at 3, 6 and 9 weeks after operation （ P 〈 0. 05）. Biomechanics analysis showed： the biomechanical performance in experimental group 2 was significantly better than in the other three groups at 3, 6 and 9 weeks after operation and experimental groups 1 and 3 performed significantly better than the control group （ P 〈 0.05） ; there were significant differences between experimental groups 1 and 3 at 6 and 9 weeks after operation （ P 〈 0. 05）, but the difference between experimental groups 1 and 3 at the first 3 weeks was insignificant （P 〉 0. 05）. Histochemical staining （HE and Masson） showed the osteotylus quantity was greater and the healing process faster in experimental group 2 than in the other 3 groups. The density of new trabecular bone and content of collagenous fiber in osteotylus were significantly higher in experimental group 2 than in the other 3 groups at 3, 6 and 9 weeks after operation （ P 〈 0. 05�

关 键 词：胫骨骨折 模型 动物 骨折愈合 应力 物理 

分 类 号：R683.4[医药卫生—骨科学]