自体红骨髓一期移植治疗股骨粉碎型骨折  

One-stage treatment with autologous red bone marrow transplantation for femoral comminuted fracture

作　　者：潘琳琳[1] 吴昊[1] 刘广辉[1] 赵振群[2] Pan Lin-lin;Wu Hao;Liu Guang-hui;Zhao Zhen-qun(Department of Traumatic Orthopedics,the Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010030, Inner Mongolia Autonomous Region, China;Department of Pediatric Orthopedics, the Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010030, Inner Mongolia Autonomous Region, China)

机构地区：[1]内蒙古医科大学第二附属医院创伤骨科,内蒙古自治区呼和浩特市010030 [2]内蒙古医科大学第二附属医院小儿骨科,内蒙古自治区呼和浩特市010030

出　　处：《中国组织工程研究》2017年第25期4015-4021,共7页Chinese Journal of Tissue Engineering Research

基　　金：内蒙古医科大学第二附属医院院基金(2015YJJ24)~~

摘　　要：背景:骨折愈合是否需要一期红骨髓移植,是否植入间充质干细胞?当股骨粉碎性骨折时进行闭式复位髓内钉内固定术,同期进行自体红骨髓一期移植是否可促进骨折处成骨的作用,尚处于研究阶段。目的:探讨采取闭式复位髓内钉内固定方法,一期治疗同时给予自体红骨髓移植对骨折愈合的影响。方法:选择健康新西兰兔20只,麻醉后以30 cm高度质量为5 kg重锤自由下落的做功条件制作兔股骨粉碎型骨折模型。给予2.0 mm直径克氏针髓内固定系统模仿股骨髓内钉内固定术对其进行固定。将兔股骨粉碎性骨折内固定造模成功的右侧股骨定义为骨折内固定组,将其左股骨定义为红骨髓移植组。红骨髓移植组将提取的1 mL自体红骨髓注射于骨折处。于造模后第14,28天分批处死10只兔,测量X射线片上骨折周围骨痂最厚处骨痂厚度;苏木精-伊红染色后光镜观察2组骨折处组织切片中软骨细胞数量及骨小梁相对面积。结果与结论:(1)骨折后14 d,骨折内固定组较红骨髓移植组骨折周围骨痂生成厚度明显减小(P<0.01),差异有显著性意义;(2)骨折后14 d,红骨髓移植组骨折处软骨细胞生成数量大于骨折内固定组(P<0.01),骨折愈合速度快于骨折内固定组;(3)骨折后28 d,骨折内固定组较红骨髓移植组骨折处骨小梁相对面积明显缩小(P<0.01);(4)结果提示,红骨髓移植对于闭式复位髓内钉内固定修复兔股骨干粉碎型骨折的愈合具有促进作用。BACKGROUND:Whether one-stage bone healing with red bone marrow or mesenchymal stem cell transplantation is needed?Whether closed reduction with intramedullary interlocking nailing combined with autologous red bone marrow transplantation can promote osteogenesis in the one-stage treatment of femoral comminuted fracture still remains unclear.OBJECTIVE:To explore the effects of closed reduction with intramedullary interlocking nailing and one-stage treatment with autologous red bone marrow transplantation on fracture healing.METHODS:Twenty healthy New Zealand rabbits were selected and anesthetized,and then the models of femoral comminuted fracture were established at the hinder limbs after throwing a5kg of hammer from30cm height.All rabbits underwent intramedullary fixation using Kirschner wire(diameter:2mm);the right limbs served as control groups,and the left limbs as transplantation group,subjected to the injection of autologous red bone marrow(1mL)into the fracture region.Then the rabbits were respectively killed at14,and28days after modeling,the thickness of thickest callus was measured on X-ray films,and the number of chondrocytes and relative area of bone trabecula in the fracture region were observed through hematoxylin-eosin staining under light microscope.RESULTS AND CONCLUSION:(1)The thickness of callus formation in the control group was significantly less than that in the transplantation group at14days after modeling(P<0.01).(2)The number of chondrocytes in the transplantation group was significantly more than that in the control group at14days after modeling(P<0.01),and the fracture healing in the transplantation group was faster that in the control group.(3)Compared with the transplantation group,the relative area bone trabecula in the fracture region in the control group was significantly reduced at28days after modeling(P<0.01).(4)These finding indicate that red bone marrow transplantation promotes fracture healing in the intramedullary fixation for femoral comminuted fracture in rabbits.

关 键 词：干细胞 移植 自体红骨髓 股骨干 粉碎型骨折 一期移植 动物模型 

分 类 号：R318[医药卫生—生物医学工程]