滑动臂定位器联合钢板手术治疗胫骨中段骨折的效果  

Effect of Sliding Arm Locator and Steel Plate in Surgical Treatment of Middle Tibial Fracture

作　　者：田红波 金粉勤 吴鸣 徐继平 肖海军 殷诺 潘明芒 吕波 薛锋 TIAN Hongbo;JIN Fenqin;WU Ming;XU Jiping;XIAO Haijun;YIN Nuo;PAN Mingmang;LYU Bo;XUE Feng(Shanghai Fengxian District Central Hospital,Shanghai 200233,China)

机构地区：[1]上海市奉贤区中心医院,上海200233

出　　处：《中外医学研究》2021年第4期172-175,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：上海市奉贤区科学技术委员会科学技术发展基金项目(20141202)。

摘　　要：目的:滑动臂定位器联合钢板手术治疗胫骨中段骨折的生物力学分析及其对血清骨形态发生蛋白(BMP)-7,胰岛素样生长因子(IGF)-1和护骨素(OPG)水平的影响。方法:2015年1月-2018年12月选择新西兰雄性大白兔50只,制作出胫骨骨折模型,随机数字法分为观察组和对照组,每组25只。观察组予以滑动臂定位器联合钢板治疗,对照组予以套筒定位器联合钢板治疗。比较两组手术时间、术中出血量、骨痂形成量和骨折愈合时间,观察两组手术后2、6周三点弯曲强度、拉伸强度和扭曲强度,比较血清BMP-7、IGF-1和OPG水平。结果:观察组手术时间、术中出血量和骨折愈合时间明显优于对照组(P<0.01)。观察组骨痂形成量明显多于对照组(P<0.01)。观察组手术后2、6周三点弯曲强度、拉伸强度和扭曲强度均明显高于对照组(P<0.01)。观察组手术后2、6周BMP-7,IGF-1和OPG水平明显高于对照组(P<0.01)。手术后6周,两组BMP-7、IGF-1、OPG水平均较手术后2周增高(P<0.01)。结论:滑动臂定位器联合钢板手术治疗胫骨中段粉碎性骨折具有手术时间短,术中出血量少,骨痂形成多,骨折愈合时间快,在生物力学方面具有明显优势,可能与BMP-7、IGF-1和OPG水平升高有关。Objective:To evaluate the biomechanical analysis of middle tibial fracture with slide arm locator combined with steel plate and its impact on the levels of bone morphogenetic protein (BMP)-7,insulin-like growth factor (IGF)-1 and osteoprotegerin (OPG).Method:A total of 50 male New Zealand white rabbits from January 2015 to December 2018 were divided into the observation group and the control group,25 rabbits in each group.The observation group was treated with the slide arm locator and steel plate,and the control group was treated with the sleeve locator and steel plate.The operation time,intraoperative blood loss,bone callus formation and fracture healing time were observed in the two groups,the three-point bending strength,tensile strength and torsional strength at 2,6 weeks after surgery were observed in the two groups,and the serum BMP-7,IGF-1 and OPG levels were compared between the two groups.Result:The operative time,intraoperative blood loss,and fracture healing time in the observation group were significantly better than those in the control group (P<0.01),and the bone callus formation in the observation group was significantly higher than that in the control group (P<0.01).The three-point bending strength,tensile strength and twist strength at 2,6 weeks after surgery in the observation group were significantly higher than those in the control group (P<0.01).The BMP-7,IGF-1 and OPG levels 2,6 weeks after surgery in the observation group were significantly higher than those in the control group (P<0.01);at 6 weeks after surgery,the BMP-7,IGF-1 and OPG levels in the two groups were significantly higher than those at 2 weeks after surgery (P<0.01).Conclusion:The treatment of middle tibial fracture with slide arm locator combined with steel plate has the advantages,with short operative time,less intraoperative blood loss,more callus formation,faster fracture healing time and excellent biomechanics,and may be associated with the increase of levels of BMP-7,IGF-1 and OPG.

关 键 词：滑动臂定位器 钢板 胫骨骨折 疗效 生物力学测定 

分 类 号：R687.3[医药卫生—骨科学]