失神经对大鼠胫骨骨折愈合影响作用的实验研究  

Effect of Denervation on Tibia Fracture Healing of Rat

作　　者：苗军[1] 夏群[2] 张继东[2] 金鸿宾[2] 王继芳[1] 刘志新[1] 张晛[1] 

机构地区：[1]解放军总医院骨科,北京100853 [2]天津市天津医院,天津300211

出　　处：《中国矫形外科杂志》2003年第12期834-836,共3页Orthopedic Journal of China

基　　金：天津市卫生局科研基金资助项目 (0 0ky2 1 )

摘　　要：目的 :通过失神经后大鼠胫骨骨折愈合情况的观察 ,研究周围神经系统影响骨折愈合的作用。方法 :造成大鼠双侧胫骨闭合横行骨折 ,一侧切断股神经坐骨神经 ,为骨折失神经组 ,另一侧保留神经为骨折正常神经支配组。术后 4周处死大鼠 ,取对应双侧胫骨标本称湿重、拍X线片、测定生物力学强度及骨计量学检查。结果 :湿重及X线片骨痂评分显示 ,失神经组骨痂形成量明显大于正常神经支配组 ,但力学强度降低。骨计量学显示失神经组骨痂类骨质宽度、破骨细胞指数、破骨细胞吸收表面增大 ,双标记线间距离较窄、矿化沉积速率较慢、类骨质成熟时间相对延长。结论 :失神经可使骨折形成有明显缺陷的骨痂 ,完整的神经支配是骨折正常愈合的必要条件。Objective:To study the effect of peripheral nervous system on fracture healing.Methods:In 20 Wistar rats,closed transverse fractures were produced at bilateral tibia.Femoral nerves and sciatic nerves were resected at one side as denervated tibia fracture model,and the other side as innervated tibia fracture model.Animals were executed after 4 weeks and tibia was required.Callus size was evaluated by wet weight and radiograph,and mechanical property was recorded in a three-point bending test.The callus microstructure was measured by bone histomorphometery.Result:On the denervated sides,wet weight and radiographs showed an increased callus formation,but three-point bending test showed mechanically weaker.Bone histomorphormetery displayed that mineralized trabecular bone volume was significantly decreased on denervated sides as compared with normally innervated sides whereas osteoid width,osteoclast index and trabecular osteoclastic resorption surface increased.Compared with innervated groups,dynamic parameters presented that mineral appositional rate in denervated sides were significantly decreased indicating that bone mineralization was obviously inhibted.Conclusion:Intact innervation is essential for normal fracture healing because nerve injury can induce a large,but mechanically insufficient callus.

关 键 词：骨折 骨痂 神经 骨计量学 

分 类 号：R683.42[医药卫生—骨科学]