一期原位骨延长技术治疗四肢火器伤骨缺损的研究

目的　探讨四肢火器伤骨缺损的治疗方法和一期原位骨延长技术的生物学基础。　方法　对犬肢体火器伤骨缺损模型分别采用一期原位骨延长和传统的后期骨移植两种方法治疗,比较其骨愈合的病理过程及局部微循环血流量的变化。　结果　两组动物骨折局部血流量无显著差别。一期原位骨延长组８ 周内骨延长长度为２８２ ±０９４ ｃｍ , 相对长度为１９３ ％ （１５８ ％ ～２１４ ％ ） 。其骨愈合时间明显比后期植骨组短,伤肢功能也较好。软骨内化骨是骨延长过程中主要的成骨形式。　结论　一期原位骨延长技术治疗火器伤骨缺损,在缩短疗程,简化操作等方面具有明显优越性,且对火器伤骨折的愈合过程和局部血液循环无明显不良影响。

Primary shortening followed by bone lengthening in situ for the treatment of gunshot bone defect

OBJECTIVE: To study the treatment of gunshot bone defect and the biological basis of primary shortening followed by callus distraction in situ. METHODS: The canine with gunshot bone defect were treated by two methods, primary shortening followed by callus distraction or delayed bone graft. The local blood flow and pathomorphological change were observed and compared with each other. RESULTS: In the experiment, the bone lengthening was stopped at the 56th day with (2.82 +/-e 0.94) cm (19.3%) gain in the group of bone lengthening, and the time of bone healing was much shorter in the group of bone lengthening than in the group of delayed graft. There was no significant difference between the groups in the time of soft tissue healing and local blood flow. CONCLUSIONS: The technique of primary bone lengthening is simple and has no side effect on tissue healing and local blood flow.