间断拔钉对股骨颈骨折愈合的影响

目的：探讨间断拔钉对股骨颈骨折愈合的影响。方法：取本地自然放养的健康成年山羊18只，建立双侧股骨颈骨折后3枚加压螺纹钉固定的模型，随机取样的一侧为实验侧，分别于术后4、8、12周各拔1钉；另一侧为对照侧，术后12周时3枚钉一起拔出。模型建立后随机分为A、B、C3组，分别于术后8、12、16周处死取材。期间做X线检查、核素骨显像、组织学检查对比两侧愈合情况有无差别。结果：骨同位素显像血流相及血池相显示A、B组实验侧动脉灌注及静脉回流较对照侧通畅，静态相显示实验侧血运优于对照侧。组织学观察结果显示：在血管生成、编织骨生成、坏死骨清除等阶段实验侧均较对照侧提前。结论：应用间断拔钉法治疗股骨颈骨折，可改善股骨头血运，加快股骨颈骨折愈合。

Research of the effect of drawing out the screws intermittently on the healing of femoral neck fracture

Objective: To study the effect of drawing out the screws intermittently on the healing of femoral neck fracture.Method:Eighteen healthy goats with matured skeleton were used to make the model of femoral neck fracture fixed with three compression screws.One side was selected randomly to be the experimental side and the three screws were drawn out respectively in the 4th,8th,12th week after the operation.The other side was the control side and the three screws were drawn out in the 12th week after the operation totally.After the model was made they were divided into A,B,C groups,which were sacrificed separately in the 4th,8th,12th week after the operation.Tthe experimental side was compared with the control side on X ray ,SPECT ,and microscopic inspection.Result:The data of SPECT appears: the blood flow in the artery and the vein of the experimental side was better than that of the control side in group A,B.There was no difference between the two sides in group C.The microscopic inspection showed: The generation of new blood capillary and interlaced bone in the experiment side was more rapid than that of the control side.The clearance of necrosis bone chips in the experiment side was accelerated.Conclusion:Drawing out screw intermittently can improve the blood flow of the feraoral head and facilitate the healing of the fracture.