骨骺生长滑动钢板的设计及动物实验研究

目的：设计一种骨骺部可滑动延长钢板，通过动物实验了解该钢板在动物体内能否在有效固定骨折的同时，又能减轻对骨骼纵向生长的抑制，减少肢体畸形的发生。方法：根据儿童、青少年股骨髁部的解剖特点设计出适用于儿童、青少年股骨髁部骨折的内固定滑动钢板。实验动物选30只1．5月龄健康山羊，12只为正常对照组，余18只为钢板内固定组，其中右后肢采用普通钢板固定，左后肢采用滑动钢板固定。术后不同时相点对所有山羊双侧股骨进行X线摄片检查和使用组织化学、电镜观察评估骨骺细胞的生长情况。结果：X线摄片检查钢板内固定组在术后1d双侧股骨长度差异无统计学意义，在术后1、2、4、6个月双侧股骨长度差异有统计学意义，可滑动延长钢板侧股骨长度明显长于普通钢板侧，股骨长度术后l、2、4、6个月分别与术后1d增长的数值进行比较分析，普通钢板侧和正常对照组右侧股骨长度差异有统计学意义，可滑动延长钢板侧和正常对照组左侧股骨长度差异无统计学意义（尸〉0．05）；光镜观察示滑动组骨骺板总厚度及肥大细胞计数均明显大于普通钢板固定组（尸〈0．01）；Safranine0组织化学观察示滑动组于术后3、6个月SafranineO组织化学染色明显深于普通组；电镜观察示滑动组于术后3、6个月软骨增殖区软骨细胞分裂及生长活跃。结论：动物实验证实可滑动钢板在动物体内随骨骺的生长可自动延长，对骺板无加压抑制作用，能明显减少继发骺板损伤，不会产生骨骺生长抑制、骨骺早闭，符合发育期骨骺生长的生理特点。

Design and experimental study of an epiphyseal slide-traction plate

Objective: To develop an epiphyseal slide-traction plate in child,which can supply the fracture a sufficient internal fixation,and will not restrain the growth of epiphyses. Animal experiments were carried out with the plates to compare the slide-traction with traditional plate. Methods: Develop a slide-traction plate for the configuration of the femur condylus of children. Thirty adolescent goats in the experiment were divided into control group(12 goats) and plate group(18 goats). In plate group,right femurs of goats were fixed with common plates and the left femurs with slide-traction plates. All the goats were given X-ray examination at different time after surgery. And the goats were sacrificed at 3 and 6 month,histological method and electron microscopy were performed to evaluate the development of epiphyseal plate. Results: The both femurs of the goats in control group have no difference in evidence in length at all time we examined. And the both femurs of the goats fixed with plates have no difference in evidence in length at 1 day after surgery. However,the both femurs of the goats fixed with plates have difference in evidence in length at 1 month,2 month,3 month,6 month after surgery. The increased length of the femurs at 1 month,2 month,3 month,6 month after surgery was also compared with the length at 1 day after surgery,there was difference in evidence between the right femurs of the control group and the femurs were fixed with common plates, but no difference in evidence between the left femurs of the normal control group and the femurs were fixed with slide-traction plate(P>0.05). More thicker epiphyseal plate were found in the left femurs than the right femurs of the group fixed with plates at 3 and 6 month after surgery(P<0.01). In the plate group,safranine O staining showed epiphyseal plates at the left femurs had more fuscous staining than the right femurs at 3 and 6 month after surgery and electron microscopy also found that the cells of the epiphyseal plates of left femurs were more eugenic than the right femurs at 3 and 6 month after surgery. Conclusion: The epiphyseal slide-traction plate can slide with the growth of epiphyses,which is suitable for fixation of the fracture in this part.