球囊扩张注射型硫酸钙固定治疗骨质疏松性胫骨平台塌陷性骨折的实验研究

目的评估球囊扩张注射型硫酸钙固定治疗骨质疏松性胫骨平台塌陷性骨折（SchatzkerⅢ型）的疗效。方法健康雌性犬16只,体重（27±1.8）kg5,～7岁龄。适应性饲养1周,喂0.1%低钙饲料,静脉注射地塞米松磷酸钠注射液2.5mg/kg,每周2次3,个月后造成骨质疏松犬,将其分为2组：A组12只,B组4只。A组犬处死取材,随机选择16个胫骨构建胫骨外侧平台塌陷性骨折模型,其中8个实施球囊扩张复位注射型硫酸钙固定术（A1组）,另外8个实施撬拨复位植骨螺丝钉内固定术（A2组）,对两组骨折复位情况进行测量,未行手术的8个胫骨为对照组（A3组）,术后对A1、A2、A3三组胫骨外侧平台感兴趣区（interest regionI,R）进行生物力学测试。B组犬活体行与A1组相同的手术,术后4周取材做组织学检查。结果 A1组骨折复位程度和生物力学测试结果不比A2组差,组织学检查：B组硫酸钙逐渐被吸收,硫酸钙周围有新生骨小梁。结论球囊扩张注射型硫酸钙固定治疗骨质疏松性犬胫骨平台塌陷性骨折复位效果优良、生物力学性能优越,有良好的成骨效果。

Study on balloon distension and fixation with injectable calcium sulfate for treatment of osteoporotic and depressed tibial plateau fracture

Objective To evaluate the curative effect of implementing balloon distension and fixation by injectable calcium sulfate in treating osteoporotic and depressed tibial plateau fracture(Schatzker Ⅲ type) in animal models.Methods Osteoporosis models were established in 16 health female dogs,weighting(27±1.8)kg,aging 5-7 years.Then they were randomly divided into 2 groups: group A(n=12),group B(n=4).Dogs in group A were killed to draw materials,and randomly selected 16 tibias to build tibial plateau fracture model,in which 8 tibias were treated by balloon distension and fixation with injectable calcium sulfate(group A1),the other 8 were treated by reduction,bone grafting and screw internal fixation(group A2).Then the degree of reduction of the two groups was measured.The 8 tibias which were not performed surgery were taken as control group(group A3).The interest region(IR) of the lateral tibial plateau of A1,A2,and A3 groups was analyzed for biomechanical testing.Dogs in group B were performed the same operation as group A1 in vivo,and drawn out for histological examination after 4 weeks.Results Group A1 was as good as group A2 in the degree of reduction and biomechanical testing.Histological examination in group B showed gradual absorbation of calcium sulfate and new bone trabeculas around calcium sulfate.Conclusion The balloon distension and fixtion with injectable calcium sulfate for treatment of tibial plateau fracture in dogs can achieve to good reduction,superior biomechanics performance,and satisfactory osteogenesis.