中空植骨式动力髋螺钉治疗猪股骨颈骨折的实验研究

目的：通过设计一种中空植骨式动力髋螺钉（中空钉，Hb—DHS）来提高骨折愈合率和降低骨坏死率。方法：本实验选取8只健康实验猪（华南型，雌雄各半，20～30kg／只），平均分为两组（8周组和16周组，每组4只），取双后肢制作股骨颈骨折（颈中型，Garden III型）动物模型，骨折间隙为0．5mm，取髂骨植骨，右侧中空钉固定、左侧普通钉固定。术后8、16周采用x线分析骨折愈合及股骨头坏死情况并处死动物进行大体标本分析。结果：术后8、16周，Lane-Sandhu评分骨折愈合及ARCO分期股骨头坏死时发现中空钉组与普通钉组比较差异有统计学意义（P〈0．05）；大体标本观察时发现股骨头色泽、外观形态、关节软骨面、软骨下骨质、股骨颈骨折部、中空钉内部植骨存活状态及与周围骨小梁连接状况等中空钉组与普通钉组比较差异有统计学意义。结论：应用中空钉（Hb-DHS）治疗实验猪股骨颈骨折（颈中型，Garden III型）可以提高骨折愈合率、降低股骨头坏死率，为临床治疗青壮年股骨颈骨折（颈中型，Garden III型）提供了理论依据。

Hollow-Bone-Graft Dynamic Hip Screw in Treating Femoral Neck Fracture of Pig. An Experimental Research

Objective：Bone secondary healing requires strongly internal fixation, intramedullary reduced pressure and early functional exercise. This animal experimental research may evaluate the bone healing effect of the femoral neck between Hollow-Bone-Graft Dynamic Hip Screw （Hb-DHS） and standard Dynamic Hip Screw （DHS）. Methods：Eight young adults pigs （South Chinese type, half male/half female, 20-30kg/each） were enrolled in this study and randomly divided into two groups（eight weeks group and sixteen weeks group） and each group contained four pigs. Then medium-sized and Gardenm type fracture models were successfully established on each pig, on which the fracture gap was 0.5mm and the left femur was fixed with Hb-DHS and grafted iliac bone, the right femur was fixed with DHS. Then 8, 16 weeks postoperatively, X-ray difference of bone healing and osteonecrosis were observed and general specimens were also observed. All the experimental datas were analysed by SPSS16.0. Results： There were significant differences 8 or 16 weeks after the operation between Hb-DHS group and DHS group in X-ray examination, Lane-Sandhu score evaluation of the bone healing, ARCO stage of femoral head necrosis and general specimens （P〈0.05）. There were also remarkable differences between the two groups in the color of femoral head, the appearance, the cartilage surface, bone under the cartilage, the region of fracture, the graft survival condition and the connection with peripheral trabecular bone （P〈0.05）. Conclusion： Hb-DHS could improve bone healing and reduce femoral head necrosis in treating femoral neck fracture （medium-sized and Garden m type fracture models） in the experimental animal, which might provide theoretical basis for treating femoral neck fracture （medium-sized and Garden III type fracture models） in adults.