有限接触式髓内钉对异体骨愈合及微循环影响的研究

目的设计、制造一种可与人工表面关节结合的有限接触式股骨髁上型带锁髓内钉,构成人工半膝关节系统,用于提高儿童保肢手术效果。方法以家猪为实验对象,分为实验组与对照组两组,植入不同类型髓内钉,建立股骨下段异体骨关节移植动物模型。通过放射影像、微血管墨汁造影及组织学观察,研究髓内钉对异体骨愈合及微循环的影响。结果有限接触式髓内钉对骨再血管化进程的影响小于无槽髓内钉,两组间有显著差异;异体骨愈合速度也较无槽髓内钉快,骨痂密度较高。结论有限接触式髓内钉减少了对骨原有生物环境的破坏,有利于宿主骨-异体骨结合面的愈合,可与人工表面关节结合应用于异体骨关节移植,有较好的临床应用价值。

Effect of Limited Contact Femoral Supracondylar Interlocking Intramedullary Nail on Bone Union and Microcirculation

Objective To design and manufacture a new limited contact femoral supracondylar interlocking intramedullary nail as part of a new custom-made hemi-knee joint and to improve the results of children's limb salvage. Methods In reconstruction of the femoral distal defect with allograft, two kinds of intramedullary nail were implanted into experimental and control groups of pigs. Serial tests were carried out including radiology, Chinese ink microarteriography and histology to investigate bone union and microcirculation.Results The effect of limited contact nails on allograft-host healing and revascularization of bone was smaller than on non-chuted nails. Healing of allograft-host with limited contact nails fixation was faster than non-chuted nails and the density of bony callus was higher than that of non-chuted nails. Conclusion This limited contact supracondylar interlocking intramedullary nail can reduce destruction of biological environment of bone and benefit allograft-host healing. It is useful in limb salvage surgery of allograft.