不同宽度捆绑带对骨折愈合的影响*★

背景：有研究认为捆绑带的使用会影响骨折部位的血运甚至造成骨折延迟愈合、不愈合。 目的：观察3种不同宽度捆绑带对骨折愈合的影响。 方法：将新西兰大白兔建立股骨干非负重骨折动物模型，随机分为3组，均采用髓内固定，分别在骨折部位加用3，6，9 mm宽度的捆绑带固定，于固定后2，4，6周行大体观察、骨密度测定、骨痂前后直径、组织学检查进行比较，观察不同宽度捆绑带在骨折愈合中的作用及影响。 结果与结论：固定后4，6周，6 mm捆绑带组骨密度明显优于9 mm捆绑带组(P < 0.05)。固定后4，6周9 mm捆绑带组骨密度和固定后2，4，6周骨痂直径明显低于其他2组(P < 0.05)。6 mm捆绑带组新生骨小梁数量和成骨细胞数均多于其他两组。结果证实，保持相同的捆绑带束缚力条件下，6 mm宽度的捆绑带固定对骨折愈合的效果最佳。

Influence of different-width cerclage bands on fracture healing

BACKGROUND: Some research shows that the use of cerclage bands can even damage fracture healing and bring about fracture nonunion or delayed healing. OBJECTIVE: To observe the influence of cerclage bands of three sizes on fracture healing. METHODS: Totally 45 New Zealand white rabbits were randomly divided into three groups, and the femoral shaft fracture animal models of non-weight-bearing were established. The three groups were all used with intramedullary fixation, and the cerclage bands were 3, 6, and 9 mm respectively. The effects of the three groups were evaluated and compared through the gross observation, the bone mineral density, the diameter of callus and histological examination were measured and performed at 2, 4, and 6 weeks after operation in order to understand the role of cerclage bands in fracture fixation and fracture healing. RESULTS AND CONCLUSION: At 4 and 6 weeks after fixation, the bone mineral density in the 6 mm group was superior to that in the 9 mm group (P < 0.05). The bone mineral density at 4 and 6 weeks after fixation and the diameter of callus at 2, 4, 6 weeks after fixation were both lower in the 9 mm group than the other groups (P < 0.05). The number of new trabecular bone and osteoblasts in the 6 mm group was higher than that in the other groups. These findings indicated that 6 mm cerclage bans has a best effect on fracture healing under the same binding force.