自身骨泥在长管状骨骨折中的应用与实验研究

探讨长管状骨钢板内固定产生的自身骨泥有无骨诱导活性,能否作为植骨材料及其临床应用。采用22只兔桡骨钻孔采集的骨泥股部肌肉内植入,在二周时五只兔做ECT检测,在一、二、三周取材,做组织形态学观察和碱性磷酸酶(ALP)检测。另5只兔桡骨中段骨折模型一侧自身骨泥植骨、对侧对照,二周做ECT检测。研究结果显示:自身骨泥植入兔肌袋内一周软骨生长,三周网织骨形成;ALP二周水平最高;二周ECF检查肌肉植入区出现放射性浓集,放射性计数明显高于对侧正常肌肉(P<0.05)。骨折模型植骨ECT计数比值明显高于对侧(P<0.05)。52例56处长管状骨钢板内固定自身骨泥植骨取得了良好效果,无一侧骨延迟愈合或骨不连。结果表明长管状骨内固定产生的自身骨泥具有诱导成骨活性,可做为植骨材料,应用于长管状骨骨折钢板内固定一期植骨,可望促进骨折愈合。

Experimental Study and Clinical Application of Autogenous Bone Dust to Treat Fracture of Diaphysis or Metaphysis of Long Bone

To investigate the osteogenesis of the autogenous bone dust produced by drilling in the diaphysis or metaphysis of a long bone before internal fixation with plates and its clinical application as an autograft.The bone dust was implanted into thigh musles of 22 rabbits.The implanted muscles were examined by single photo emission computed tomography (SPECT) at 2 weeks.The samples were harvested at 1, 2, 3 weeks, and then observed with histomorphology; alkaline phospholase assay (ALP) were performed. An experimental model of fracture was estabilished in each side of the radius of rabbits. And autogenous bone dust was implanted in the right radial fracture, and the left radial fracture implanted noth-ing. The fractures were examined by SPECT at 2 weeks.The results demonstrated that, cartilage was found at 1 week af-ter operation, bone formation was found at 3 weeks, the activity of ALP reached the peak at 2 weeks, 99mTC-MDP was accumulated in the implanted thigh muscles at 2 weeks. It was found that there was significant difference in the up-take of 99mTC-MDP between the impanted muscle and the contralateral norrmal muscle at the same area (P<0.05) . There was also singificant difference between the implanted side and control side in the radial fracture model at 2 weeks (P<0.05) .The autogenous bone dust was used primarily to complement the fixation in 52 cases with 56 long bone frac-ture and good results were achieved in those patients. The conclusion is that the autogenous bone dust has the ability of os-teoinduction and can promote bone formation in clinical treatment of fracture as a primarily autogenous bone graft.