胫骨短缩加压外固定结合骨延长后血供重建及血流动力学实验研究
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AN EXPERIMENTAL STUDY ON BLOOD SUPPLY AND HEMODYMIC CHANGES AFTER TIBIA SHAFT OSTEOTOMY SHORTENING WITH COMPRESSIVE EXTERNAL FIXATION AND BONY LENGTHENING
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    摘要:

    本文通过对18只性成熟杂种青山羊胫骨干中段截骨短缩,短缩率平均为原胫骨长度的13.6%,然后采用半环槽式外固定器加压固定,同时行胫骨上干骺端截骨延长(10mm/d),平均延长率为20.21%,采用X线摄片,微血管铸型扫描电镜(SEM)观察以及放射微球法局部血流量测定,动态观察延长区和截骨短缩加压端骨修复过程中血循环重建及血流动力学变化。实验发现以10mm/d速度延长,延长停止时延长区新生血管极为丰富和沿应力方向排列,未发现血管稀疏或缺失区,提示新生血管随延长同步增长,延长区新生骨皮质哈佛氏血管系统由延长区

    Abstract:

    Bony tissue of an average of 13.61% of the original length was resected from the middle part of the tibia shaft in 18 adult goats. Then the ostcotomized ends were compressively fixed with the sulcared half-ring external fixator.Simultaneouly, upper metaphysiotomy to lengthen the tibia with a rate of 1.0mm/d and an average lengthening rate of 20.21% of the original length in tibia was performed. The restoration of the blood circulation and hemodynamic changes during the repair process of the lengthened area and the compressively fixed bone ends were studied with roentgenography, microvascular cast observed with scanning electron microscopy(SEM) and radioactivc microsphere measurement of regional blood flow. It was found that the time of lengthening cessation there were abundant vascular networks in the lengthened zone and paralleled to the long axis of the bone. No vascular int erruption or vessel deficient arca was seen. Thesc facts show that the newly-growing vessels in the lengthened area have the same rate of the lengthening on the condition of 1.0mm/d and were gradually converted into the Haversian system of the newly formed cortex of the lengthened area. In the 2nd week after lengthening cesseation, the vessels of the cortex of the osteotomy shortening ends could grow across the space and could anastomose with each other. The primary healing could bc observed under the well-reduction and stable compressive external fixation. The results showed that the treatment of the tibia shaft shortening ends by compressive external fixation with bony lengthening simultaneously could not obviously affect the restoration of the blood supply.

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杨柳,李起鸿.胫骨短缩加压外固定结合骨延长后血供重建及血流动力学实验研究[J].医用生物力学,1995,10(1):40-45

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