CAJ | 학술논문

目的观察关节囊切开与未切开内固定复位对兔创伤性股骨颈骨折的影响.方法将60只健康雄性新西兰大白兔随机分为3组:假手术组(S组,8只)、关节囊切开复位组(O组,26只)和关节囊未切开复位组(C组,26只),采用手术结合钝性打击的方法制作股骨颈骨折模型,内固定复位;X线检查股骨颈骨折愈合,酶联免疫吸附试验(ELISA)、免疫磁珠技术检测术后外周血中骨钙素(BGP)水平和循环内皮细胞(CEC)数量,苏木素-伊红(HE)染色后镜下观察股骨头组织形态的变化并统计空骨陷窝率.结果术后8、12周X线评分,O组分别为(31.6±4.8)、(34.4±7.6)分,高于C组(23.4±3.1)、(29.0±5.9)分(P＜0.05);BGP水平和CEC数量,O、C组均较S组升高(P＜0.05),O组和C组比较,差异无统计学意义(P＞0.05);S、C、O组空骨陷窝率分别为(2.4±1.1)％、(23.7±3.3)％和(11.6±4.8)％,C组较O组升高(P＜0.05).结论兔创伤性股骨颈骨折后行关节囊切开内固定复位有利于骨折愈合,并可降低股骨头坏死率.
목적 관찰관절낭절개여미절개내고정복위대토창상성고골경골절적영향.방법 장60지건강웅성신서란대백토수궤분위3조:가수술조(S조,8지)、관절낭절개복위조(O조,26지)화관절낭미절개복위조(C조,26지),채용수술결합둔성타격적방법제작고골경골절모형,내고정복위;X선검사고골경골절유합,매련면역흡부시험(ELISA)、면역자주기술검측술후외주혈중골개소(BGP)수평화순배내피세포(CEC)수량,소목소-이홍(HE)염색후경하관찰고골두조직형태적변화병통계공골함와솔.결과 술후8、12주X선평분,O조분별위(31.6±4.8)、(34.4±7.6)분,고우C조(23.4±3.1)、(29.0±5.9)분(P＜0.05);BGP수평화CEC수량,O、C조균교S조승고(P＜0.05),O조화C조비교,차이무통계학의의(P＞0.05);S、C、O조공골함와솔분별위(2.4±1.1)％、(23.7±3.3)％화(11.6±4.8)％,C조교O조승고(P＜0.05).결론 토창상성고골경골절후행관절낭절개내고정복위유리우골절유합,병가강저고골두배사솔.
Objective To observe the therapeutic effect of treating traumatic femoral neck fracture rabbits with open or close joint capsule reduction.Methods Sixty healthy male New Zealand white rabbits were randomly divided into 3 groups:sham-operated group (S group,n =8),close restoration group (C group,n =26) and open restoration group (O group,n =26).The animal models of traumatic femoral neck fracture were established in O and C groups.A "T" type of incision was made in the joint capsue in O group,and the joint capsule in C group was not damaged.The curative effectiveness of femoral neck fractures was evaluated by X-ray examination.The bone gla protein (BGP) expression was assayed in serum by enzyme linked immunosorbent assay (ELISA),and circulating endothelial cells (CECs) were tested by immunomagnetic beads.The femoral head and neck of the rabbits killed at 12th week after operation were observated histologically.Results The X-ray scores and 8th and 12th week in O group (31.6 ±4.8 and 34.4 ± 7.6) were significantly higher than in C group (23.4 ± 3.1 and 29.0 ± 5.9) (P ＜ 0.05).The BGP expression and number of CECs in O group and C group were significantly increased as compared with S group (P ＜ 0.05),but there was no significant difference between C group and O group (P ＞ 0.05).Histologically,the rate of empty bone lacuna in O group was significantly lower than in C group [(11.6 ± 4.8) ％ vs.(23.7 ± 3.3) ％,P ＜ 0.05].Conclusion After traumatic femoral neck fracture,the open joint capsule reduction method can reduce the pressure of joint capsule and protect the residual blood supply,which is conducive to fracture healing.