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首页> 外文期刊>Open Journal of Urology >A New Model to Study Healing of a Complex Femur Fracture with Concurrent Soft Tissue Injury in Sheep
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A New Model to Study Healing of a Complex Femur Fracture with Concurrent Soft Tissue Injury in Sheep

机译：研究绵羊并发软组织损伤的复杂股骨骨折愈合的新模型

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High energy bone fractures resulting from impact trauma are often accompanied by subcutaneous soft tissue injuries, even if the skin remains intact. There is evidence that such closed soft tissue injuries affect the healing of bone fractures, and vice versa. Despite this knowledge, most impact trauma studies in animals have focussed on bone fractures or soft tissue trauma in isolation. However, given the simultaneous impact on both tissues a better understanding of the interaction between these two injuries is necessary to optimise clinical treatment. The aim of this study was therefore to develop a new experimental model and characterise, for the first time, the healing of a complex fracture with concurrent closed soft tissue trauma in sheep. A pendulum impact device was designed to deliver a defined and standardised impact to the distal thigh of sheep, causing a reproducible contusion injury to the subcutaneous soft tissues. In a subsequent procedure, a reproducible femoral butterfly fracture (AO C3-type) was created at the sheep’s femur, which was initially stabilised for 5 days by an external fixator construct to allow for soft tissue swelling to recede, and ultimately in a bridging construct using locking plates. The combined injuries were applied to twelve sheep and the healing observed for four or eight weeks (six animals per group) until sacrifice. The pendulum impact led to a moderate to severe circumferential soft tissue injury with significant bruising, haematomas and partial muscle disruptions. Posttraumatic measurements showed elevated intra-compartmental pressure and circulatory tissue breakdown markers, with recovery to normal, pre-injury values within four days. Clinically, no neurovascular deficiencies were observed. Bi-weekly radiological analysis of the healing fractures showed progressive callus healing over time, with the average number of callus bridges increasing from 0.4 at two weeks to 4.2 at eight weeks. Biomechanical testing after sacrifice showed in- creasing torsional stiffness between four and eight weeks healing time from 10% to 100%, and increasing ultimate torsional strength from 10% to 64% (relative to the contralateral control limb). Our results demonstrate the robust healing of a complex femur fracture in the presence of a severe soft tissue contusion injury in sheep and demonstrate the establishment of a clinically relevant experimental model, for research aimed at improving the treatment of bone fractures accompanied by closed soft tissue injuries.
机译：即使皮肤保持完整，由撞击创伤引起的高能骨折也常伴有皮下软组织损伤。有证据表明，这种闭合的软组织损伤影响骨折的愈合，反之亦然。尽管有这些知识，但大多数动物撞击创伤研究都集中在孤立地骨折或软组织创伤上。但是，考虑到同时对两个组织的影响，必须更好地了解这两种损伤之间的相互作用，以优化临床治疗。因此，本研究的目的是建立新的实验模型，并首次表征绵羊同时患有闭合性软组织创伤的复杂骨折的愈合。摆锤冲击装置的设计目的是向绵羊的大腿远端施加确定的标准化冲击，对皮下软组织造成可再生的挫伤。在随后的步骤中，在绵羊股骨上产生了可再现的股骨蝴蝶骨折（AO C3型），该骨折最初通过外固定器结构稳定了5天，以使软组织肿胀消退，最终在桥接结构中使用锁板。将合并的伤害施用于十二只绵羊，并观察愈合四到八周（每组六只动物）直至处死。摆锤的冲击导致中度至重度的周围软组织损伤，并伴有明显的瘀伤，血肿和部分肌肉破裂。创伤后测量显示房室内压升高和循环组织破裂标志物，在四天内恢复到正常的损伤前值。在临床上，未观察到神经血管缺陷。对愈合性骨折的双周放射学分析显示，随着时间的推移愈伤组织逐渐愈合，愈伤组织桥的平均数量从两周的0.4增加到八周的4.2。处死后的生物力学测试表明，在四到八周的愈合时间中，扭转刚度从10％增加到100％，极限扭转强度从10％增加到64％（相对于对侧对照肢体）。我们的结果证明了绵羊在严重软组织挫伤的情况下复杂股骨骨折的稳固愈合，并证明了临床相关实验模型的建立，旨在改善伴有闭合性软组织损伤的骨折的治疗。

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