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首页> 外文期刊>Injury >Fracture healing after reamed and unreamed intramedullary nailing in sheep tibia.
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Fracture healing after reamed and unreamed intramedullary nailing in sheep tibia.

机译：扩孔和未加筋髓内钉治疗胫骨胫骨后骨折愈合。

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Intramedullary nailing is a well-established method for stabilisation of long-bone shaft fractures. It is still a controversy as to whether the procedure should be done by an unreamed or reamed technique. In the present animal study, 24 sheep were treated with intramedullary nailing. Midshaft fractures (Arbeitsgemeinschaft fur Osteosynthese (AO) type 42-A2/3) were created. Eight sheep were treated with an unreamed nailing technique (UN), a further eight sheep underwent tibia nailing by the reamed technique using the conventional AO reaming system (RC) and in a further eight sheep, reamed nailing was performed using an experimental reaming system (RE). Intra-operatively, the intramedullary pressure was measured and, during a healing time of 10 weeks, the growth of callus formation was labelled with fluorescence markers after 4 and 6 weeks. After 10 weeks, the animals were euthanised and the quality of fracture healing was determined by recording stiffness in torsion, antero-posterior and mediolateral bending and the load at yield. In addition, the callus formation at the fracture zone was evaluated by fluorescence microscopy and macroradiographs. The results showed a decrease of intramedullary pressure when reamed nailing was performed with the RE (72.5 mmHg) system compared with the conventional AO reaming system (227 mmHg). Mechanical testing did not reveal any significant differences either for torsional or bending stiffness or for load at yield for any of the three procedures. Histological evaluation showed a similar callus formation for the UN group and the RE group. Callus formation in the UN (65 mm(2)) and RE (63 mm(2)) groups showed a higher increase during the first 6 weeks than those treated with the conventional AO reaming system (27 mm(2)). This means that, especially during the first weeks of fracture healing, damage to the bone by the reaming process can be reduced by reaming with a reaming device with lowered cutting flutes and smaller drive-shaft diameter. Intramedullary pressure can be significantly reduced by using reaming systems with reduced drive-shaft diameters and deepened cutting flutes. In the early phase of fracture healing, callus formation can be influenced positively when using the RE system.
机译：髓内钉是一种稳定的长骨干骨折稳定的方法。关于该程序是否应采用无扩孔技术或扩孔技术仍存在争议。在本动物研究中，对24只绵羊进行了髓内钉治疗。产生了中轴骨折（骨合成（AO）42-A2 / 3型）。使用未扩孔钉技术（UN）处理了八只绵羊，使用常规AO扩孔系统（RC）通过扩孔技术对另外八只绵羊进行了胫骨钉固定，在另外八只绵羊中，使用了实验扩孔系统进行了扩钉（回覆）。术中测量髓内压，并在10周的愈合时间内，在4周和6周后用荧光标记物标记愈伤组织的生长。 10周后，对动物实施安乐死，并通过记录扭转刚度，前后弯曲和内侧弯曲以及屈服载荷来确定骨折愈合的质量。另外，通过荧光显微镜和X射线照相术评估在骨折部位的愈伤组织形成。结果表明，与常规的AO铰孔系统（227 mmHg）相比，使用RE（72.5 mmHg）系统进行扩孔钉时，髓内压力降低。机械测试没有发现任何三种方法的扭转或弯曲刚度或屈服载荷的显着差异。组织学评估显示，UN组和RE组的愈伤组织形成相似。在UN（65 mm（2））和RE（63 mm（2））组中，愈伤组织的形成在开始的6周内显示出比用常规AO扩孔系统（27 mm（2））处理的愈伤组织形成更高。这意味着，特别是在骨折愈合的最初几周内，可以通过使用铰刀装置进行铰刀来扩孔，从而减少铰刀对骨头的损害，铰刀具有降低的切削刃和较小的驱动轴直径。通过使用减小传动轴直径和加深切削刃的铰孔系统，可以显着降低髓内压力。在骨折愈合的早期阶段，使用RE系统可积极影响愈伤组织的形成。

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