新型动态加压交锁髓内针对骨折愈合的影响罗刚1刁鑫伟2李长青1.DOCVIP

新型动态加压交锁髓内针罗 刚1 刁鑫伟2 李长青1 周跃1 第三军医大学第二附属医院骨科，重庆 400037；2 第三军医大学第二附属医院病理科，重庆 400037） 摘要目的：探讨新型动态加压交锁髓内针影响骨折愈合的组织学及骨痂内I型胶原和骨钙素的表达变化。方法：2周岁青山羊只，制作双侧股骨干中段横断骨折模型，实验以动态加压交锁髓内针固定，旨在骨折断端形成持续性动态压应力条件，对照以普通髓内针固定。分别于术后第7、14、30、60、90d在骨折愈合处取材，行组织病理学和RT-PCR等检测。结果：组织学结果显示实验组骨折间隙内软骨痂基质的钙化、软骨内成骨及编制骨的改建均快于对照组。RT-PCR结果显示两组的I型胶原和骨钙素表达均骨折上升，于术后达到峰值，实验组明显高于对照组（P0.05）。结论：动态加压交锁髓内针促进成骨细胞外基质的和软骨内成骨，从而有效加速骨折愈合。 关键词交锁髓内针；骨折愈合；动态压应力；I型胶原；骨素 Effect of fracture healing dynamic compressive interlocking intramedullary nail Gang Luo1Xin-wei Diao2 Chang-qing Li1Yue Zhou1 （1 Department of orthopedics,Xinqiao hospital, Third Military Medical University, Chongqing, 40037；2 Department of pathology,Xinqiao hospital, Third Military Medical University, Chongqing, 40037） Abstract Objective：To explore the novel dynamic compressive interlocking intramedullary nail on fracture healing in histology and bone callus within type I collagen and osteocalcin expression changes. Methods: 15 2-year-old bilateral middle femoral shaft transverse fracture model sheep were involved, one of fractured femurs was fixed by autodynamic compressive intramedullary nail as the experimental side, which could produce continuous dynamic compressive stress at the fracture level, the other side was fixed by ordinary intramedullary nail as the control. Respectively at 7, 14,30,60,and 90d after surgery, the samples were collected from the fracture for histopathological observation and RT-PCR detection. Results: As the results of the histological observation, the cartilage callus matrix calcification, endochondral bone and preparation of the bone alterations in the experimental sides were faster than the control. As the results of RT-PCR detection, the expression of type I collagen and osteocalcin were increased after surgery, the peak of expression was appeared during the postoperative 14th to 30th day. Meanwhile, there was significant difference between the experimental group and the control( P0.05). Conclusion: The autodynam