材料与方法临床资料结果-第三军医大学学报.doc

? 新型纳米生物活性接骨螺钉固定犬股骨髁间骨折 苏 保1，李吉东2，蒋电明1，李玉宝2，邬 均1，李 军1 (400016 重庆，重庆医科大学附属第一医院骨科1；610064 成都，四川大学分析测试中心2) [摘要] 目的 评估纳米羟基磷灰石（nano-hydroxyapatite，n-HA）/聚酰胺66（Polyamid，PA66）/玻璃纤维（glass fiber, GF）新型生物活性螺钉固定犬髁间骨折的效果。方法 制备n-HA/PA66/GF生物活性螺钉。取24只成年中华田园犬，按随机数字表法分为2组：生物螺钉实验组和金属螺钉对照组。使用电锯将动物股骨外侧髁锯断造股骨髁间骨折，分别使用生物螺钉及金属螺钉固定骨折。术后4、8、12、24周行大体观察、组织学、CT片、生物力学及血常规、生化检测，术后24周行肝、肾、脾组织学检测。结果 2种螺钉均能有效固定犬髁间骨折。术后2组动物均活动正常，切口愈合良好。术后12周CT显示2组动物髁间骨折均已骨性愈合。组织学检测发现n-HA/PA66/GF螺钉表面被新生骨覆盖，新生骨不断钙化、成熟，骨-钉界面结合紧密。金属螺钉与骨之间存在较大间隙，螺钉周围骨组织被1层纤维组织包裹。生物力学测试证实2组最大推出载荷在术后4、8、12周无统计学差异（P﹥0.05），但在术后24周有统计学差异（P﹤0.05），推出生物螺钉所需的最大载荷比对照组大。术后24周碱性磷酸酶水平升高[ (58.8±14.49)U/L]，其余外血常规、生化均正常。肝、脾、肾HE染色未见异常。结论 n-HA/PA66/GF生物活性螺钉具有良好的内固定性能和体内相容性，具有广阔的应用前景。 [关键词]　接骨螺钉；纳米羟基磷灰石/聚酰胺66玻璃纤维；生物活性假体；应力遮挡 [中图法分类号] R318.08;R681.8;R687.32 [文献标志码] A [基金项目] 重庆市科委科技攻关课题（[2009]6号，CSTC2009AB5080） [通信作者] 蒋电明，E-mail： jdm571026@ In vivo study on a new nano-hydroxyapatite/polyamide 66/glass fiber bioactive bone screw for fixing femur intercondylar fracture in dogs Su Bao1, Li Jidong2, Jiang Dianming1, Li Yubao2, Wu Jun1, Li Jun1 (1Department of Orthopaedics, the First Affiliated Hospital, Chongqing Medical University, Chongqing, 400016; 2Analytical and Testing Center, Sichuan University, Chengdu, Sichuan Province, 610064, China) [Abstract] Objective: To evaluate the effect of a new nano-hydroxyapatite/polyamide 66/glass fiber (n-HA/PA66/GF) bioactive bone screw on fixing femur intercondylar fracture in dogs. Methods: The n-HA/PA66/GF bioactive bone screws were prepared. Twenty-four dogs were randomly divided into a bioactive bone screw experimental group and a metal screw control group. The dog models of femur intercondylar fracture were established using an electric saw, and the fractures were fixed with bioactive bone screws and metal bone screws, respectively. Gross examination, histological staining, CT examination, biomechanical test, blood routine and biochemical examination were performed at 4, 8, 12 and 24 weeks after operation.