新医学2016，Vol.47Issue(5)：318-323,6.DOI:10.3969/j.issn.0253-9802.2016.05.009
外固定架加压-牵开-再加压治疗非感染性骨折不愈合实验研究
Experimental study of accordion maneuver in the treatment of non-infected nonunion using external fixator
摘要
Abstract
Objective To evaluate the efficacy and explore the biological mechanism of the accordion maneuver in the treatment of non-infected fracture nonunion.Methods Eighty seven New Zealand white rabbit models with non-infected femoral nonunion were successfully established and randomly divided into three groups (n =29).In the experimental group,the animals were treated with the accordion technique of alternating com-pression with distraction using external fixator after femoral reduction.In the control group,the rabbits were handled with compression without distraction following femoral reduction.In blank control group,the femoral fracture was fixed after femoral reduction without compression or distraction.At 2,4,6,8,1 2 weeks after cor-responding treatment,X-ray imaging was performed to assess the callus formation.Immunohistochemistry stai-ning was utilized to measure the expression level of VEGF (quantity of stained cells).Results The percent-age of bone union in the experimental group was significantly higher compared with those in the control and blank control groups (P <0.01 7).At 8 and 1 2 weeks after treatment,a large quantity of new bone formation was observed and osteoblasts attached to the bone margin.The process of osteogenesis was almost completed. In the control group,neither chondrocyte nor osteoblast proliferation was documented.No apparent increase in callus formation was found.In the blank control group,mature fibrous connective tissue was observed at the end of bone fracture.A slight amount of chondrocyte and bone callus formation was noted.At 2 and 4 weeks, the quantity of stained cells did not significantly differ between the experimental and control groups (P >0.05),whereas both considerably higher than that in the blank control group (both P <0.05).At 6 and 1 2 weeks,the number of stained cells in the experimental group was significantly higher compared with that in the control group (P <0.05).Conclusion The accordion technique is an efficacious treatment of non-infected nonunion by up-regulating the expression of VEGF.关键词
新西兰大白兔/伊利扎罗夫技术/外固定架/加压-牵开-再加压/张力-应力法则/骨折,不愈合Key words
New Zealand rabbit/Ilizarov technique/External fixator/Compression-distraction-compression/Tension-stress principle/Fracture,Nonunion引用本文复制引用
段建伟,魏俊强,张猛,闫石..外固定架加压-牵开-再加压治疗非感染性骨折不愈合实验研究[J].新医学,2016,47(5):318-323,6.基金项目
河北省医学科学研究课题 （）
