临床小儿外科杂志

目的建立幼兔桡骨不同尺寸骨缺损模型,确定幼兔桡骨临界性骨缺损长度。方法选取健康3月龄雄性新西兰兔20只(2.2～2.5 kg),采用左右侧配对设计的方法在双侧桡骨中段分别制作15 mm及20 mm桡骨骨缺损模型,按骨缺损长度分为A组(15 mm)及B组(20 mm),每组各20侧。分别于术后第1天,术后第4、8、12 周行 CT检查,应用CT-Hedberg评分评估骨愈合情况。于术后 12 周处死所有实验兔,取出尺桡骨标本,通过大体观察及HE染色组织学观察分析缺损区骨愈合情况。结果术后实验兔均存活,术后第12周大体观察: A组19例( 95%)桡骨断端有连续性骨痂生成,新生骨表面光滑,塑形良好; B组缺损断端髓腔封闭,缺损区由纤维组织填充。术后第12周CT图像可见A组皮质骨塑性完全,B组断端及缺损尺侧均有新骨生成,髓腔封闭。术后各时间点CT-Hedberg评分:A组(3.0±0.6,3.9±0.3,4.0±0.2)与B 组(1.6±0.5,2.7±0.6,2.9±0.6)间差异有统计学意义(P<0.05)。组织学结果:A 组缺损已修复完全,新生骨组织内可见血管再生,B组缺损区由纤维组织填充。结论在进行幼龄兔骨缺损研究时,可选择3月龄雄性新西兰兔桡骨干构建20 mm长骨缺损。

Objective To establish a radial defect model with different lengths and determine the optimal length of bone critical-size defects in juvenile rabbits. Methods Twenty healthy male New Zealand white rabbits aged 3 months(2.2～2.5 kg)were selected. And 15 mm and 20 mm radial bone defects were made randomly in bilateral radius respectively. Based upon defect length, radiuses were divided into group A(15 mm)and group B(20 mm)(n=20 each). At Day 1 and 4-week intervals postoperatively, computed tomography(CT)scans were performed. The healing of bone defect was evaluated with CT — Hedberg scores. The rabbits were sacrificed at 12 weeks postoperatively and forearms were harvested for gross observations and histological analysis of new bone formation. Results All rabbits survived after operation. Continuous bridged callus with a smooth surface were observed in 19(95%)in group A. However, both ends were closed in group B and defect area was filled with fibrous tissue. In group A, perfectly plastic cortical bone was observed on CT images at 12 weeks postoperatively. And small amount of callus was found at both ends and ulnar side of radius in group B with closed marrow cavity. CT — Hedberg score comparison showed a significant difference between groups A and B at each timepoint postoperatively(3.0±0.6, 3.9±0.3, 4.0±0.2 vs 1.6±0.5, 2.7±0.6, 2.9±0.6, P<0.05). Histological analysis showed that bone defect in group A had been repaired perfectly and neonatal revascularization was also present. In group B, the ends of defects were closed and defect area was filled with fibrous tissue. Conclusion A model of radial bone defect has been established in juvenile rabbits. And 20 mm is the most ideal length.

引言
1 材料与方法
2 结果
3 讨论

表1 术后不同时期CT-Hedberg评分表<br/>Table 1 Scores of CT-Hedberg postoperation

表1 术后不同时期CT-Hedberg评分表
Table 1 Scores of CT-Hedberg postoperation

图1 术后12周大体观察图。A:A组(15 mm缺损)标本断端有桥接骨痂生成,新生骨形态与正常桡骨基本一致(箭头标记); B:B组(20 mm缺损)标本断端及邻近尺骨侧仅有少量新骨生成,髓腔闭合(右侧箭头标记),中央缺损区为纤维软组织(左侧箭头标记); 图2A组术后各时间点CT观察结果。A:术后第1天断端平行整齐,切口周围软组织肿胀; B:术后第4周断端及邻近尺骨侧可见大量低密度新生骨痂生成; C:术后第8周断端低密度骨痂影较前减少,并有连续性皮质骨生成,但形态尚不规则; D:术后第12周皮质骨厚度增加,塑性完全,与正常桡骨形态基本一致,髓腔部分再通; 图3B组术后各时间点CT观察结果。A:术后第1天断端整齐,切口周围软组织肿胀; B:术后第4周断端及邻近尺骨侧有少量不规则新生骨痂生成,且密度不均匀,呈云絮状; C:术后第8周断端新生骨痂密度较前增高,部分断端髓腔开始闭合; D:术后第12周断端新生骨硬化,髓腔闭塞,缺损中央为软组织影,未修复; 图4术后第12周断端组织学染色结果,HE染色图片(×20)。A:A组(15 mm)可见缺损部位为较成熟的骨组织,骨板排列较为规则,箭头标记处为新生血管; B:B组(20mm)可见由断端向缺损中心生长的骨组织,靠近边缘处骨板排列杂乱,骨细胞较少,箭头标记处可见中央缺损区为纤维结缔组织
Fig.1 Gross observations at 12 weeks postoperation; Fig.2 CT sectional views of group A postoperation; Fig.3 CT sectional views of group B postoperation; Fig.4 Histological evaluations of defects at 12 weeks postoperation(HE staining×20)

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引言

1 材料与方法

2 结果

3 讨论

期刊信息

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引言

1 材料与方法

2 结 果

3 讨 论

期刊信息

2 结果

3 讨论