Local tissue properties in bone healing: Influence of size and stability of the osteotomy gap
Local tissue properties in bone healing: Influence of size and stability of the osteotomy gap
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DOI：
10.1002/jor.1100160413
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发表时间：
1998-07-01
影响因子：
2.8
通讯作者：
Claes, L
中科院分区：
文献类型：
--
作者：
Augat, P;Margevicius, K;Claes, L
为了表征骨折修复中的部位特异性力学和组织学特性，并将这些特性与初始力学情况联系起来，在42只绵羊的跖骨中使用了实验性骨折模型。横向截骨术的力学情况由三种间隙尺寸（1、2或6 mm）和两种应变量（7或31%）描述。允许限定轴向运动的外固定器提供了这些设置的控制。术后9周，解剖愈合区域，测量骨折间隙和骨膜骨痂分区的拉伸和压缩性能。中央矢状切片用于定量组织学。我们发现截骨线沿着组织的质量对于恢复机械稳定性是最重要的。增加截骨间隙的大小导致机械和组织学质量较差，修复过程不完全。片段间应变没有显着影响修复过程。较小的应变水平已经刺激了二级修复过程，并且这种刺激作用不能通过增加应变量来进一步增强。我们发现骨段之间的大间隙不如小间隙愈合得好，这表明在骨折治疗中避免大间隙是有利的。
To characterize the site-specific mechanical and histological properties in fracture repair and to relate these properties to the initial mechanical situation, an experimental fracture model was used in the metatarsus of 42 sheep. The mechanical situation of a transverse osteotomy was described by three gap sizes (1, 2, or 6 mm) and two amounts of strain (7 or 31%). An external fixator that allowed a defined axial movement provided control of these settings. Nine weeks following surgery, the healing area was dissected and tensile and compressive properties were measured in subregions of the fracture gap and the periosteal callus. The central, sagittal section was used for quantitative histology. We found the quality of the tissue along the osteotomy line to be most important for regaining mechanical stability. Increasing the size of osteotomy gaps resulted in poorer mechanical and histological qualities, and the repair process was less complete. Interfragmentary strain did not significantly influence the repair process. The smaller strain levels had already stimulated the secondary repair process, and this stimulatory effect could not be further enhanced by increasing the amount of strain. Our finding that large gaps between bone segments were not as well healed as were smaller gaps suggests that it is advantageous to avoid large gaps in fracture treatment.