可滑动钢板跨骺板固定骺板周围骨折对骺板生长发育影响的研究
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1.青岛市胶州中心医院;2.哈尔滨医科大学附属第一医院

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青岛市医药科研指导计划(2019-WJZD118)


An experimental study on the effect of sliding plate fixation of epiphyseal fracture on the growth and development of epiphyseal plate
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Affiliation:

1.Qingdao jiaozhou Central Hospital;2.Department of Joint Trauma,Jiaozhou Central Hospital of Qingdao;3.the First Affiliated Hospital of Harbin Medical University, Harbin

Fund Project:

Qingdao medical research guidance plan

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    摘要:

    摘要 目的 设计骺板周围骨折实验模型,观察可滑动钢板跨骺板固定骺板周围骨折对骺板生长发育的影响。 方法 制备幼年兔右侧股骨远端骺板上方3-5mm骨折模型,随机分4组,每组8只。应用同一规格、型号可滑动钢板跨骺板和骺板周围骨折线,双皮质螺钉固定。术后2,4,6,8周分别处死每组兔子。取出标本,测量股骨长度。然后将骺板矢状面作病理切片,测量骺板厚度及单位柱内肥大细胞形态学变化情况。左侧股骨远端骺板作为正常对照组。 结果 在可滑动钢板内固定2、4、6周后,取出钢板,主要观察指标与正常对照组对比,统计学上无显著差异。但可滑动钢板内固定8周以后,取出钢板,主要观察指标与对照组对比,统计学上存在显著差异。 结论 在可滑动钢板、螺钉不伤及骺板前提下,跨骺板内固定初期(6周内),随着骺板生长发育,可滑动孔产生滑动作用,未对骺板生长发育产生显著影响(P>0.05)。但随着时间推移(8周以后),骺板中肥大细胞增值、分裂,可滑动孔螺钉到达末端,限制骺板生长发育,对骺板发育产生影响。与正常对照组对比,存在显著差异(P<0.001)。

    Abstract:

    Abstract Methods:The model of 3-5mm fracture above the epiphyseal plate of the right distal femur of young rabbits was made and randomly divided into 4 groups, 8 in each group. The plates and screws of the same specification were used to fix the fracture. Rabbits in each group were killed at 2, 4, 6 and 8 weeks after operation. Take out the specimen and measure the length of femur. The thickness of epiphyseal plate and the morphological changes of mast cells were measured. The left epiphyseal plate of distal femur was used as the control group. RESULTS AND CONCLUSION:After 2、4、6 weeks of internal fixation with sliding plate, the experimental group took out the plate, and there was no significant difference in the observation indexes between the experimental group and the normal control group. However, after 8 weeks of internal fixation with sliding plate, the plate was taken out. There was statistically significant difference between the observation group and the control group. On the premise of no injury to the epiphyseal plate caused by the sliding plate and screw, the sliding hole produced sliding effect with the growth of epiphyseal plate at the initial stage of cross epiphyseal plate internal fixation (≤ 6weeks), but had no significant effect on the growth and development of epiphyseal plate(P>0.05). However, with the passage of time(≥8week), mast cells in epiphyseal plate increase in value and divide, and can reach the end of the sliding hole screw, which limits the growth and development of epiphyseal plate, and has an impact on the development of epiphyseal plate. Compared with the control group, there was significant difference(P<0.001). Key words:Sliding plate; Trans epiphyseal plate; Periepiphyseal fracture; Internal fixation; Epiphyseal plate thickness; Mast cell.

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  • 收稿日期:2020-01-30
  • 最后修改日期:2020-02-05
  • 录用日期:2020-03-16
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