缺血对腓骨近端骺板影响的实验研究
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摘要
目的探讨腓骨近端骨骺缺血对骺板影响。方法选择8周龄幼兔12只,随机分成3组,分别对幼兔小腿按照带骨骺腓骨移植时腓骨头切取方法细心分离双侧腓骨近端及血管。通过阻断髂总血管方法对腓骨近端骨骺血供分别阻断0、1和1.5小时。术后每周复查X线,观察并记录各幼兔腓骨头骨骺闭合时间。用统计学方法对各组腓骨骨骺闭合时间进行统计学比较分析。结果缺血0小时组骨骺闭合时间为8.25±0.71周,缺血1小时组骨骺闭合时间为8.13±0.99周,缺血1.5小时组骨骺闭合时间为8.13±0.99周。三组腓骨骨骺闭合时间无明显差异(P>0.05)。结论在带骨骺腓骨移植过程中骨骺缺血时间控制在一定时间范围内,骨骺短期的缺血不会导致骨骺早闭。
Objective To investigate the effect of ischemia on epiphyseal plate of proximal fibula.Methods Twelve young rabbits of 8 weeks old were randomly divided into 3 groups. The proximal blood vessels of the fibula were carefully exposed according to the cutting method of transplantation of fibula with epiphysis. The blood supply to the proximal epiphysis of the fibula was blocked by 0,1 and 1.5 hours by blocking the right common iliac vessels. X-ray examination was performed every week after operation to observe and record the time of epiphyseal closure of fibula. Statistical analysis was used to compare the closure time of fibula epiphysis in each group. Results the closure time of epiphysis in 0 hour ischemia group was 8.25±0.71 weeks,the closure time of epiphysis in 1 hour group was 8.13+0.99 weeks,and the closure time of epiphysis in 1.5 hour ischemia group was 8.13±0.99 weeks. There was no significant difference in the closure time between the three groups(P>0.05). Conclusion In the process of epiphyseal fibula transplantation,if the time of epiphyseal ischemia is controlled within a certain time,the short term epiphyseal ischemia would not lead to premature closure of epiphysis.
Objective To investigate the effect of ischemia on epiphyseal plate of proximal fibula.Methods Twelve young rabbits of 8 weeks old were randomly divided into 3 groups. The proximal blood vessels of the fibula were carefully exposed according to the cutting method of transplantation of fibula with epiphysis. The blood supply to the proximal epiphysis of the fibula was blocked by 0,1 and 1.5 hours by blocking the right common iliac vessels. X-ray examination was performed every week after operation to observe and record the time of epiphyseal closure of fibula. Statistical analysis was used to compare the closure time of fibula epiphysis in each group. Results the closure time of epiphysis in 0 hour ischemia group was 8.25±0.71 weeks,the closure time of epiphysis in 1 hour group was 8.13+0.99 weeks,and the closure time of epiphysis in 1.5 hour ischemia group was 8.13±0.99 weeks. There was no significant difference in the closure time between the three groups(P>0.05). Conclusion In the process of epiphyseal fibula transplantation,if the time of epiphyseal ischemia is controlled within a certain time,the short term epiphyseal ischemia would not lead to premature closure of epiphysis.
引文
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[14]陈振光,郑晓辉.带血管蒂腓骨上段骨瓣的解剖与临床[J].解剖与临床,2007,10,12(5):293-295.
[15]Herring CL,Hall RL,Goldner JL.Replacement of te lateral malleolus of the ankle joint with a reversed proximal fibular bone graft[J].Foot Ankle Int,1997,18(6):317-323.
[16]胡顺敬,杨建文,王接应.腓骨小头倒转移植再造外踝治疗腓骨下端动脉瘤骨囊肿一例报告[J].中华骨科杂志,2004,24(1):57.
[17]王树锋,吕占辉,王明山,等.带血供胖骨小头骨筋移植的解剖与临床研究[J].中华骨科杂志,2001,22(2):99-102.
[18]杨大威,徐玉东,周冬枫.骨搬移法对下肢缺血疾病疗效的基础研究[J].哈尔滨医科大学学报,2003,37(2):137-139.
[2]Donski PK,O'Brien BM.Free microvascular epiphyseal transplantation:an experimental study in dogs[J].Br J Plast Surg,1980,33(2):169-178.
[3]Aponte-Tinao L,Ayerza MA,et al.Survival,recurrence,and function after epiphyseal preservation and allograft reconstruction in osteosarcoma of the knee[J].Clin Orthop Relat Res,2015,473(5):1789-1796.
[4]Fodden DI.A study of wrist injuries in children:the incidence of various injuries and of premature closure of the distal radial growth plate[J].Arch Emerg Med,1992,9(1):9-13.
[5]Tsai TM,Ludwig L,Tonkin M.Vascularized fibular epiphyseal transfer.A clinical study[J].Clin Orthop Relat Res.1986,210:228-234.
[6]刘亚平,程国良,潘达德,等.带血管腓骨移植的远期疗效报告[J].中华骨科杂志,2001,21(1):22-26.
[7]杨运发,张光明,侯之启,等.带骨骺腓骨近段移植重建小儿尺骨远端骨骺2例[J].实用手外科杂志.2011,6,25(2):101-103.
[8]陈峥嵘,张光健,孙敬娟.腓骨移植治疗上肢侵袭性良性骨肿瘤和恶性骨肿瘤[J].中华骨科杂志,1994;10(4):214
[9]Blackley HR,Wunder JS,Davis AM,et al.Treatment of giantcell tumors of long bones with curettage and bone-grafting[J].J Bone Joint Surg(Am),1999;81(6):811.
[10]Innocenti M,De lcroix L,Romano GF.Epiphyseal transplant:harvesting technique of the proximal fibula based on the anterior tibial artery[J].Microsurgery,2005,25(4):284-292.
[11]Bae DS,Waters PM,Sampson CE.Use of free vascularized fibular graft for congenital ulnar pseudarthrosis:surgical decision making in the growing child[J].J Pediatr Orthop,2005,25(6):755-62.
[12]Ceruso M,Falcone C,Innocenti M.Skeletal reconstruction with a free vascularized fibula graft associated to bone allograft after resection of malignant bone tumor of limbs[J].Handchir Mikrochir Plast Chir,2001,33(4):277-82.
[13]卢美源,李晓光.用带血管的腓骨近段重建桡腕关节的临床研究[J].山东医科大学学报_医学版,1995,33(4):336-338.
[14]陈振光,郑晓辉.带血管蒂腓骨上段骨瓣的解剖与临床[J].解剖与临床,2007,10,12(5):293-295.
[15]Herring CL,Hall RL,Goldner JL.Replacement of te lateral malleolus of the ankle joint with a reversed proximal fibular bone graft[J].Foot Ankle Int,1997,18(6):317-323.
[16]胡顺敬,杨建文,王接应.腓骨小头倒转移植再造外踝治疗腓骨下端动脉瘤骨囊肿一例报告[J].中华骨科杂志,2004,24(1):57.
[17]王树锋,吕占辉,王明山,等.带血供胖骨小头骨筋移植的解剖与临床研究[J].中华骨科杂志,2001,22(2):99-102.
[18]杨大威,徐玉东,周冬枫.骨搬移法对下肢缺血疾病疗效的基础研究[J].哈尔滨医科大学学报,2003,37(2):137-139.
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