上海口腔医学

上海口腔医学 ›› 2022, Vol. 31 ›› Issue (5): 497-500.doi: 10.19439/j.sjos.2022.05.009

• 论著 • 上一篇    下一篇

平行折叠的双层兔胫骨骨间愈合的实验研究

王晓林1, 苏明2, 李德龙2, 韩正学2   

  1. 1.首都医科大学附属北京世纪坛医院 口腔科,北京 100038;
    2.首都医科大学附属北京口腔医院 口腔颌面头颈肿瘤科,北京 100050
  • 收稿日期:2021-04-02 修回日期:2021-09-04 出版日期:2022-10-25 发布日期:2022-11-01
  • 通讯作者: 韩正学,E-mail:hanf1989@hotmail.com
  • 作者简介:王晓林（1987-）,男,硕士,住院医师,E-mail: wangxiaolin@bjsjth.cn

Experimental study of the gap ossification in the double-barrel technique in rabbit tibia

WANG Xiao-lin1, SU Ming2, LI De-long2, HAN Zheng-xue2   

  1. 1. Department of Stomatology, Beijing Shijitan Hospital, Capital Medical University. Beijing 100038;
    2. Department of Oromaxillofacial Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University. Beijing 100050, China
  • Received:2021-04-02 Revised:2021-09-04 Online:2022-10-25 Published:2022-11-01

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摘要： 目的: 建立管状骨平行折叠的实验动物模型,采用影像学、组织形态学等方法对平行折叠的2段胫骨之间的愈合情况进行评价。方法: 选择6只家兔,将其一侧胫骨自中间截断,将远端部分向近端折叠180°,并以微型钛板、钛钉固定,形成双层胫骨。术后即刻、3个月、6个月行X线检查,观察2段胫骨间隙的影像学变化,并测量2段胫骨的间隙宽度,采用SPSS 19.0软件包对数据进行统计学分析。术后3个月、6个月分别处死3只动物,观察2段胫骨间的组织学变化。结果: 术后3个月X线片显示,2段胫骨之间间隙缩小,与术后即刻相比,术后3个月靠近截骨断端处两胫骨之间间隙明显变小,差异有统计学意义（P<0.05）,而中间段两胫骨之间间隙宽度无显著变化（P=0.552）。术后6个月,X线片见2段胫骨远端接触区内骨质几乎完全消失,2段管状骨的骨髓腔融为一体。术后3个月,镜下见两骨块之间无明显分界,接触区内可见大量新生编织骨。术后6个月,可见接触区内骨质大部分吸收,接触区两侧有大量新生板层骨将2段管状骨连接为一个整体。结论: 平行折叠的2段胫骨在紧密贴合、坚固内固定条件下,接触区发生骨改建,2段骨融为一体,成为一根粗的管状骨。

关键词: 双层折叠技术, 骨间愈合, 胫骨, 兔

Abstract: PURPOSE: Double-barrel vascularized fibula graft is one of the most common surgical techniques to augment or maintain the height of the neo-mandible. The purpose of this study was to investigate whether the gap completely disappeared and gap ossification ultimately achieved between the double barrels. METHODS: Six rabbits were used in the study. Each animal's tibia was vertically osteotomized at its midpoint, folded onto each other and fixed by mini-titanium plate, thus an animal model of “double barrel” was established. Specimens were obtained at 3 months and 6 months postoperatively, then the gap ossification between the double barrels was evaluated by radiography and histomorphology. Measurements of the gap width between the two tibial struts on X-ray films were performed 3 months after the operation at three sites: distal, middle and proximal site. Measurements were compared with those obtained immediately after operation using SPSS 19.0 software package. RESULTS: Three months after operation, radiography demonstrated that the gap between the double barrels gradually became vague. Histological study showed that irregular new woven bone formed in the gap between the two struts. There was significant difference in mean gap width at the distal and proximal site (P<0.05), but there was no significant difference at the middle site(P=0.552). Radiological and histological study showed cortical bone resorption in the contact area and two thin tubular bones fused into a thicker one 6 months postoperatively. CONCLUSIONS: The double-barrel tibia fixed with titanium microplate can fuse into a large, unique, continuous bone barrel.

Key words: Double- barrel technique, Gap ossification, Tibia, Rabbit

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