Farouk O, Krettek C, Miclau T, Schandelmaier P, Guy P, Tscherne H
Trauma Department, Hanover Medical School, Germany.
Injury. 1997;28 Suppl 1:A7-12. doi: 10.1016/s0020-1383(97)90110-8.
A cadaver arterial injection study was performed to analyse the vascular supply to the femur and to study the effects of two surgical plating techniques on femoral vascularity. A 16-hole LC-DCP was applied on the intact femora of five fresh human cadavers. On one side, the plate was inserted using a conventional lateral plate osteosynthesis (CLPO) technique with elevation of the vastus lateralis muscle to expose the shaft. On the contralateral side, the plate was inserted percutaneously beneath the muscle using a minimally invasive plate osteosynthesis (MIPO) technique. After plating, blue silicone dye was injected through the common femoral artery. Cadaveric dissection was then performed to identify the femoral perforating arteries (PAs) and the nutrient artery (NA) of the femur. The pattern of periosteal filling and medullary perfusion of the injected dye was analysed and the topography of the PAs and NA was determined. CLPO placed the PAs and NA of the femur at risk. MIPO maintained the integrity of the PAs and NA and was associated with superior periosteal and medullary perfusion. The results of this study indicate that MIPO is superior to the CLPO in maintaining arterial femoral vascularity and perfusion.
进行了一项尸体动脉注射研究，以分析股骨的血管供应，并研究两种手术钢板固定技术对股骨血管的影响。将一块16孔LC-DCP应用于五具新鲜人类尸体的完整股骨上。在一侧，采用传统外侧钢板接骨术（CLPO）技术插入钢板，掀起股外侧肌以暴露股骨干。在对侧，采用微创钢板接骨术（MIPO）技术经皮在肌肉下方插入钢板。钢板固定后，通过股总动脉注入蓝色硅酮染料。然后进行尸体解剖，以识别股骨穿动脉（PAs）和滋养动脉（NA）。分析注入染料的骨膜填充和骨髓灌注模式，并确定PAs和NA的局部解剖位置。CLPO使股骨的PAs和NA面临风险。MIPO维持了PAs和NA的完整性，并与更好的骨膜和骨髓灌注相关。本研究结果表明，在维持股动脉血管和灌注方面，MIPO优于CLPO。
