Hwang K, Schmitt J M, Hollinger J O
Department of Plastic Surgery, Inha University Hospital, 7-206 Shinheung-dong, Choong-gu, Inchon, 400-103, Korea.
J Craniofac Surg. 2000 Mar;11(2):184-8. doi: 10.1097/00001665-200011020-00015.
This study demonstrates interfacial changes of titanium miniplate/screw with normal calvaria and nonvascularized calvarial bone graft ensued from craniectomy in a 53-year-old female. In 18 months after operation, a right parietal bone containing an L-shaped miniplate with screws, 5 mm long and 2 mm in external diameter, was harvested, fixed, and embedded in methylmetacrylate. Fifteen micrometer thick sections were made by an EXAKT cutting-grinding system (Exakt Company, Hamburg, Germany), and reviewed under the bright field light microscope. The mean of the bone-contacting surface ratio (BCSR) in six screwed bone was 64.1%; 69.3% in normal bone, and 60.4% in grafted bone. The trabecular bone areas in 10 x 5 mm (50 mm2) rectangular area of diploe surrounding the screws was 43.02 mm2; 45.25 mm2 in normal calvaria; and 41.82 mm2 in grafted bone. The mean Ca/P peak-height ratio of the plated and screwed calvaria was 1.47 in a 9 mm wide zone around each screw; 1.37 in normal calvaria; and 1.51 in grafted calvaria. We concede that the effect of direct contact of titanium with screws onto the bone is as much as an osseous integration (osseointegration).
本研究展示了一名53岁女性颅骨切除术后钛微型钢板/螺钉与正常颅骨及非血管化颅骨骨移植之间的界面变化。术后18个月，获取了一块包含L形微型钢板及螺钉（螺钉长5mm，外径2mm）的右顶骨，进行固定并嵌入甲基丙烯酸甲酯。使用EXAKT切割研磨系统（德国汉堡的Exakt公司）制作15微米厚的切片，并在明场光学显微镜下进行观察。六枚螺钉固定骨的骨接触表面比率（BCSR）平均值为64.1%；正常骨为69.3%，移植骨为60.4%。围绕螺钉的板障10×5mm（50mm²）矩形区域内的小梁骨面积为43.02mm²；正常颅骨为45.25mm²；移植骨为41.82mm²。在每个螺钉周围9mm宽的区域内，有钢板和螺钉固定的颅骨的平均钙/磷峰高比率为1.47；正常颅骨为1.37；移植颅骨为1.51。我们承认钛与螺钉直接接触对骨的影响等同于骨整合（骨结合）。
