Mayr E, Laule A, Suger G, Rüter A, Claes L
Klinik für Unfall-und Wiederherstellungschirurgie, Augsburg, Germany.
J Orthop Trauma. 2001 Aug;15(6):407-14. doi: 10.1097/00005131-200108000-00005.
To determine whether pulsed low-intensity ultrasound (frequency of 1.5 megahertz, pulsed by one kilohertz, signal burst width of 200 microseconds, intensity of thirty milliwatts per square centimeter, and daily treatment time of twenty minutes per day) stimulates regenerate maturation after callus distraction.
Prospective, controlled animal trial.
Operatively, we created a fifteen-millimeter defect in the right metatarsus of eighteen female mature merino sheep. A segmental transport was begun on Day 5 using a high-stiffness experimental ring fixator. The distraction rate was one millimeter per day divided into two increments of 0.5 millimeters each. On Day 21 after the operation, distraction was finished and the maturation period started and lasted until Day 84 after operation. During this period, Group 1 was treated with a daily twenty-minute low-intensity ultrasound stimulation (frequency of 1.5 megahertz, pulsed by one kilohertz, signal burst width of 200 microseconds, intensity of thirty milliwatts per square centimeter). Group 2 had no stimulation. Animals bore full weight. Plain radiographs in the anteroposterior view were taken every two weeks during the maturation period. After the animals were killed on Day 84, anteroposterior and lateral high resolution radiographs and computed tomography (CT) scans of the regenerate were performed. For each plain and high resolution radiograph, two different relationships (callus relation, the ratio of the amount of periosteal callus to the size of the space between the proximal fragment and transported segment; and interzone relation, the ratio of the fibrous callus interzone to the size of the new formed callus) were calculated. Using CT scan, callus area, bone density, and bone mineral content were evaluated.
The results of interzone relation (both views) and callus relation (lateral view) in high-resolution radiographs and bone mineral content in CT indicate a significantly accelerated maturation of the regenerate in the ultrasound stimulated group even when a Bonferroni-Holm adjustment was used for multiple testing.
Pulsed low-intensity ultrasound appears to stimulate the healing processes in the regenerate in this animal model and may have applicability in clinical practice.
确定脉冲低强度超声（频率为1.5兆赫兹，由1千赫兹脉冲，信号突发宽度为200微秒，强度为每平方厘米30毫瓦，每日治疗时间为20分钟）是否能刺激骨痂牵张后再生组织的成熟。
前瞻性对照动物试验。
通过手术在18只成年雌性美利奴绵羊的右跖骨上制造一个15毫米的缺损。在第5天使用高刚度实验性环形固定器开始节段性骨搬运。牵张速率为每天1毫米，分为两个0.5毫米的增量。术后第21天，牵张结束，成熟期开始并持续至术后第84天。在此期间，第1组每天接受20分钟的低强度超声刺激（频率为1.5兆赫兹，由1千赫兹脉冲，信号突发宽度为200微秒，强度为每平方厘米30毫瓦）。第2组不接受刺激。动物负重行走。在成熟期每两周拍摄一次前后位平片。在第84天处死动物后，对再生组织进行前后位和侧位高分辨率X线片及计算机断层扫描（CT）。对于每张平片和高分辨率X线片，计算两种不同的关系（骨痂关系，即骨膜骨痂量与近端骨折块和搬运节段之间间隙大小的比值；以及中间区关系，即纤维性骨痂中间区与新形成骨痂大小的比值）。使用CT扫描评估骨痂面积、骨密度和骨矿物质含量。
高分辨率X线片的中间区关系（两个视图）和骨痂关系（侧视图）以及CT中的骨矿物质含量结果表明，即使在使用Bonferroni-Holm校正进行多重检验时，超声刺激组的再生组织成熟也明显加速。
在该动物模型中，脉冲低强度超声似乎能刺激再生组织的愈合过程，可能在临床实践中具有适用性。
