间歇性气动软组织压迫对动物模型骨折愈合的影响。

Effect of intermittent pneumatic soft-tissue compression on fracture-healing in an animal model.

作者信息

Park Sang-Hyun, Silva Mauricio

机构信息

The J. Vernon Luck Sr. M.D. Orthopaedic Research Center at Orthopaedic Hospital/University of California at Los Angeles, USA.

出版信息

J Bone Joint Surg Am. 2003 Aug;85(8):1446-53. doi: 10.2106/00004623-200308000-00004.

DOI:10.2106/00004623-200308000-00004

PMID:12925623

Abstract

BACKGROUND

The fracture-healing process is closely related to blood supply. Intermittent pneumatic compression of the surrounding soft tissue may alter blood flow and, therefore, modify the healing process. The object of the present study was to evaluate the effect of intermittent pneumatic compression on fracture-healing in an animal model.

METHODS

Unilateral, transverse, mid-tibial osteotomies with a 3-mm gap were performed in thirty rabbits. The osteotomy site was stabilized with a double-bar external fixator. The femoral vein was ligated to induce venous stasis. Beginning on the fourth postoperative day, fifteen rabbits were treated with intermittent pneumatic compression with use of four rubber balloons, two around the distal part of the calf and two around the midpart of the calf, for one hour daily for four weeks (the study group) and fifteen rabbits were not treated with intermittent pneumatic compression (the control group). Peripheral computerized tomographic examination was performed biweekly to measure callus area and mineral content at the fracture gap. At eight weeks, the rabbits were killed, and the biomechanical properties of the healing fractures were evaluated with a torsional test.

RESULTS

An increase in callus area and mineral content at the osteotomy gap was observed in the study group, compared with the values in the control group, starting four weeks after the index procedure. At six weeks, the rabbits treated with intermittent pneumatic compression exhibited, on the average, a 32.2% larger callus area (p = 0.035) and a 49.7% higher mineral content (p = 0.01) at the osteotomy site compared with the values in the control group. The torsional stiffness, maximum torque, angular displacement at maximum torque, and energy required to failure of specimens in the study group were an average of 27.0% (p = 0.05), 61.5% (p = 0.0001), 35.4% (p = 0.0003), and 110.8% (p = 0.0001) higher, respectively, than those in the control group at eight weeks.

CONCLUSIONS

Intermittent pneumatic compression enhanced callus mineralization and development and it improved the biomechanical properties of a healing osteotomy site in the rabbit tibia.

摘要

背景

骨折愈合过程与血液供应密切相关。对周围软组织进行间歇性气动压迫可能会改变血流，从而改变愈合过程。本研究的目的是评估间歇性气动压迫对动物模型骨折愈合的影响。

方法

对30只兔子进行单侧、横向、胫骨中段截骨，截骨间隙为3毫米。用双杆外固定器固定截骨部位。结扎股静脉以诱导静脉淤滞。术后第4天开始，15只兔子使用4个橡胶气球进行间歇性气动压迫，两个围绕小腿远端，两个围绕小腿中部，每天1小时，共4周（研究组），15只兔子不进行间歇性气动压迫（对照组）。每两周进行一次外周计算机断层扫描检查，以测量骨折间隙处的骨痂面积和矿物质含量。8周时，处死兔子，用扭转试验评估愈合骨折的生物力学性能。

结果

与对照组相比，研究组在索引手术后4周开始，截骨间隙处的骨痂面积和矿物质含量增加。6周时，与对照组相比，接受间歇性气动压迫治疗的兔子截骨部位的骨痂面积平均大32.2%（p = 0.035），矿物质含量高49.7%（p = 0.01）。研究组标本的扭转刚度、最大扭矩、最大扭矩时的角位移和破坏所需能量在8周时分别比对照组平均高27.0%（p = 0.05）、61.5%（p = 0.0001）、35.4%（p = 0.0003）和110.8%（p = 0.0001）。