Harry Lorraine E, Sandison Ann, Paleolog Ewa M, Hansen Ulrich, Pearse Michael F, Nanchahal Jagdeep
Kennedy Institute of Rheumatology Division, Faculty of Medicine, Imperial College, London, United Kingdom.
J Orthop Res. 2008 Sep;26(9):1238-44. doi: 10.1002/jor.20649.
The objective of this study was to compare the effects of soft tissue coverage by either muscle or fasciocutaneous tissue on the healing of open tibial fractures in a murine model. An open tibial fracture, stripped of periosteum with intramedullary fixation, was created in mice. Experimental groups were devised to allow exclusive comparison of either muscle alone or skin plus fascia in direct contact with healing bone. To exclusively assess the relative efficacy of muscle and fasciocutaneous tissue to promote healing of a fracture stripped of periosteum, a piece of sterile inert material (polytetrafluoroethylene) was positioned anteriorly, excluding skin and fascia (muscle group) or posteriorly, excluding muscle (fasciocutaneous group). Skeletal repair was assessed histologically and quantified by histomorphometry; quantitative peripheral computed tomography (pQCT) and mechanical testing using a four-point bending technique. This standardized, reproducible model allowed characterization of the morphology of open fracture healing. At 28 days postfracture, there was faster healing in the experimental muscle coverage group compared to skin and fascia alone. Furthermore, there was almost 50% more cortical bone content and a threefold stronger union beneath muscle compared to fasciocutaneous tissue (p < 0.05 by one-way ANOVA). Exclusive comparison of muscle and fasciocutaneous tissue in our novel murine model demonstrates that muscle is superior for the coverage of open tibial fractures for both the rate and quality of fracture healing.
本研究的目的是在小鼠模型中比较肌肉或筋膜皮组织进行软组织覆盖对开放性胫骨骨折愈合的影响。在小鼠身上制造开放性胫骨骨折，去除骨膜并进行髓内固定。设计实验组以单独比较肌肉或直接与愈合骨接触的皮肤加筋膜。为了专门评估肌肉和筋膜皮组织促进去除骨膜的骨折愈合的相对功效，将一块无菌惰性材料（聚四氟乙烯）放置在前侧，排除皮肤和筋膜（肌肉组）或后侧，排除肌肉（筋膜皮组）。通过组织学评估骨骼修复，并通过组织形态计量学进行量化；使用四点弯曲技术进行定量外周计算机断层扫描（pQCT）和力学测试。这种标准化、可重复的模型能够对开放性骨折愈合的形态进行表征。骨折后28天，与单独使用皮肤和筋膜相比，实验性肌肉覆盖组的愈合更快。此外，与筋膜皮组织相比，肌肉下方的皮质骨含量几乎多50%，骨愈合强度高三倍（单因素方差分析，p<0.05）。在我们新的小鼠模型中对肌肉和筋膜皮组织进行单独比较表明，对于开放性胫骨骨折的覆盖，无论是骨折愈合的速度还是质量，肌肉都更具优势。
