Orthopedic Centre, Oslo University Hospital, Ullevaal, Norway.
Scand J Surg. 2009;98(3):189-94. doi: 10.1177/145749690909800311.
Both fracture and fracture treatment affect bone mineral density (BMD). BMD after standard intramedullary reaming of the femoral cavity and after reaming with a reamer-irrigator-aspirator (RIA) system were studied with the hypothesis that the RIA technique would lead to lower BMD levels.
Dual-energy X-ray absorptiometry (DXA) was performed on the third day after operation with standard intramedullary nailing technique (n = 6) or RIA technique (n = 7) in intact femora of young Norwegian landrace pigs.
Significantly lower BMD were found in the mid-shaft and total femur after reaming with the RIA technique compared to the non-operated femur. Traditional reaming technique resulted in significantly higher BMD in the distal -femur.
The results of this study indicate that standard reaming increased BMD in the distal femur, suggesting compressive effects on trabecular bone. The RIA technique decreased BMD in the femoral diaphysis and total femur, suggesting removal of trabecular bone. A possible clinical impact of the findings remains to be investigated.
骨折和骨折治疗都会影响骨密度（BMD）。本研究旨在探讨标准髓内扩孔与扩孔冲洗吸引（reamer-irrigator-aspirator，RIA）系统后股骨腔的 BMD 变化，假设 RIA 技术会导致更低的 BMD 水平。
在完整的年轻挪威兰德瑞斯猪的股骨上，分别采用标准髓内钉技术（n=6）和 RIA 技术（n=7）进行手术，在术后第 3 天使用双能 X 射线吸收法（DXA）检测。
与未手术的股骨相比，RIA 扩孔后中段和整个股骨的 BMD 明显降低。传统扩孔技术使股骨远端的 BMD 显著增加。
本研究结果表明，标准扩孔增加了股骨远端的 BMD，提示对小梁骨产生了压缩效应。RIA 技术降低了股骨骨干和整个股骨的 BMD，提示去除了小梁骨。这些发现的可能临床影响仍有待研究。
