Kirby B M, Wilson J W
Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison 53706.
J Orthop Res. 1991 Mar;9(2):174-9. doi: 10.1002/jor.1100090204.
Wire cerclage devices do not restrict cortical vascularity; however, bands, because they are flat and wide, have been implicated as the cause of fracture nonunion by disruption of cortical vascularity. This experiment evaluated the effect of cerclage bands on the cortical vascularity of bones that had not been fractured. Stainless-steel bands of four sizes (2.5, 5.0, 7.5, and 10.0 mm wide) and nylon bands of five sizes (2.5, 3.6, 4.8, 7.6, and 9.0 mm wide) were applied 1 cm apart to both femoral diaphyses of four mature dogs. In two additional dogs, 18-gauge cerclage wires were applied 5 mm apart on one femur and nylon bands were applied immediately adjacent to one another on the other femur to cover 3 cm of the length of each femoral diaphysis. These six dogs were euthanatized and perfused 7 days postoperatively and specimens were studied by microangiography and correlated histology. Two additional dogs were studied 4 and 15 weeks after application of nylon and metal bands. There was no evidence of complete cortical devascularization under any size or type of cerclage appliance at any time interval. Numerous examples of vessels traversing the cortex directly beneath all the cerclage appliances were observed. Cerclage devices, even when flat and wide, do not restrict cortical vascularity when applied to intact bones.
钢丝环扎装置不会限制皮质骨的血管供应；然而，由于束带扁平且宽，有人认为它会破坏皮质骨的血管供应，从而导致骨折不愈合。本实验评估了环扎束带对未骨折骨骼皮质骨血管供应的影响。将四种尺寸（宽2.5、5.0、7.5和10.0毫米）的不锈钢束带和五种尺寸（宽2.5、3.6、4.8、7.6和9.0毫米）的尼龙束带，以1厘米的间距分别应用于四只成年犬的双侧股骨干。在另外两只犬中，将18号钢丝环扎线以5毫米的间距应用于一侧股骨，将尼龙束带彼此紧邻地应用于另一侧股骨，以覆盖每侧股骨干3厘米的长度。这六只犬在术后7天实施安乐死并进行灌注，通过微血管造影和相关组织学对标本进行研究。在应用尼龙和金属束带后的4周和15周，对另外两只犬进行了研究。在任何时间间隔内，在任何尺寸或类型的环扎器械下，均未发现皮质骨完全缺血的证据。观察到许多血管直接穿过所有环扎器械下方皮质骨的例子。当应用于完整骨骼时，环扎器械即使扁平且宽，也不会限制皮质骨的血管供应。
