经皮尼古丁对兔模型骨折愈合的影响。

The effect of transdermal nicotine on fracture healing in a rabbit model.

机构信息

Department of Orthopedic Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.

出版信息

J Orthop Trauma. 2012 Dec;26(12):724-7. doi: 10.1097/BOT.0b013e318270466f.

DOI:10.1097/BOT.0b013e318270466f

PMID:22955337

Abstract

OBJECTIVE

Cigarette smoking inhibits fracture healing and places the patient at a higher risk of delayed union and nonunion. Nicotine has been implicated as the primary ingredient responsible for these effects. However, an analysis of current published investigations reveals conflicting data, with some evidence that nicotine alone does not significantly affect healing. We undertook an animal study of the effects of transdermal nicotine on fracture healing.

METHODS

Twenty-two adult male New Zealand white rabbits were randomly assigned to the nicotine group or the control group. A midshaft tibial osteotomy was performed on the left tibiae of all 22 rabbits. The nicotine rabbits were exposed using a 10.5-mg transdermal patch applied daily to the ear. Radiographs were obtained, and the area of fracture callus was assessed. Rabbits were euthanized at 21 days. Fractures were stressed to failure, and load/deformation curves were recorded.

RESULTS

The average area of callus formation was greater in the control group (

CONTROL

0.158 cm, Nicotine: 0.124 cm), but the difference was not statistically significant (P = 0.30). There was a significant difference between the 2 groups for mean normalized torque to failure (Nicotine: 36% of nonfractured side,

CONTROL

69% of nonfractured side, P = 0.028). The control group mean normalized stiffness was significantly greater than that for the nicotine rabbits (

CONTROL

87%, Nicotine: 43%, P = 0.036). There were 3 nonunions in the nicotine group (27%) compared with none in the control group (P = 0.062).

CONCLUSIONS

In a rabbit model of fracture healing, transdermal nicotine exposure resulted in decreased mechanical strength of healing fractures at 21 days and a higher rate of nonunion at 21 days compared with that of controls.

摘要

目的

吸烟会抑制骨折愈合，并使患者发生延迟愈合和不愈合的风险更高。尼古丁已被认为是造成这些影响的主要成分。然而，对当前已发表的研究的分析显示出相互矛盾的数据，有一些证据表明尼古丁本身并不会显著影响愈合。我们进行了一项关于透皮尼古丁对骨折愈合影响的动物研究。

方法

22 只成年雄性新西兰白兔被随机分配到尼古丁组或对照组。所有 22 只兔子的左侧胫骨中段均进行了胫骨切开术。尼古丁兔通过每天应用于耳上的 10.5 毫克透皮贴剂暴露。获取 X 线片，并评估骨折骨痂的面积。兔子在 21 天时安乐死。骨折处受到破坏直至失效，并记录负载/变形曲线。

结果

对照组的骨痂形成面积平均较大（对照组：0.158cm，尼古丁组：0.124cm），但差异无统计学意义（P=0.30）。2 组之间平均归一化失效扭矩有显著差异（尼古丁组：非骨折侧的 36%，对照组：非骨折侧的 69%，P=0.028）。对照组的归一化刚度平均值明显大于尼古丁兔（对照组：87%，尼古丁组：43%，P=0.036）。尼古丁组有 3 例（27%）发生骨折不愈合，而对照组无一例（P=0.062）。