Barbieri Giuliano, Barbieri Cláudio Henrique
Medicine and Rehabilitation of the Locomotor Apparatus, Department of Biomechanics, Ribeirão Preto School of Medicine, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
Clinics (Sao Paulo). 2014 Sep;69(9):634-40. doi: 10.6061/clinics/2014(09)10.
To compare normal and delayed bone healing by measuring ultrasound conduction velocity across the bone callus.
A model of transverse linear and 5 mm resection osteotomies of sheep tibiae was used. Fourteen sheep were operated on and were divided into two groups of seven according to osteotomy type. The procedure was performed on the right tibiae and the intact left tibiae were used as controls. The transverse and axial ultrasound velocities were measured at 30-day intervals for 90 days, after which the animals were killed and both the right and left tibiae were resected for in vitro biomechanical analysis.
Both the transverse and axial ultrasound velocities progressively increased, but the increase was smaller for the delayed union that resulted from the resection osteotomy. The mechanical resistance was higher for the normally healed tibiae that resulted from a linear osteotomy; this result closely correlated with the ultrasound velocity results. Significant differences were found for the comparisons between the intact and operated tibiae in both groups and between the groups for both the transverse and axial ultrasound velocities, but the differences were greater for the latter.
We conclude that in vivo transverse and axial ultrasound velocities provide highly precise information about the healing state of both linear and resection diaphyseal osteotomies, but the axial ultrasound velocity most likely has greater discriminatory power. This method has the potential for clinical application in humans.
通过测量穿过骨痂的超声传导速度来比较正常和延迟的骨愈合情况。
采用绵羊胫骨横向线性截骨和5毫米切除截骨模型。对14只绵羊进行手术,根据截骨类型将其分为两组,每组7只。手术在右侧胫骨上进行,完整的左侧胫骨用作对照。在90天内每隔30天测量横向和轴向超声速度,之后处死动物,切除左右两侧胫骨进行体外生物力学分析。
横向和轴向超声速度均逐渐增加,但切除截骨导致的延迟愈合增加幅度较小。线性截骨导致的正常愈合胫骨的机械阻力较高;这一结果与超声速度结果密切相关。两组中完整胫骨与手术胫骨之间以及横向和轴向超声速度在两组之间的比较均发现显著差异,但后者差异更大。
我们得出结论,体内横向和轴向超声速度可提供有关线性和骨干切除截骨愈合状态的高度精确信息,但轴向超声速度最有可能具有更大的鉴别能力。该方法具有在人类临床应用的潜力。