Oktaş Birhan, Orhan Zafer, Erbil Barış, Değirmenci Erdem, Ustündağ Nil
Department of Orthopedics and Traumatology, Medical Faculty of Kırıkkale University, 71450 Yahşihan, Kırıkkale, Turkey.
Eklem Hastalik Cerrahisi. 2014;25(3):158-62. doi: 10.5606/ehc.2014.33.
The aim of this study is to compare the effect of extracorporeal shock wave therapy (ESWT) on fractures with intact periosteum and excised periosteum.
Thirty-seven Wistar albino rats were randomized into four groups. Osteotomy and intramedullary Kirschner wire fixation were performed on all right femurs under ketamin anesthesia. The first group (n=10) was identified as control group. In the second group (n=10), periosteum located at the osteotomy site was excised circumferentially during surgery. In the third group (n=9), periosteum was left intact and ESWT was applied. In the forth group (n=8), periosteums of all rats were excised and ESWT was applied. All fracture lines were evaluated radiographically each two weeks and histologically at the sixth week. Results were evaluated statistically.
In periosteum excised group which represents a model of open fractures with soft tissue defect, ESWT application had a significantly positive histologic effect on bone healing. However, radiological evaluation did not reveal any statistically significant difference between groups with intact and excised periosteums.
According to our findings, ESWT can be used to improve fracture healing and prevent pseudoarthrosis in the treatment of open fractures with accompanying soft tissue and periosteum damage. However, further clinical studies are required to include ESWT in routine practice.
本研究旨在比较体外冲击波疗法（ESWT）对骨膜完整和骨膜切除的骨折的影响。
37只Wistar白化大鼠随机分为四组。在氯胺酮麻醉下对所有右侧股骨进行截骨术并髓内克氏针固定。第一组（n = 10）为对照组。第二组（n = 10）在手术过程中环形切除截骨部位的骨膜。第三组（n = 9）骨膜保持完整并接受ESWT治疗。第四组（n = 8）切除所有大鼠的骨膜并接受ESWT治疗。每两周对所有骨折线进行X线评估，并在第六周进行组织学评估。对结果进行统计学分析。
在代表伴有软组织缺损的开放性骨折模型的骨膜切除组中，ESWT治疗对骨愈合具有显著的组织学积极作用。然而，影像学评估未显示骨膜完整组和骨膜切除组之间存在任何统计学上的显著差异。
根据我们的研究结果，在治疗伴有软组织和骨膜损伤的开放性骨折时，ESWT可用于促进骨折愈合并预防假关节形成。然而，需要进一步的临床研究将ESWT纳入常规治疗。
