Ayanoğlu Semih, Esenyel Cem Zeki, Adanır Oktay, Dedeoğlu Semih, İmren Yunus, Esen Tugçe
Okmeydanı Training and Research Hospital, Department of Orthopedics and Traumatology, İstanbul, Turkey.
Bağcılar Training and Research Hospital, Department of Orthopedics and Traumatology, İstanbul, Turkey.
Acta Orthop Traumatol Turc. 2015;49(3):319-25. doi: 10.3944/AOTT.2015.14.0231.
Bone fragment and graft stabilization are important during reconstructive surgery of cases with comminuted fractures and bone defects. We examined the effect of Hyalonect surgical mesh on the healing dynamics of metaphyseal bone defects created in rabbit tibiae.
Approximately 5-mm defects were created on the anterior aspect of the proximal tibial metaphysis of 80 male rabbits. The rabbits were randomly assigned to four groups: Group I, bone defects left alone (control group); Group II, bone defect covered with Hyalonect; Group III, bone defect filled with allograft; and Group IV, bone defect filled with allograft and covered with Hyalonect.
No significant histological differences were noted between Groups II and III or Groups III and IV at 3 and 6 weeks. At 3 weeks, Groups II, III, and IV had significantly better healing than Group I (p<0.05). In addition, Group IV showed significantly better healing than Group II at 3 and 6 weeks. At 6 weeks, only Group IV showed better healing than Group I (p<0.05). Radiologically, Groups II, III, and IV showed better healing than Group I at 3 and 6 weeks (p<0.05).
Hyalonect application and bone grafting significantly accelerated the healing process when used alone or together. Hyalonect application along with bone grafting resulted in better early radiological healing than bone grafting alone.
在粉碎性骨折和骨缺损病例的重建手术中,骨碎片和移植物的稳定至关重要。我们研究了透明质酸外科网片对兔胫骨干骺端骨缺损愈合动力学的影响。
在80只雄性兔的胫骨近端干骺端前方制造约5毫米的缺损。将兔随机分为四组:第一组,骨缺损不做处理(对照组);第二组,骨缺损用透明质酸覆盖;第三组,骨缺损填充同种异体骨;第四组,骨缺损填充同种异体骨并用透明质酸覆盖。
在3周和6周时,第二组和第三组之间或第三组和第四组之间未观察到明显的组织学差异。在3周时,第二组、第三组和第四组的愈合明显优于第一组(p<0.05)。此外,在3周和6周时,第四组的愈合明显优于第二组。在6周时,只有第四组的愈合优于第一组(p<0.05)。影像学上,在3周和6周时,第二组、第三组和第四组的愈合优于第一组(p<0.05)。
单独或联合使用透明质酸和骨移植可显著加速愈合过程。与单独骨移植相比,透明质酸联合骨移植在早期影像学上愈合更好。