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废用性骨质疏松性骨骨折愈合的分析:实验研究

Analysis of fracture healing in osteopenic bone caused by disuse: experimental study.

作者信息

Paiva A G, Yanagihara G R, Macedo A P, Ramos J, Issa J P M, Shimano A C

机构信息

Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.

Departamento de Morfologia, Fisiologia e Patologia Básica, Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.

出版信息

Braz J Med Biol Res. 2016 Mar;49(3). doi: 10.1590/1414-431X20155076. Epub 2016 Feb 2.

Abstract

Osteoporosis has become a serious global public health issue. Hence, osteoporotic fracture healing has been investigated in several previous studies because there is still controversy over the effect osteoporosis has on the healing process. The current study aimed to analyze two different periods of bone healing in normal and osteopenic rats. Sixty, 7-week-old female Wistar rats were randomly divided into four groups: unrestricted and immobilized for 2 weeks after osteotomy (OU2), suspended and immobilized for 2 weeks after osteotomy (OS2), unrestricted and immobilized for 6 weeks after osteotomy (OU6), and suspended and immobilized for 6 weeks after osteotomy (OS6). Osteotomy was performed in the middle third of the right tibia 21 days after tail suspension, when the osteopenic condition was already set. The fractured limb was then immobilized by orthosis. Tibias were collected 2 and 6 weeks after osteotomy, and were analyzed by bone densitometry, mechanical testing, and histomorphometry. Bone mineral density values from bony calluses were significantly lower in the 2-week post-osteotomy groups compared with the 6-week post-osteotomy groups (multivariate general linear model analysis, P<0.000). Similarly, the mechanical properties showed that animals had stronger bones 6 weeks after osteotomy compared with 2 weeks after osteotomy (multivariate general linear model analysis, P<0.000). Histomorphometry indicated gradual bone healing. Results showed that osteopenia did not influence the bone healing process, and that time was an independent determinant factor regardless of whether the fracture was osteopenic. This suggests that the body is able to compensate for the negative effects of suspension.

摘要

骨质疏松症已成为一个严重的全球公共卫生问题。因此,先前已有多项研究对骨质疏松性骨折的愈合进行了调查,因为对于骨质疏松对愈合过程的影响仍存在争议。当前的研究旨在分析正常大鼠和骨质减少大鼠在两个不同时期的骨愈合情况。60只7周龄雌性Wistar大鼠被随机分为四组:截骨术后 unrestricted 并固定2周(OU2)、截骨术后 suspended 并固定2周(OS2)、截骨术后 unrestricted 并固定6周(OU6)、截骨术后 suspended 并固定6周(OS6)。在尾部悬吊21天后,当骨质减少状况已经形成时,在右胫骨的中三分之一处进行截骨术。然后通过矫形器固定骨折肢体。在截骨术后2周和6周收集胫骨,并通过骨密度测定、力学测试和组织形态计量学进行分析。与截骨术后6周的组相比,截骨术后2周组骨痂的骨矿物质密度值显著更低(多变量一般线性模型分析,P<0.000)。同样,力学性能表明,与截骨术后2周相比,动物在截骨术后6周时骨骼更强壮(多变量一般线性模型分析,P<0.000)。组织形态计量学表明骨愈合是渐进的。结果表明,骨质减少并不影响骨愈合过程,并且时间是一个独立的决定因素,无论骨折是否为骨质疏松性骨折。这表明身体能够补偿悬吊的负面影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0bec/4763822/94328a04165c/1414-431X-bjmbr-1414-431X20155076-gf001.jpg

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