Qiu Xing, Cheng Liang-Liang, Wang Ben-Jie, Liu Bao-Yi, Yang Lei, Yu Mingyang, Gu Guishan, Zhao De-Wei
Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, Dalian, China.
Department of Orthopaedics, The First Hospital of Jilin University, Changchun, China.
Orthop Surg. 2018 Feb;10(1):69-74. doi: 10.1111/os.12364. Epub 2018 Feb 9.
The present study investigates the feasibility of micro perfusion of femoral head specimens from femoral neck fracture patients by the inferior retinacular arteries and performing intraosseous artery quantitative analysis of the femoral head. Twelve femoral neck fracture patients who had undergone conventional hip replacement surgery were included in this study. Femoral head specimen arteries were first dissected and exposed and then perfused by the inferior retinacular arteries and all the femoral heads underwent micro-CT scanning. After micro-CT scanning, a digital 3-D model was reconstructed to quantify the femoral head intraosseous arteries for comparison with a normal femoral head. The artery length density, artery volume density, and artery length/volume ratio were calculated separately and compared with normal femoral head parameters. Micro-CT scanning displayed the epiphyseal arterial network structure and their fine vascular branches in all 12 femoral neck fractures. Blood was supplied from the inferior retinacular artery to the epiphyseal arterial network then to all the fine blood vessels within the femoral head. No statistical differences were observed in femoral heads' intraosseous artery length densities or volume densities between the normal and femoral neck fracture specimens, while the artery length/volume ratio showed a statistical difference, and the ratio increased from 19 to 46. Micro perfusion of the femoral head by the inferior retinacular arteries is possible and can present the epiphyseal network and their fine arterial branches in pathologic conditions to provide a morphological basis for the study of femoral head disease.
本研究探讨经股骨颈骨折患者的下支持带动脉对股骨头标本进行微灌注以及对股骨头进行骨内动脉定量分析的可行性。本研究纳入了12例接受传统髋关节置换手术的股骨颈骨折患者。首先解剖并暴露股骨头标本动脉，然后经下支持带动脉进行灌注，所有股骨头均接受微计算机断层扫描（micro-CT扫描）。在微CT扫描后，重建数字三维模型以量化股骨头骨内动脉，以便与正常股骨头进行比较。分别计算动脉长度密度、动脉体积密度和动脉长度/体积比，并与正常股骨头参数进行比较。微CT扫描显示了所有12例股骨颈骨折中的骨骺动脉网络结构及其细小的血管分支。血液从下支持带动脉供应至骨骺动脉网络，然后供应至股骨头内的所有细小血管。正常标本与股骨颈骨折标本的股骨头骨内动脉长度密度或体积密度未见统计学差异，而动脉长度/体积比存在统计学差异，该比值从19增加至46。经下支持带动脉对股骨头进行微灌注是可行的，并且能够呈现病理状态下的骨骺网络及其细小动脉分支，为股骨头疾病的研究提供形态学依据。
