Popkov Dmitrii A, Silanteva Tamara A, Gorbach Elena N, Mingazov Eduard R, Kononovich Natalia A, Popkov Arnold V
Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopaedics, 6, M. Ulyanova Street, Kurgan, Russia.
Open Access Maced J Med Sci. 2018 Nov 15;6(11):1972-1976. doi: 10.3889/oamjms.2018.342. eCollection 2018 Nov 25.
The use of intramedullary elastic nailing is a method of choice for prevention of complications in children with osteogenesis imperfecta. However, the morphology of the growing long bones in the conditions created was not investigated.
The purpose of our experiment was to study the impact of elastic intramedullary nailing on the histostructure of long bones in their physiological growth.
Six mongrel dogs underwent intramedullary elastic transphyseal nailing of the intact tibia with two titanium wires. Six months after nailing, a light-optical microscopic and histomorphometric study of the operated and contralateral tibiae was performed.
It was found that asymmetric lesion of the distal physis induces a decrease in the height of the distal epimetaphysis. Adaptive changes in the hyaline cartilage of both articular ends were revealed corresponding to the initial stage of chondropathy. Intramedullary nailing promotes an increase in the thickness of the compact bone and the volume of the trabecular bone.
Elastic transphyseal nailing of the intact tibia has a shaping effect which is expressed by an increase in the volume of spongy and compact bone, adaptive changes in the hyaline cartilage. Asymmetric damage to growth zones should be avoided to prevent deformities.
髓内弹性钉固定术是预防成骨不全患儿并发症的一种首选方法。然而，在该术式所营造的条件下，对生长中的长骨形态学尚未进行研究。
本实验旨在研究弹性髓内钉固定术对长骨生理生长过程中组织结构的影响。
选用6只杂种犬，用两根钛丝对其完整胫骨行髓内弹性经骨骺钉固定术。钉固定6个月后，对手术侧和对侧胫骨进行光学显微镜及组织形态计量学研究。
发现远端骨骺的不对称损伤导致远端干骺端高度降低。在两个关节端的透明软骨中均发现了与软骨病初期相对应的适应性变化。髓内钉固定促进了密质骨厚度增加和松质骨体积增大。
对完整胫骨行弹性经骨骺钉固定术具有塑形作用，表现为松质骨和密质骨体积增加，透明软骨出现适应性变化。应避免生长区的不对称损伤以防止畸形。
