Kazezian Zepur, Yu Xiancheng, Ramette Martin, Macdonald Warren, Bull Anthony M J
Centre for Blast Injury Studies, Imperial College London, London, UK.
Department of Bioengineering, Imperial College London, London, UK.
Bone Joint Res. 2021 Mar;10(3):166-172. doi: 10.1302/2046-3758.103.BJR-2020-0367.R1.
In recent conflicts, most injuries to the limbs are due to blasts resulting in a large number of lower limb amputations. These lead to heterotopic ossification (HO), phantom limb pain (PLP), and functional deficit. The mechanism of blast loading produces a combined fracture and amputation. Therefore, to study these conditions, in vivo models that replicate this combined effect are required. The aim of this study is to develop a preclinical model of blast-induced lower limb amputation.
Cadaveric Sprague-Dawley rats' left hindlimbs were exposed to blast waves of 7 to 13 bar burst pressures and 7.76 ms to 12.68 ms positive duration using a shock tube. Radiographs and dissection were used to identify the injuries.
Higher burst pressures of 13 and 12 bar caused multiple fractures at the hip, and the right and left limbs. Lowering the pressure to 10 bar eliminated hip fractures; however, the remaining fractures were not isolated to the left limb. Further reducing the pressure to 9 bar resulted in the desired isolated fracture of the left tibia with a dramatic reduction in the fractures to other sites.
In this paper, a rodent blast injury model has been developed in the hindlimb of cadaveric rats that combines the blast and fracture in one insult, necessitating amputation. Experimental setup with 9 bar burst pressure and 9.13 ms positive duration created a fracture at the tibia with total reduction in non-targeted fractures, rendering 9 bar burst pressure suitable for translation to a survivable model to investigate blast injury-associated diseases. Cite this article: 2021;10(3):166-172.
在近期冲突中,大多数肢体损伤是由爆炸所致,导致大量下肢截肢。这些截肢会引发异位骨化(HO)、幻肢痛(PLP)和功能缺陷。爆炸载荷机制会造成骨折与截肢并存。因此,为研究这些情况,需要能复制这种综合效应的体内模型。本研究的目的是建立爆炸致下肢截肢的临床前模型。
使用激波管,将尸体斯普拉格-道利大鼠的左后肢暴露于爆压为7至13巴、正相持续时间为7.76毫秒至12.68毫秒的爆炸波中。通过X光片和解剖来确定损伤情况。
13巴和12巴的较高爆压导致髋部、右肢和左肢多处骨折。将压力降至10巴可消除髋部骨折;然而,其余骨折并非仅局限于左肢。进一步将压力降至9巴,导致左胫骨出现预期中的孤立骨折,其他部位的骨折显著减少。
本文在尸体大鼠后肢建立了一种啮齿动物爆炸伤模型,该模型将爆炸和骨折合并于一次损伤中,从而需要进行截肢。爆压9巴、正相持续时间9.13毫秒的实验设置在胫骨处造成骨折,同时非靶向骨折总数减少,这使得9巴爆压适合转化为可存活模型,用于研究爆炸伤相关疾病。引用本文:2021;10(3):166 - 172。