Suzhou Medical College of Soochow University, Suzhou, China.
Teaching Hospital of the Medical College of Yangzhou University, Suzhou Ruihua Orthopedic Hospital, Yangzhou, China.
J Orthop Surg Res. 2022 Sep 5;17(1):408. doi: 10.1186/s13018-022-03302-2.
The occurrence of nonunion after tibial fracture surgery is mainly related to insufficient blood supply. Therefore, anatomical study of the internal and external tibial artery is very important, but there is no good method for displaying the intraosseous artery clearly and intuitively. This hinders the protection and reconstruction of it by surgeons, as well as the development of new instruments and techniques by researchers.
To develop a transparent specimen that could clearly display the intraosseous artery of the tibia.
In 10 isolated pig calves with popliteal vessels, the popliteal artery was exposed and a tube was placed. A casting agent was then injected at constant pressure, and the tissue around the blood vessel was preliminarily removed after solidification. The perivascular tissue and periosteum were further removed via alkali corrosion, and the tibia was fixed with an external fixator to protect the non-corrosive areas at both ends. Alternate acid corrosion and flushing were then applied until the intraosseous artery was completely exposed. The distribution and branches of intraosseous nutrient arteries were observed with the naked eye and via microscopy. Three-dimensional (3D) scanning and 3D printing filling techniques were used to make transparent tibia specimens with preservation of intraosseous arteries.
A cast specimen of the intraosseous artery of porcine tibia was successfully generated via epoxy resin perfusion combined with acid-alkali etching, and the intraosseous artery was clearly visible. The 3D printing and filling technique successfully produced a transparent tibia specimen with preservation of internal bone arteries, and accurately restored the external shape of the tibia. The foramen of the nutrient artery appeared near the middle upper third of the lateral edge of the tibia. After entering the tibia, the nutrient artery proceeded forward, medial, and downward for a certain distance, twisted and turned near the midpoint of the medullary cavity, and divided into the ascending and descending branches. After going in the opposite direction for a distance, the ascending trunk sent out 2-3 branches, and the descending trunk sent out 2-3 branches.
The cast specimen of pig intraosseous artery generated via the above-described perfusion corrosion method provides methodological guidance for the study of anatomical characteristics of the intraosseous artery, and a theoretical basis for the study of new methods of internal fixation and reconstruction of the blood supply of the lower tibia.
胫骨骨折手术后发生骨不连主要与血供不足有关。因此，对胫内外侧动脉进行解剖学研究非常重要，但目前尚无很好的方法能够清晰直观地显示骨内动脉。这阻碍了外科医生对其的保护和重建，也阻碍了研究人员对新的内固定器械和技术的开发。
制作一种能清晰显示胫骨骨内动脉的透明标本。
在 10 例带有人工血管的猪小腿标本中，显露并套入腘动脉，在恒压下注入铸型剂，待血管周围组织凝固后初步去除血管周围组织和骨膜。然后用碱液腐蚀进一步去除骨膜，并用外固定器固定胫骨以保护两端未腐蚀的部位。交替进行酸腐蚀和冲洗，直至骨内动脉完全显露。肉眼和显微镜下观察骨内营养动脉的分布和分支。应用 3D 扫描和 3D 打印填充技术，制作保留骨内动脉的透明胫骨标本。
成功制作了猪胫骨骨内动脉的环氧树脂灌注结合酸蚀铸型标本，可清晰显示骨内动脉。3D 打印填充技术成功制作了透明胫骨标本，保留了内部骨动脉，准确还原了胫骨的外部形态。营养动脉的骨孔位于胫骨外侧缘中上 1/3 附近。进入胫骨后，营养动脉向前、向内侧和向下走行一定距离，在骨髓腔中点附近扭曲转向，分为升支和降支。在反方向走行一定距离后，升支发出 2-3 个分支，降支发出 2-3 个分支。
该灌注腐蚀法制作的猪骨内动脉铸型标本为研究骨内动脉解剖学特征提供了方法学指导，为研究胫骨下段内固定和血供重建的新方法提供了理论依据。
