Hansen-Leth C
Acta Orthop Scand. 1979 Feb;50(1):39-47. doi: 10.3109/17453677909024088.
The osseous healing process of the amputation stump was investigated in adult rabbits. Histological investigation showed that the medullary cavity was closed after 2-3 weeks, chiefly by endosteal callus. After closure of the cavity there was a gradual spongious change in the bone tip and simultaneously the cortex atrophied and the medullary cavity dilated. After amputation on the crus bone rebuilding dominated, whereas after amputation on the femur deterioration of bone was most noticeable. A combination of amputation and medullary plugging caused a change in the course of healing. The medullary cavity did not close until 7-10 weeks after operation and there was distinct periosteal callus formation. The microangiographic investigation showed a transient hypervascularization in the cortex 3-4 weeks after amputation; whereas after simultaneous plugging of the medullary cavity the hypervascularization continued for up to 7 weeks after operation. Following amputation proximally on the crus the arterial supply of the cortex came mainly from the periost, whereas the cortex after distal amputation was vascularized from the medullary cavity. This finding can be due to an interruption of the arterial supply from the nutrient artery associated with proximal amputation, whereas this artery remains intact with amputation distally on the crus.
在成年兔中研究了截肢残端的骨愈合过程。组织学研究表明，2至3周后髓腔闭合，主要是通过骨内膜骨痂。髓腔闭合后，骨端逐渐发生海绵状改变，同时皮质萎缩，髓腔扩张。小腿截肢后以骨重建为主，而股骨截肢后骨的退变最为明显。截肢与髓腔堵塞相结合导致愈合过程发生改变。术后7至10周髓腔才闭合，并有明显的骨膜骨痂形成。微血管造影研究显示，截肢后3至4周皮质出现短暂的血管过度增生；而同时堵塞髓腔后，血管过度增生在术后持续长达7周。小腿近端截肢后，皮质的动脉供应主要来自骨膜，而远端截肢后皮质则由髓腔供血。这一发现可能是由于近端截肢导致营养动脉的动脉供应中断，而小腿远端截肢时该动脉保持完整。
