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截骨术中产生的热量对骨愈合的影响相关问题(作者译)

[Problems concerning bone union influenced by heat generated in osteotomy (author's transl)].

作者信息

Ohtaki E

出版信息

Nihon Seikeigeka Gakkai Zasshi. 1979 Dec;53(12):1839-55.

PMID:544718
Abstract

The author experimentally investigated in rabbits how the heat generated by bone saws affected bone union in osteotomy. Radiographic and soft X-ray findings revealed that recovery of the lesion in every bone shaft after osteotomy was marked in all. However, the time required to obtain complete recovery of the lesion differed depending on the instruments used. That is to say, it required 3 weeks after surgery by means of Gigli's saw, 4 weeks by means of Stryker bone saw and lower speed bur (2,000 rpm) and 6 weeks by means of higher speed bur (18,000 rpm). Recovery of lesion by bone cut with each bone saw on the unscalded side was one or two weeks earlier than that in the scalded side. This was also proved on histopathological findings. With regard to the disappearance of osteocytes in the bone cortex at the cut surfaces of bones, micrometric findings revealed that there was a great difference between the scalded and the unscalded side in every group except in the group where a Gigli's saw was used. However, almost no difference was observed on the unscalded side among every bone saw. According to scanning electron microscopic findings at every surface cut with various bone saws, collagen fiber was preserved on the unscalded side where physiological saline solution was sprayed. Particularly, the collagen fiber appeared to be torn off in the case of lower speed bur (2,000 rpm), the cut surface was well uniform in the case of higher speed bur (18,000 rpm). Thus, I have learnt that we do not need to give much attention to the kind of instrument, if effort using physiological saline solution, are made to avoid the heat generated by bone saws when osteotomy is done.

摘要

作者在兔子身上进行了实验研究,观察骨锯产生的热量如何影响截骨术中的骨愈合。X线和软X线检查结果显示,所有兔子截骨术后每个骨干的损伤恢复情况均很明显。然而,损伤完全恢复所需的时间因使用的器械而异。也就是说,使用吉利锯手术后需要3周,使用史赛克骨锯和低速牙钻(2000转/分钟)需要4周,使用高速牙钻(18000转/分钟)需要6周。在未烫伤侧,每种骨锯截骨后的损伤恢复比烫伤侧早一到两周。这在组织病理学检查结果中也得到了证实。关于骨皮质在骨切割面处骨细胞的消失情况,微观测量结果显示,除了使用吉利锯的组外,每组烫伤侧和未烫伤侧之间存在很大差异。然而,在未烫伤侧,各种骨锯之间几乎没有差异。根据用各种骨锯切割的每个表面的扫描电子显微镜检查结果,在喷洒生理盐水的未烫伤侧,胶原纤维得以保留。特别是,在低速牙钻(2000转/分钟)的情况下,胶原纤维似乎被撕裂,在高速牙钻(18000转/分钟)的情况下,切割面非常均匀。因此,我了解到,在进行截骨术时,如果努力使用生理盐水以避免骨锯产生的热量,我们无需过多关注器械的种类。

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