Nyman R, Magnusson M, Sennerby L, Nyman S, Lundgren D
Department of Radiology, University Hospital of Uppsala, Sweden.
Acta Orthop Scand. 1995 Apr;66(2):169-73. doi: 10.3109/17453679508995515.
We tested the principle of guided tissue regeneration (GTR) for healing segmental long-bone defects. 7 mm (3 animals) or 10 mm (5 animals) long segmental defects were created in the diaphyses of both radii in 8 rabbits. The defect on one side was covered with a barrier membrane of expanded polytetrafluoroethylene membrane shaped as a tube, while the contralateral side with no membrane served as the control. Healing was followed with radiographs obtained repeatedly during a 13- (n 3) or 27- (n 5) week period. Thereafter, the animals were killed and ground sections of the defect sites were prepared for histologic examination. Radiographically, the control sites showed some early subperiosteal callus formation and nonunion of the defects after 6 weeks. The bone ends were rounded off and sealed with cortical bone. No major changes were noted after 6 weeks. At the test sites, subperiosteal bone formation at the bone ends was first observed radiographically at 2 weeks. At 9 weeks, a thin cortical bone bridged the defect along the inner surface of the membrane. Histologically, an interrupted line of thin, cortical bone was observed along the inner surface of the barrier membrane. Fatty bone marrow occupied the central and largest volume of the defect. We conclude that it seems possible to use the principle of GTR to accomplish bone union of segmental long-bone defects.
我们测试了引导组织再生（GTR）原理用于修复节段性长骨缺损的效果。在8只兔子的双侧桡骨干中制造了7毫米（3只动物）或10毫米（5只动物）长的节段性缺损。一侧的缺损用管状的膨体聚四氟乙烯膜屏障覆盖，而对侧未覆盖膜作为对照。在13周（n = 3）或27周（n = 5）期间反复拍摄X线片以观察愈合情况。此后，处死动物并制备缺损部位的磨片用于组织学检查。X线片显示，6周后对照部位出现一些早期骨膜下骨痂形成且缺损未愈合。骨端变圆并被皮质骨封闭。6周后未观察到重大变化。在测试部位，2周时X线片首次观察到骨端的骨膜下骨形成。9周时，一层薄的皮质骨沿着膜的内表面桥接了缺损。组织学上，沿着屏障膜的内表面观察到一条中断的薄皮质骨线。脂肪骨髓占据了缺损的中央且最大体积。我们得出结论，似乎可以利用GTR原理实现节段性长骨缺损的骨愈合。
