Markel M D, Bogdanske J J
Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison 53706-1102.
Am J Vet Res. 1994 Jun;55(6):862-6.
The effect of 5 fracture fixation methods on bone mineral density (BMD) measurement of femurs, using dual-energy X-ray absorptiometry (DXA) was determined in a canine model. Six regions of interest were measured, including the entire femur, the diaphysis of the femur, and small regions centered over the middiaphysis of the bone (lateral middiaphyseal cortex, medial middiaphyseal cortex, middiaphyseal medullary canal, and total middiaphysis). Eight unpaired femurs were collected and scanned by use of DXA before (5 separate scans/femur) and after (5 separate scans/femur) fixation by use of 1 of 5 fixation methods. These fixation methods included: intramedullary (IM) nail; IM nail and cerclage wires; IM nail and external skeletal fixation; locked IM nail; and a dynamic compression plate (DCP). All implants were made of stainless steel. The IM nail fixation devices caused significant decreases in the DXA measurement of BMD in the small regions of interest, compared with femurs without fixation devices (mean decrease, 37.3%; P < 0.05). The locked nail caused similar, but larger, decreases in the DXA measurement of BMD, compared with the IM nail fixation methods (P < 0.05). Plate fixation caused a small, but significant (P < 0.05), decrease (2.8%) in the DXA measurement of BMD in the large regions of interest, but when all regions were averaged, it did not cause significant change in this measurement, compared with femurs without fixation devices.(ABSTRACT TRUNCATED AT 250 WORDS)
在犬类模型中,使用双能X线吸收法(DXA)测定了5种骨折固定方法对股骨骨密度(BMD)测量的影响。测量了6个感兴趣区域,包括整个股骨、股骨干以及以骨中干为中心的小区域(外侧中干皮质、内侧中干皮质、中干髓腔和整个中干)。收集了8根未配对的股骨,在使用5种固定方法之一进行固定之前(每根股骨进行5次单独扫描)和之后(每根股骨进行5次单独扫描),使用DXA进行扫描。这些固定方法包括:髓内(IM)钉;IM钉加环扎钢丝;IM钉加外骨骼固定;锁定IM钉;以及动力加压钢板(DCP)。所有植入物均由不锈钢制成。与未使用固定装置的股骨相比,IM钉固定装置导致感兴趣小区域的DXA测量的BMD显著降低(平均降低37.3%;P<0.05)。与IM钉固定方法相比,锁定钉导致DXA测量的BMD有类似但更大的降低(P<0.05)。钢板固定导致感兴趣大区域的DXA测量的BMD有小幅但显著(P<0.05)的降低(2.8%),但当对所有区域进行平均时,与未使用固定装置的股骨相比,该测量值没有显著变化。(摘要截断于250字)