Boelitz R, Dallek M, Meenen N M, Jungbluth K H
Abteilung für Unfall- und Wiederherstellungschirurgie, Universitätskrankenhaus Hamburg-Eppendorf.
Unfallchirurgie. 1994 Jun;20(3):131-7. doi: 10.1007/BF02588157.
In young rabbits of five to six weeks of age we revealed bony bridging as constant reaction of the epiphyseal cartilage on drilling with a 2 mm diameter trephine into the distal femur growth plate. Gross growth disturbances will be the consequence of such partial closures. For this present study we inserted one 2 mm Kirschner-wire across the epiphyseal plate of the distal femur. The drilling was directed distally. During longitudinal growth the epiphysis moves away from the wire, that remains 8 weeks after the operation completely within the metaphyseal cancellous bone. Four, 8, 12 and 16 weeks postoperatively one group of the rabbits were sacrificed. After radiological examination of the explanted femurs fixation and embedding in methylmetacrylate for morphological examination was performed. Our histological results reveal, that the crossing Kirschner-wire does not irritate the growth plate, even the physiological structure of the epiphyseal cartilage in the direct contact to the metal implant is not altered. The defect within the epiphyseal plate left after the relative retraction of the wire caused by growth activity fills with cancellous bone. Its trabecular structure is markedly thinner than the spongy bone within the metaphysis and shows longitudinal orientation. These trabeculae undergo segmental disruption by the growth pressure of the surrounding epiphyseal plate. In consequence there is no bone bridging and growth alterations by the Kirschner-wire crossing of the epiphyseal plate. This proves experimentally the clinical experienced therapeutic value of Kirschner-wires for internal fixation of dislocated joint injuries.
在5至6周龄的幼兔中，我们发现，用直径2毫米的环钻钻入股骨远端生长板时，骨骺软骨会持续出现骨桥接反应。这种部分闭合会导致明显的生长障碍。在本研究中，我们将一根2毫米的克氏针穿过股骨远端的骨骺板。钻孔方向为远端。在纵向生长过程中，骨骺远离克氏针，术后8周克氏针仍完全位于干骺端松质骨内。术后4周、8周、12周和16周分别处死一组兔子。对取出的股骨进行放射学检查后，固定并嵌入甲基丙烯酸甲酯进行形态学检查。我们的组织学结果显示，穿过的克氏针不会刺激生长板，即使与金属植入物直接接触的骨骺软骨的生理结构也未改变。由于生长活动导致克氏针相对回缩后，骨骺板内留下的缺损会被松质骨填充。其小梁结构明显比干骺端的海绵骨薄，并呈纵向排列。这些小梁会因周围骨骺板的生长压力而发生节段性破坏。因此，克氏针穿过骨骺板不会导致骨桥接和生长改变。这通过实验证明了克氏针在脱位关节损伤内固定方面的临床治疗价值。
