Seibold R, Schlegel U, Kessler S B, Cordey J, Perren S M, Schweiberer L
Chirurgische Klinik und Poliklinik, Klinikum Innenstadt, Ludwig-Maximilians-Universität München.
Unfallchirurg. 1995 Dec;98(12):620-6.
The healing process of spiral fractures of the sheep tibia was investigated in an experiment with simulated clinical conditions. The effects of conventional internal fixation techniques with the DCP and the intramedullary nail are compared with those of internal fixation with the spine fixator. The internal fixation techniques are described in terms of their bending stiffness when mounted on the fractured bone. The in vivo investigation was documented clinically and radiographically and the post mortem specimens were evaluated histologically. The bending stiffness of the healed bone was assessed in relation to the contralateral side. After application of the DCP, primary healing took place and extensive transcortical necrosis occurred in the implant bed. Intramedullary nailing led to secondary healing and to necrosis of the inner cortex close to the endosteum. After internal fixation with the spine fixator, gap healing took place and no cortical necrosis was observed. The clinical course was generally good after all procedures. The histological evaluation shows that damage to the vascularity of the bone can only be avoided by using the spine fixator. This principle seems to be appropriate for the purposes of biological internal fixation.
在模拟临床条件的实验中，对绵羊胫骨螺旋骨折的愈合过程进行了研究。将动力加压钢板（DCP）和髓内钉的传统内固定技术的效果与脊柱固定器内固定的效果进行了比较。根据内固定技术安装在骨折骨上时的弯曲刚度来描述这些技术。对活体研究进行了临床和放射学记录，并对死后标本进行了组织学评估。相对于对侧评估愈合骨的弯曲刚度。应用DCP后，实现了一期愈合，植入床出现广泛的皮质穿通性坏死。髓内钉固定导致二期愈合以及靠近骨内膜的内皮质坏死。使用脊柱固定器内固定后，出现间隙愈合，未观察到皮质坏死。所有手术操作后的临床过程总体良好。组织学评估表明，只有使用脊柱固定器才能避免对骨血管的损伤。这一原则似乎适用于生物内固定的目的。
