中国组织工程研究 ›› 2023, Vol. 27 ›› Issue (9): 1422-1426.doi: 10.12307/2023.216

• 骨与关节生物力学 bone and joint biomechanics • 上一篇    下一篇

机械牵张应力对兔肢体截骨后动脉血管的影响

唐辉宇,侯  彪,夏晓丹,向  伟,谢松林   

  1. 南华大学附属南华医院手足外科,湖南省衡阳市   421001
  • 收稿日期:2021-12-13 接受日期:2022-02-24 出版日期:2023-03-28 发布日期:2022-07-01
  • 通讯作者: 谢松林,硕士,主任医师,南华大学附属南华医院手足外科,湖南省衡阳市 421001
  • 作者简介:唐辉宇,男,1992年生,湖南省衡阳市人,汉族,2020年南华大学毕业,硕士,医师,主要从事血管再生机制研究。
  • 基金资助:
    湖南省卫计委科研计划重点项目(A2017018);湖南省科技厅技术创新引导计划(2018SK51705);湖南省卫计委科研课题(B2017065),项目负责人皆为谢松林

Effect of mechanical tension stress on arterial vessels after limb osteotomy in rabbits

Tang Huiyu, Hou Biao, Xia Xiaodan, Xiang Wei, Xie Songlin   

  1. Department of Hand and Foot Surgery, Affiliated Nanhua Hospital, University of South China, Hengyang 421001, Hunan Province, China
  • Received:2021-12-13 Accepted:2022-02-24 Online:2023-03-28 Published:2022-07-01
  • Contact: Xie Songlin, Master, Chief physician, Department of Hand and Foot Surgery, Affiliated Nanhua Hospital, University of South China, Hengyang 421001, Hunan Province, China
  • About author:Tang Huiyu, Master, Physician, Department of Hand and Foot Surgery, Affiliated Nanhua Hospital, University of South China, Hengyang 421001, Hunan Province, China
  • Supported by:
    Key Project of Scientific Research Program of Hunan Provincial Health and Family Planning Commission, No. A2017018 (to XSL); Hunan Provincial Science and Technology Department Technology Innovation Guide Program, No. 2018SK51705 (to XSL); Scientific Research Project of Hunan Provincial Health and Family Planning Commission, No. B2017065 (to XSL)

摘要:

文题释义:
机械牵张应力:在骨断裂时,缓慢、稳定、单向的机械拉伸可缓慢牵开骨段,骨间隙可被新生骨取代,从而实现骨延长,多应用于临床肢体延长。
截骨:将胫骨平台到踝关节总长平均分为上、中、下3份;在胫骨上1/3和中1/3的交界处截断胫骨的上1/3。

背景:通过牵张应力进行肢体延长已成为治疗骨折乃至断肢患者的有效措施,但是机械牵张应力如何影响肢体动脉血管的潜在机制尚未阐明。
目的:探讨缓慢稳定单向的机械牵张应力对肢体动脉血管的影响。
方法:75只成年新西兰兔随机分成模型对照组(后肢截骨不延长)、实验组(后肢截骨并延长)及空白组(肢体不做任何处理),每组25只。实验组延长速度0.5 mm/次,2次/d,共延长10 d。各组于Ilizarov外固定术后第 8,10,12,16,19 天(即牵张成骨延长开始第3,5,7,11,14天)收集隐动脉血管标本,观察比较隐动脉血管长度;同时对患肢摄X射线片检查截骨情况;并通过苏木精-伊红染色观察动脉结构、炎性反应等。
结果与结论:①在血管长度方面:自 Ilizarov外固定支架牵拉第5天开始,相较于模型对照组,实验组的隐动脉长度均显著增加 (P < 0.01);②X射线片检查方面,截骨术后第16天(即延长结束后1 d)实验组截骨端延长约10 mm,间隙无骨痂生成;③苏木精-伊红染色显示,外固定术后第8,10,12,16,19天实验组动脉组织结构完整,未见血管内膜损伤,平滑肌细胞未见坏死,未见炎性细胞浸润;④上述结果表明,缓慢稳定单向的机械牵张应力在延长胫骨截骨端长度的同时,可延长肢体动脉,且保持动脉血管组织结构稳定,提示牵张应力促进肢体延长的潜在机制在于刺激动脉血管的生长。

https://orcid.org/0000-0002-5019-497X (唐辉宇)

中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程

关键词: 牵张应力, 肢体延长, 动脉血管, 兔, 截骨

Abstract: BACKGROUND: Limb lengthening by tensile stress has become an effective measure in the treatment of fracture and limb amputation, but the underlying mechanism of how mechanical tensile stress affects limb arteries and vessels has not been clarified.  
OBJECTIVE: To investigate the effect of slow steady unidirectional mechanical tension stress on limb artery.
METHODS:  Totally 75 adult New Zealand rabbits were randomly divided into model control group (the hind limb was amputated and not prolonged), experimental group (the hind limb was amputated and lengthened) and blank group (no limb treatment), with 25 rabbits in each group. The prolonged speed of the experimental group was 0.5 mm/time, twice a day, for 10 days. Saphenous artery specimens were collected at 8, 10, 12, 16, and 19 days (i.e., 3, 5, 7, 11, and 14 days from the start of distraction osteogenesis) after Ilizarov external fixation. The length of saphenous artery was observed and compared. At the same time, X-ray examination was conducted to detect the osteotomy of the affected limb. Arterial structure and inflammatory response were observed by hematoxylin-eosin staining.  
RESULTS AND CONCLUSION: (1) In terms of vascular length: Since the 5th day of Ilizarov external fixation stent pulling, the length of saphenous artery in the experimental group was significantly increased compared with the model control group (P < 0.01). (2) In terms of X-ray examination, at 16 days after osteotomy (i.e., 1 day after the extension ends), the end of osteotomy in the experimental group was extended by about 10 mm, and no callus was formed in the gap. (3) Hematoxylin-eosin staining showed that at 8, 10, 12, 16, and 19 days after external fixation, the arterial tissue structure of the experimental group was intact, without intima vascular injury, smooth muscle cell necrosis or inflammatory cell infiltration. (4) These results indicate that slow and steady unidirectional mechanical stretch stress can prolong the limb arteries and keep the arterial vascular structure stable while lengthening the length of tibial osteotomy end, suggesting that the potential mechanism of stretch stress promoting limb lengthening lies in the stimulation of arterial vascular growth.

Key words: stretch stress, limb lengthening, artery, rabbit, osteotomy

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