| Objective: Although bones have strong healing ability, union of fracture process is still in trouble which at a percentage of 5 to 10. The result of it is that bones can not be connected. Therefore, nonunion is one of important and difficult problems in bone fracture today,as well as a main trouble for department of orthopaedics trauma.Marrow has the ability to formulate bone.Through many authors'research by experiment and initial application in clinic aslo fully confirmed the osteogenic potential of autologous bone marrow transplantation.In this experiment, we make madels of bone nonunion,then inject marrow liquors or peripheral blood into bone fracture places at different time in each groups. The aim is to get the differences of experiment side among each group and differences between experiment side and control side through the X-rayPhotographs,the bone densitometry and the histological observation; to discuss influences of different time interval of autologous bone marrow transplantation to healing of disconnected bones;to provide a reliable basis for clinical autologous bone marrow transplantation.Methods:Selecting 40 health New Zealand rabbits, ages: 4-6 weeks, weights:2.5-3.0kg. Under the aseptic condition,After the success of narcotic ,have a incision in the anteriomedialis of the forelimb,separate skin,anadesma,muscle,blood vessel and nerves gradually,exposes radial bone's midpiece thoroughly,separate interosseous membrane.Cut out a period of radial bone about 1.0cm.Wash the wound thoroughly with normal sodium, clear up bone cips, close the cavity of fractured bone with bone wax.Filled the coloboma with muscular tissue (0.5×0.8×1.5cm3) from tissues around the coloboma,and then,close the incision without any internal or external fixation. 2 months later madels were done. All of experimental animals be randomly divided into 2 groups:group A :20days interval;group B : 40days interval.Make every anmials'bone fracture side pultaceous with Xiao zhendao guiding by X-ray. In group A, respectively inject 2ml marrow into bone fracture place in the right(experiment side) at the 1thday,21thday,41thday;at the same time, inject 2ml peripheral blood in the left(control side). In group B, respectively inject 2ml marrow into bone fracture place in the right(experiment side) at the 1thday,41thday;at the same time, inject 2ml peripheral blood in the left(control side). Take out 4 rabbits stochastically in each groups separately at the 11thday,21thday,31thday,41thday,61thday. Through the X-ray Photographs,the bone densitometry and the histological observation,appraise the bone fracture cicatrization situation and the callus quality. Then process the information, carries on the statistical analysis, draws the conclusion. Results: 1 X-ray results1.1 X-ray results in the experiment side of the two groups at the different period.The performance of the two groups are almost the same at the 11thday: there are a little ground-glass-shaped bony callus in bone fracture place ,and shows girdle-shaped high-density umbra.The periosteal reaction and the cortical bone defect can be fonud. The performance of the two groups are also almost the same at the 21thday:the translucent callus appeared in the bone coloboma, it's density is uneven and lower than the normal bone.The 31thday:the continuous callus appeared,the density of group A is higher than the group B.The 41thday: bone coloboma in group A concrete well, cortical plate continuous exist. Low density cavitas medullaris formulate among new bones. The continuous callus appeared in group B,the density is a little lower than the normal bone. The 61thday: bone coloboma in group A concrete well, cortical plate continuous exist, cavitas medullaris in radial bone was recanalization. Bone coloboma in group B concrete well, cortical plate continuous exist. Low density cavitas medullaris could be found.1.2 The performance of the two groups at the same period are almost the same,and the performance at the different periods are similar.That is colobomas have no osseous conjunction ,a few sclero-bone can be seen in bone fracture side, cavitas medullaris blocked up.2 histology observation 2.1 The histology results in the experiment side of the two groups at the different period. The performance of the two groups are almost the same at the 11thday: lots of bone matrix cells are saw growing heavily among cicatricial tissue, a little of blood capillary accrementition also can be seen. The performance of the two groups are also almost the same at the 21thday: a large number of blood capillary exist, callus formation formulate in cartilage bone, hyperblastosis actively,there are many rough and newgrowth bone trabecula,being cord-like.Around it,there are many osteoblasts. The 31thday: in group A,there are much reticulate bone trabecula and early Havers' system growing ,which arranged chaoticly.In group B, fibrous tissue and bony callus exist together in experiment side.Discontinuous bony callus and early Havers' system's growing can be seen,but arranged chaoticly,fibrous tissue gradually replace the bone tissue. The 41thday: in group A woven bone matures further and mixs together gradually, and the new bone links into the pieces, and the bone trabecula's interval reduces, no cartilage,blood tumor and fibrous tissue, bone trabecula arranges irregularly, bone trabecula wider,not concentrated.In group B, there are much reticulate bone trabecula and Havers' system growing ,which arranged chaoticly, fibrous tissue more less than the 31thday. The 61thday: In group A, new bone has already rebuilt, lamellar bone can be seen, the cortical bone well-distributed and concentrated,have many new vessels. In group B, woven bone matured and mixs together gradually, and the new bone links into the pieces, and the bone trabecula's interval reduces,bone trabecula arranges irregularly, bone trabecula wider,not concentrated.2.2 Control side:in every period and every group have lots of fibrous tissue produced, no callus formation.3 Bone density and histology score of the two groups show a increasing trend,the group A is more obviously,show a gradually increasing trend.And the control side have no this trend. Results of comparison of experiment side and control side at all the periods of the two groups all have the statistical significance (P<0.05). Results of experiment side between the two groups at 31thday,41thday,61thday have the statistical significance (P<0.05).4 The increment of bone density and histology score of groupA at the different period early the 41thday show a low-high-low trend,and the main increment focus in the early 30 days,the peak appeared in the period of 10th-20thday.Conclusion:1 Autologous bone marrow transplantation can raise healing speed and quality after bone fracture,and is a reliable method to deal with disunion.2 In Autologous bone marrow transplantation, appropriate time intervals duplicate injection is more effective in promoting fracture healing.3 The osteogenesis after autologous bone marrow transplantation mainly embody in the early 30 days,and the peak appeared in the period of 10th-20thday.So,the fit time interval about bone marrow transplantation is 20 days-30 days. |
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