The Changes Of Bone-tendon Junction Applicated Distraction Technique By Minimally Invasive

Objective:To ascertain the effect of change traction stress on bone-tendon junction by utilizing llizarov distraction technique of minimally invasive, provide the theoretical basis for the clinical.Methods:PartⅠ:In the 18 experimental dogs were right rear ankle joints fitted with llizarov external fixator, use 1mm/d of the stretch speed, manufacture trauma induced ankle plantar flexion 20°, taken X-ray film confirmed after the maintenance of a fixed 3 weeks, and then the same speed (1mm/d), to correct deformities. Started after orthopedic 2,4 weeks, collecte bilateral bone-tendon junction specimens, by light microscopy, transmission electron microscopy of bone tendon junction of the histological changes.PartⅡ:clinical typical cases by the use of llizarov techniques with traditional Chinese medicine orally, from the whole of patients symptoms, signs, observation and other aspects of quality of life, to understand the effectiveness of this treatment.ResultsPartⅠ:1. Observed by Histological:2 weeks:Achilles tendon fibers are straighter, during which the cells structure are still complete, fibrocartilage zone cartilage cells increased, distal part of the zone calcification. PAS staining showed no calcification of fibrocartilage zone cartilage cells PAS-positive particles increased, calcified fibrocartilage zone of the cartilage cells not contain PAS positive granules. Tidemark to the fibrocartilage zone, show up and broaden of the curve.4 weeks: Achilles tendon fiber is more straight, during which the cells structure are still complete. Fibrocartilage zone is significantly thicker, especially the ventral surface, distal portion of its obvious calcification, while the proximal parts of expansion to the tendon area. PAS staining showed no calcification of fibrocartilage zone cartilage cells PAS-positive granules decreased at 2 weeks, calcified fibrocartilage zone of the cartilage cells contain PAS positive granules.Tidemark is riser and wider than befoe cartilage cells in bone and joint mild hyperplasia.2. Observed by transmission electron microscopy:2 weeks:Cartilage cells become flat, nuclear deviation, mainly euchromatin, multi cytoplasm,Golgi complex,rough endoplasmic reticulum,mitochondria increase, structure is still intact, and can see a small amount of lipid droplets. Collagen fibers are disorder, some faults, can see a small new collagen fibers appear.4 weeks:More cartilage cells are irregular, nuclear deviation, some margination of chromatin under the nuclear membrane, cell surface pseudopodia, cytoplasm and Golgi complex,rough endoplasmic reticulum,mitochondria and other organelles than before to reduce the number, and shows rough Endoplasmic reticulum and vacuolar degeneration of mitochondrial double-membrane structure is well.PartⅡ:confirmed the Ilizarov technique in correction with the Chinese Herbs relief after foot and ankle deformities and weakness, pain and discomfort of the tendon end of the curative aspects.Conclusions:1. Ilizarov distraction technique in minimally invasive moderate stretch stress, less fibrous cartilage after more than before, suggesting that we are in clinical use in the regulation of speed can slow down after the first, the method of combining speed.2. Ilizarov distraction in the minimally invasive technique under moderate stress stretch, increasing the fiber and the bone contact area, increasing the role of Achilles tendon moment arm, is a remodeling, is a compensatory response, is an adaptation of change.3. Ilizarov technique in the clinical application of Chinese Herbs with correction of ankle and foot deformity, its correction of deformity and relieve postoperative ankle weakness, pain and discomfort of the tendon end of the curative aspects.