Experimental And Clinical Study Of Restoring And Reconstructing Limb Bone Defect Using Autogenous Iliac Graft With Platelet-rich Fibrin

Objective By establishing the animal model of bone defect,the results of bone reconstruction was observed when platelet-rich fibrin was applied to the radial bone defect area,exploring the bone regeneration mechanisms initiated by PRF and providing experimental reference for the clinical treatment of alveolar cleft.Methods Firstly,preparation of the PRF;secondly,30 healthy white rabbits that are 3 months old regardless of sex and the average weight is between 2.5-2.8Kg are selected for the experiment.These rabbits were randomly grouped into two groups after 1.8cm bone defect models were made at both radial upper middle section.The experimental group: Intraoperatively filling in bone defect with the mixture of the PRF gel and autogenous iliac mass;The control group: Filling only autogenous iliac in bone defect on operation.3.Animals were executed at 2,4,8 weeks after operation.And animal’s bone defect area was observed through general observation,X-ray plain film and histology observation.Each group of animals is scored of bone repair and recorded of the bone defect shot density value,reference to Lane’s radiological criteria.Eventually the results were analysed with statistical software SPSS 17.0.The new bone in defect area was assessed according datas.In the clinical part,20 patients with alveolar cleft palate were treated with fissure filling.The experimental group(10 cases): Filling in fissure with the mixture of PRF gel and autologous iliac mass,and the control group(10 cases): Filling only autologous iliac in the fissure.In the 3th month and 6th month after operation,Threedimensional CT reconstruction was performed to evaluate the clinical effects.Result On the whole,each of animals’ incisions cicatrized well postoperatively,except that one rabbit’s incision on the iliac dehisced 10 days postoperatively.Then disinfecting again,the incision was healed well after suturing it again,no more dehiscing.Through general observation and X-ray analysis,the bony callus of target area in two groups after operation showed no difference on the second week;difference appears on the fourth week between two groups;significant difference on the eighth week.X-ray results indicate that the control group compared with experimental group,there is statistical significance after 2,4,8 weeks on differences(P<0.05).HE stain indicate that experimental group is better than control group at the coalescence of bone defects.Immune staining(VEGF)shows new blood vessels are gradually increasing,positive area of experimental group is larger than the control group at VEGF staining with 2,4,8weeks postoperatively.In the clinical part,in the 3th month and 6th month after operation,it was observed that the control group had more obvious bone resorption than the experimental group.The postoperative results were good with 7 cases(70%)in the experimental group and 4 cases in the control group(40%),the difference between the two groups is statistically significant(P<0.05).Conclusion The mixture of PRF and autogenous iliac mass with the better ability of bone induction and conduction can accelerate bone integration,promote the process of repair compared with using the autogenous iliac mass singly.iliac cancellous bone combined with platelet-rich fibrin has a good clinical effect on alveolar cleft palate repair compared with single bone graft...