| Objective:This research text studied the different changes of organizational morphology and micro-morphology on the sending down fishbone cartilage from weight-bearing area and non-weight-bearing area after femoral neck fracture on human. For femoral neck fracture and provide experimental basis for clinical treatment..Method:Specimens are from 36 cases of femoral head, which are operated within 2 weeks after femoral neck fracture and the GardenⅢⅣ.In those, 24 cases are from women and age from 60-79 years (the average 69.18±6.31 years ) ,12 cases are from male and age from 53-83 years(average 64.25±9.81 years).In order to compare sending down fishbone cartilage from weight-bearing area of femoral head to that one from the non-weight-bearing area , We apply hematoxylin-eosine stain to survey the recovery and re-establishment about morphology of bone trabecula on sending down fishbone cartilage; use scanning electron microscope to observe the micro-morphous of bone trabecula and collagenous fibers on the different areas; adopt immunohistochemical staining method to definite the difference about OPG and HIF on weight-bearing area and non-weight-bearing area.Results:1.morphological observation: Observation of the longitudinal profile of all samples, there is a hemorrhagic belt, which is bright red semi-curved lining attached to the cartilage cap , on the weight-bearing area of femoral head. It is not obvious on the non-weight-bearing area . 2.Hematoxylin-eosine stain showed: The majority of trabecular bone is fracture on the weight-bearing area of femoral head.There is substantial osteoblasts in ends, osteoclasts is active under the cartilage matrix, and a lot of capillaries have growed into in ends . Part of trabecular is fracture on non-weight-bearing area, but the osteoclasts is inactive on subchondral bone , the number of osteoblasts and capillaries are less than the number of weight-bearing area.3. Scanning electron microscope: The internal structure of subchondral bone is composed of the column and the plate trabecular bone in femoral head,which is arch formed structure. After femoral neck fracture ,the arched structure has suffered damage to varying degrees. A lot of trabecular bone is damaged, cylindrical trabecular bone is fracture, so that the integrity of the arch structure apparently disappeared,and many of the micro-fracture can be seen on Trabecular bone. In addition, microstructure callus-like tissue is visible of trabecular bone. There is seriously absorbed on trabecular bone surface area. Trabecular bone are mostly oval or irregular shape, with sparse, and its spread on the absorption surface and bone lacuna on Non-weight-bearing.4.OPG factor detected: There is obviously about positive expression and repair of trabecular bone on weight-bearing area.It is also have postive expression on the matrix of non-weight-bearing areas ,but that is less than the weight-bearing area.5.HIF-1αfactor Detected: There is the expression of HIF-1αon weight-bearing areas and non-weight-bearing area ,but the further is obviously,forthmore the positive cells were seen in the cytoplasm of cells and stromal on weight-bearing areas.Conclusion:1. The subchondral micro-fractures occurred after the elderly femoral neck fracture, and it is seriously in weight-bearing area than those in non-weight-bearing areas.This micro-fracture may be one of the reasons for the post-secondary necrosis collapse. 2. Bone tissue repair and reconstruction have taken place in the early stage of subchondral bone micro-fractures.3. After internal fixation of femoral neck fracture,it may be early mobilization , but should avoid weight-bearing in order to facilitate micro-fracture of subchondral bone repaired.4.It is preferred to total hip replacement for femoral neck fracture in elderly patients.
|
PDF Full Text Request