| ObjectiveTo explore the advantages role of the New Surface Contact Tripod Nail than traditional fixed equipment in the knee medial collateral ligament avulsion fracture treatment. The purpose is to find better internal fixation devices. Provide a theoretical basis for the clinical treatment of such injuries and lay the foundation for further clinical research.MethodsTake12healthy inbred Banna miniature pigs into three groups(A、B、C), each group of four. Establishment of medial collateral ligament avulsion fracture in animal models.Group A:double knee medial collateral ligament avulsion fracture of lag screw fixation; group B:double knee medial collateral ligament avulsion fracture of anchors fixation; group C:double knee medial collateral ligament avulsion fracture of the New Surface Contact Tripod Nail fixation. After the first eight weeks, each line of euthanasia and drawn.All specimens were performed for the following experiments:①X-ray and according to X-ray score and rating criteria statistical analysis;②observe and compare the gross anatomy;③biomechanical testing and statistical analysis;④histological examination and according to the fracture healing pathological grade standard and statistical analysis. Through the above studies comparing different methods of internal fixation of medial collateral ligament avulsion fracture healing influence.Results1. Postoperative animals generally:one Banna miniature pig of group A right knee wound infection may be3days postoperatively, the wound inflammation symptoms disappear after7days by strengthening of antimicrobial therapy and treatment. The rest of the experimental pigs I healing wounds, does not appear similar situation. Does not appear accidental death and diet growth in good condition.2. X-ray radiography analysis:8weeks after surgery, the callus in fracture gaps and the surrounding bone callus growth significantly of group C, more than group A and B,but in group A than group B. Further analysis of the differences between groups, multiple comparisons using LSD.The results suggest that the degree of fracture healing in group A than in group B,but worse than group C.3. Gross anatomy observation:8weeks after surgery, original surgical incision along the fracture skin and muscle to expose the surgical site:group A, the length and width of the medial collateral ligament basically unchanged, no significant atrophy, no significant change compared with intraoperative ligament tension, and medial stress test was negative. Fracture moderate soft tissue adhesions, can blunt dissection, the medial collateral ligament femoral insertion point osteoarthritis, lag screw fixation is more secure,, stable bone fragment, no obvious fracture gap, no intra-articular infection; group B, ligament length and width remain unchanged, no significant atrophy, necrosis, compared with intraoperative ligament tension slightly loose inside suspected positive stress test. Soft tissue adhesions around fracture, bone nail fixed anchor relatively strong, can micro fracture piece, visible fracture gaps, there is no joint cavity infection; group C, the length and width of the medial collateral ligament basically unchanged, no significant atrophy, no significant change compared with intraoperative ligament tension, and medial stress test was negative. Soft tissue adhesions around fracture, bone nail fixed anchor strong, Fracture stability, no obvious fracture gaps, there is no joint cavity infection. 4. Biomechanical testing and statistical analysis:8weeks after surgery, Maximum load test line tension:the average maximum load of group A is2.2109KN, the average maximum load of group B is2.0718KN; the average maximum load of group C is2.4710KN;the average maximum load of group C (the New Surface Contact-Tripod Nail) is maximum,and the average maximum load of group B(anchors) is maximum. After the maximum load of the single-factor analysis of variance shows that the maximum load of group C is greater than in group A and group B(p<0.05), there are significant differences, but the maximum load of group A is greater than in group B(p<0.05), there are significant differences.5. Histological observation:8weeks after surgery, Group A:showed a moderate amount of callus formation, between bone matrix package has more fibroblasts, visible part of mature trabecular bone, bone cells;group B:showed a small amount amount of callus formation, Between bone matrix with a large number of fibroblasts,has more cartilage cells, the volume is relatively small maturity is relatively low, a small amount of tiny trabecular bone, bone cells;group C:showed a large number of callus formation, bone matrix between packages have more fibroblasts, visible mature trabecular bone, bone cells, new bone trabecular connection on both ends of fracture, plate layer or compiling. The multiple comparison results with LSD method for three different internal fixation methods pathology, assess the degree of healing of fracture end. The results suggest that the degree of fracture healing in group C than in group A and B,and the degree of fracture healing in group A than in group B.Conclusions1. The experimental model of knee medial collateral ligament avulsion fracture could be successfully produced in the Banna miniature pigs;2. The New Surface Contact Tripod Nail can be used in the treatment of knee medial collateral ligament avulsion fractures;3. The New Surface Contact Tripod Nail has better biomechanical strength than traditional tension screws and bone anchor in the treatment of knee medial collateral ligament avulsion fracture; 4. The New Surface Contact Tripod Nail can promote fracture healing when compared with traditional tension screws and bone anchor in the treatment of knee medial collateral ligament avulsion fracture. |
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