Oštećenje periostalne cirkulacije nakon osteosinteze pločicama

Antabak, Anko (2005) Oštećenje periostalne cirkulacije nakon osteosinteze pločicama. PhD thesis, Sveučilište u Zagrebu.

[img]
Preview
PDF
Download (14MB) | Preview

Abstract

It is an indisputable fact today that the periosteum has marked osteogenetic properties and that its inner layer, the cambium, is undoubtedly, one of the most active factors in process of fracture healing. Under conditions of stable osteosynthesis, the periosteum plays an extraordinarily great role. It has been proposed that vascular insufficiency related to plate contact with the periosteal surface. As consequence of this belief, considerable effort has been made in designing bone plates with interface profiles that attempt to reduce the contact between the plate and underlying periosteum. In this study, periosteal micro vessel density under classic and now four plate’s owner constructions have been quantitated, using histomorphometric measured, in same condition of osteosynthesis. The aim is showing which has the satisfactory conditions to periosteal circulation from them. A total of 36 periosteal explants (the six intact and along six below everyone new plates) from medial tibiae of nine ships, aged 1-2 years, were analyzed. Formalin-fixed and paraffin-embedded tissues has used, and anti CD32 and CD34 (Willenbrand Factor) has endothelial marker used. Quantitative histomorphometry of volume micro vessels density has entered directly on personal computer using a program written for this purpose. Microscopic examination of intact periosteum, volume micro vessel density has 27,72±2.67 mm3/cm3. Micro vessels density of intact periosteum not demonstrated statistically significant differences in dependent of the experimental animal (p=0,34), neither dependent of the leg with which (p=0,15). Micro vessels density under classical plate were significantly lower then micro vessels density of intact periosteum, but much more significantly ware increased micro vessel density of periosteum under new constructioned plates (p=0,000). All of new plates had having satisfactory effect on periosteal microcirculation (stimulation of angiogenesis), the biggest values of micro vessels density has had cross tapped plate. Periosteum contact area of this new osteosynthesis plate was 5 %.

Abstract in Croatian

Neosporno je da periost posjeduje izrazita osteogenetska svojsva, a njegov unutarnji sloj, kambijum, spada među najaktivnije čimbenike u procesu cijeljenja prijeloma. U uvjetima stabilne osteosinteze periost ima bez dvoumljenja vrlo značajnu ulogu. Smatra se da smetnje cirkulacije kod osteosinteze pločicama nastaju rigidnim kontaktom pločice na kost. Tako se radi što manjeg oštećenja mikrocirkulacije modeliraju poločice smanjene dodirne poršine kojom naliježu na periost. U ovom se radu kvantificira stanje periostalne mikrocirkulacije ispod klasične pločice i pločica vlastite konstrukcije, promijenjenog oblika i veličine dodirne površine, u istim uvjetima osteosinteze. Cilj je izdvojiti pločicu koja najmanje oštećuje periostalnu cirkulaciju. Načinjene su četiri nove pločice i svaka je postavljana u šest navrata na intaktnu kost potkoljenice ovce. Ukupno je analizirano 36 periosta; šest intaktnih i po šest ispod svake ispitivane pločice. Histološki preparati periosta priređeni su imunohistokemijskom reakcijom za prikaz krvnih žila, koristeći von Willennnbrand faktor CD31 i CD 34. Morfometrijska mjerenja volumne gustoće periostalne cirkulacije načinjena su računalnim programom za obradbu digitalizirane slike. Volumna gustoća krvnih žila intaktnog periosta je 27,72±2.67 mm3/cm3. Nema značajne razlike izmjerenih vrijednosti volumne gustoće ovisno o nozi s koje je uzet periost (p=0,15), niti ovisno o pokusnoj životinji (p=0,34). Volumna gustoća periostalne cirkulacije intaktnog, periosta ispod klasične i novih pločica značajno se razlikuju (p=0,000). Vrijednosti za periost ispod klasične pločice su manje, a ispod novih pločica značajno veće, nego intaktnog periosta. Nakon osteosinteze klasičnom pločicom nastane oštećenje periostalne cirkulacije. Iako sve nove pločice imaju povoljno djelovanje na periost (stimuliraju angiogenezu), križno ožljebljena pločica ima daleko najveće vrijednosti volumne gustoće mikrocirkulacije periosta ispod nje. Površina kojom ova pločica naliježe na periost je 5 %.

Item Type: Thesis (PhD)
Mentors:
Mentor
Davila , Slavko
MeSH: Bone Plates - adverse effects ; Fracture Fixation, Internal - methods ; Periosteum - blood supply [ Fraktura, fiksacija, unutarnja - metode ; Kost, fiksacija pločicama - štetna djelovanja ; Periost - opskrba krvlju ]
Departments: Izvan medicinskog fakulteta
Depositing User: dr.med. Helena Markulin
University: Sveučilište u Zagrebu
Institution: Medicinski fakultet
Number of Pages: 142
Status: Unpublished
Creators:
CreatorsEmail
Antabak, AnkoUNSPECIFIED
Date: 5 September 2005
Date Deposited: 07 Dec 2006
Last Modified: 23 Sep 2011 16:09
Subjects: WE Musculoskeletal System > WE 168-190 Orthopedics. Reconstructive Orthopedics. Bone Transplantation
Related URLs:
    URI: http://medlib.mef.hr/id/eprint/157

    Actions (login required)

    View Item View Item

    Downloads

    Downloads per month over past year