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目的 探讨长管状骨骨膜切取移植后供骨再生骨膜的组织结构、生成机制和成骨能力。方法 实验杂种犬 16条 ,随机分为 4组 ,每组 4条。第 1组行胫骨骨膜次全切除 ;第 2组 :同第 1组 +滋养血管切断 ;第 3组 :同第 2组 +干骺血管切断 ( 1～ 3组均为双侧胫骨手术、左侧术后分期切取标本行光、电镜检查 ;右侧术后 8周行胫骨锯断钢板内固定 ,分期拍片 ) ;第 4组为对照组 ,仅行右胫骨锯断内固定和拍片观察。结果 第 1、2组术后 2周供区表面形成薄层组织膜 ,至 12周形态结构与正常骨膜相似 ,新生血管网与胫后、腓动脉的肌间隙支相通。第 3组“再生骨膜”始终为纤维组织。X线观察 :第 1、2组与对照组相同 ;第 3组未见骨折愈合现象。结论 再生骨膜的组织结构和成骨能力与正常骨膜相似 ,其形成机制与骨修复本能、健康骨质的基质作用、邻近组织血循的供养等因素有关 ;长管状骨骨膜大块切取移植对供骨无不利影响
Objective To investigate the tissue structure, formation mechanism and osteogenesis ability of periosteum for long bone periosteum after its transplantation. Methods 16 experimental mongrel dogs were randomly divided into 4 groups with 4 in each group. Group 1: tibial periosteum subtotal resection; Group 2: same as Group 1 + nocturnal vascular exclusion; Group 3: same as Group 2 + metaphyseal vascular closure (groups 1 to 3 were bilateral tibial surgery, left Postoperative staging specimens were examined by light and electron microscopy; the right side of the tibiofemoral plate was fixed within 8 weeks postoperatively, and staged filming was performed. The fourth group was the control group, and only the right tibia saw and internal fixation and film observation. Results The first and second groups were formed thin layer tissue membrane on the surface of the donor area 2 weeks after operation. The morphology and structure were similar to the normal periosteum at 12 weeks. The neovascularization network was connected with the interosseous space of the posterior tibial and peroneal artery. Group 3 “regenerative periosteum” is always fibrous tissue. X-ray observation: group 1 and group 2 were the same as the control group; group 3 did not show fracture healing. CONCLUSION: The structure and osteogenesis of regenerated periosteum are similar to those of normal periosteum. The formation mechanism of the regenerated periosteum is related to the instability of the bone, the matrix effect of the healthy bone and the blood supply of the adjacent tissue. The long tubular periosteum chunk is transplanted to the donor Bone without adverse effects