Kırık iyileşmesinde kırık hematomunun önemi: Hematomun tekrar kırık hattına yerleştirilmesi: Deneysel çalışma

Amaç: Açık redüksiyon intemal tespit yapılan sıçan modelinde, kırık hematomunun kırığın bulunduğu ortamdan steril koşullarda aynlıp tekrar kırık hattına yerleştirilmesinin kırık kaynaması üzerine etkileri araştırıldı. Çalışma planı: Altmış adet erkek Wistar sıçan, yirmişerli üç gruba aynıdı. Sıçanların her iki femurunda kapalı kırık oluşturularak sağ femurlardan deney grubu oluşturuldu. Sol femurlar kontrol grubu olarak aynıdı ve herhangi bir işlem yapılmadı. A grubunda kapalı kırık oluşturulmasından yarım saat sonra, B grubunda iki gün sonra, C grubunda dört gün sonra kırık hattı açılarak kırık hematomu steril koşullarda alındı; ortam serum fizyolojik ile yıkandıktan sonra hematom tekrar kırık hattına yerleştirildi. Kırıklar intramedullar olarak tespit edildi. Üçüncü ve beşinci haftalarda sıçanların femurları radyolojik, biyomekanik ve histolojik açıdan incelendi. Sonuçlar: Radyolojik değerlendirmede beşinci haftada A grubunda daha fazla denekte kaynama ve remodeling gözlendi. Biyomekanik değerlendirmede üçüncü haftada kallus alanı, eğme momenti, eğme rijiditesi ve kırık enerjisi değerlerinde anlamlı fark yoktu (p>0.05). Beşinci haftada ise A grubunun tüm biyomekanik değerleri B ve C grubunun değerlerinden anlamlı derecede daha iyi idi.

Anahtar Kelimeler:

Kemik kallusu, Biyomekanik, Femur kırıkları, Kemik oluşumu, Sıçanlar, Hastalık modelleri, hayvan, Hematom, Yara iyileşmesi, Doku nakli

The importance of fracture hematoma in fracture union: Replacement of hematoma over the fracture site: An experimental study

Objectives: In an open reduction and internal fixation model in rats, we investigated the effect of fracture hematoma on fracture union when removed from the fracture site under sterile conditions and then replaced over the fracture site. Methods: Sixty male Wistar rats were divided into three groups, each consisting of 20 rats. Fractures were induced in both femurs. The right and left femurs were included in experimental and control groups, respectively. The control femurs remained untreated. Hematoma was removed from the fracture site half an hour after fracture induction in group A, after two days in group B, and after four days in group C. Following irrigation of the fracture site with physiological saline solution, hematoma was replaced over the fracture site and the fractures were fixed intramedullary. Radiologic, biomechanical, and histologic studies were made in the third and fifth weeks. Results: Radiologically, the rats in group A showed more union and remodeling than group B and C did in the fifth week. Biomechanical evaluation showed no statistically significant differences in callus area, bending moment, bending rigidity, and fracture energy between the three groups in the third week (p>0.05) However, all biomechanical parameters of group A became significantly superior than those of group B and C in the fifth week (p<0.001). Conclusion: Removal of the fracture hematoma under sterile conditions and then replacing it over the fracture site may exert a favorable effect on fracture union in open reduction and internal fixation procedures.

Keywords:

Bony Callus, Biomechanics, Femoral Fractures, Osteogenesis, Rats, Disease Models, Animal, Hematoma, Wound Healing, Tissue Transplantation,

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