帶蒂筋膜瓣的穩(wěn)定性對(duì)其促超臨界骨缺損成骨作用影響的實(shí)驗(yàn)研究摘要：

目的：本研究旨在探討帶蒂筋膜瓣在促超臨界骨缺損成骨作用中的影響，為臨床耗時(shí)手術(shù)治療提供新的治療思路和臨床指導(dǎo)。

方法：選取30只新西蘭白兔進(jìn)行促超臨界骨缺損和骨缺損修復(fù)。15只術(shù)后采用普通肌腱瓣修復(fù)，另外15只術(shù)后采用帶蒂筋膜瓣修復(fù)。采用X線攝影術(shù)和組織學(xué)檢查記錄術(shù)后1周、3周和6周的骨缺膠原形成、愈合程度和蒂筋膜成骨程度。

結(jié)果：實(shí)驗(yàn)結(jié)果顯示，帶蒂筋膜瓣修復(fù)組在術(shù)后1周、3周和6周的骨缺膠原形成、愈合程度和蒂筋膜成骨程度顯著高于普通肌腱瓣修復(fù)組（P<0.05），兩組之間具有顯著性差異；實(shí)驗(yàn)結(jié)果還表明，在帶蒂筋膜瓣修復(fù)組中，蒂筋膜成骨過(guò)程與骨缺損愈合有協(xié)同作用。

結(jié)論：帶蒂筋膜瓣的應(yīng)用能夠顯著提高骨缺損愈合和成骨速度，同時(shí)其蒂筋膜與骨缺損愈合有協(xié)同作用。

關(guān)鍵詞：帶蒂筋膜瓣；促超臨界骨缺損；成骨；愈合；協(xié)同Introduction:

Criticalbonedefectscausedbytraumaordiseasearechallengingtotreatandoftenrequiresurgicalinterventionforproperhealing.Amongsurgicaltreatments,theuseoftendonorfasciagraftshasbeenfoundtobeeffectiveinpromotingbonehealing.However,theuseofthesegraftsaloneislimitedintheirabilitytopromoterapidandcompleteboneformation.Therefore,theaimofthisstudywastoinvestigatetheeffectofusingavascularizedfascialgraftincombinationwithtendongraftonpromotingbonehealinginarabbitmodelofcriticalbonedefect.

Methods:

ThirtyNewZealandwhiterabbitsweredividedintotwogroups:theconventionaltendongraftgroupandthevascularizedfascialgraftgroup.Fifteenrabbitsineachgroupunderwentcriticalbonedefectsurgeryandwereevaluatedforbonecollagenformation,healing,andgraftosteogenicpropertiesatpostoperativeweek1,3,and6.X-rayimagingandhistologicalexaminationwereusedtoassesstheoutcomes.

Results:

Theresultsshowedthatthevascularizedfascialgraftgrouphadsignificantlyhigherbonecollagenformation,healing,andgraftosteogenicpropertiesthantheconventionaltendongraftgroup(P<0.05)atallassessmenttimepoints.Furthermore,thevascularizedfascialgraftworkedsynergisticallywithbonehealing.Thevascularizedfascialgraftalsodisplayedsignificantlybetterboneformationatthegraft-hostinterface,asevidencedbythepresenceofmoreosteocytesandmaturebonetissuearoundthegraft.

Conclusion:

Theresultsdemonstratethattheuseofavascularizedfascialgraft,incombinationwithatendongraft,cansignificantlyimprovebonehealingandgraftosteogenicproperties.Furthermore,ourfindingssuggestthatvascularizedfascialgraftcanworksynergisticallywithbonehealing,makingitapotentiallyviableoptionfortreatingcriticalbonedefectsOverall,thestudyhighlightsthepotentialbenefitsofusingavascularizedfascialgraftincombinationwithatendongraftforcriticalbonedefects.Whilefurtherstudiesareneededtoconfirmthesefindingsandbetterunderstandthemechanismsunderlyingthissynergisticeffect,thecurrentresultssuggestthatthisapproachwarrantsfurtherinvestigationasapotentialtreatmentoptionforpatientswithsevereboneinjuries.

Oneofthekeyadvantagesofusingavascularizedfascialgraftisitsabilitytopromotetheformationofnewbloodvesselsandfacilitatenutrientandoxygendeliverytothegraftsite.Thisisespeciallyimportantforbonehealing,asosteocytesrequireaconstantsupplyofnutrientsandoxygentoproliferateandproducenewbonetissue.Inaddition,thepresenceofavascularizedfascialgraftmayhelptostimulatethelocalimmuneresponse,leadingtoimprovedtissueregenerationandreducedriskofinfection.

Anotherpotentialbenefitofusingavascularizedfascialgraftisitsabilitytoserveasascaffoldforcellmigrationandtissueregeneration.Fasciatissueishighlycellularandcontainsmanydifferenttypesofcells,includingstemcells,fibroblasts,andmyofibroblasts.Thesecellscanhelptopromotetissueregenerationandimprovetheoverallstrengthandstabilityofthegraftsite.

Whilethecurrentstudyfocusedspecificallyontheuseofavascularizedfascialgraftincombinationwithatendongraft,itispossiblethatthisapproachcouldbeadaptedforusewithothertypesofgrafts,suchasboneorcartilagegrafts.Futurestudieswillneedtoexploretheoptimalconditionsforusingavascularizedfascialgraftinconjunctionwithdifferenttypesofgrafts,andtoassessthelong-termoutcomesofthisapproachinaclinicalsetting.

Overall,thestudyprovidescompellingevidencethattheuseofavascularizedfascialgraftcansignificantlyimprovebonehealingandgraftosteogenicproperties,suggestingthatthisapproachmaybeapromisingnewoptionfortreatingpatientswithsevereboneinjuries.Withfurtherresearchanddevelopment,thisapproachhasthepotentialtorevolutionizethefieldofboneregenerationandhelpmillionsofpatientsaroundtheworldrecoverfromtraumaticinjuriesanddegenerativebonediseasesThepotentialbenefitsofusingvascularizedfascialgraftsforboneregenerationextendbeyondjustimprovingbonehealingandgraftosteogenicproperties.Thisapproachmayalsohelpreducetherisksofcomplicationsassociatedwithtraditionalbonegraftingtechniques,suchasinfection,nervedamage,andbloodvesselinjury.

Inaddition,vascularizedfascialgraftsmayofferamorecost-effectiveoptionforboneregenerationcomparedtocurrenttreatments.Traditionalbonegraftingtechniquescanbeexpensiveandrequirelengthyhospitalstays,buttheuseofavascularizedfascialgraftmayreducetheneedformultiplesurgeriesandhospitalvisits.

Furthermore,theuseofavascularizedfascialgraftmayexpandtreatmentoptionsforpatientswhoarenotcandidatesfortraditionalbonegraftingtechniques,suchasthosewithdiabetes,compromisedimmunesystems,orahistoryoffailedbonegrafts.

Despitethepromisingresultsseeninthecurrentstudy,furtherresearchisneededtofullyunderstandthepotentialbenefitsandlimitationsofusingvascularizedfascialgraftsforboneregeneration.Futurestudiescouldevaluatethelong-termoutcomesofthisapproachinlargerpatientpopulationswithawiderrangeofboneinjuriesanddiseases.

Inconclusion,theuseofavascularizedfascialgraftrepresentsapromisingnewapproachtoboneregenerationandmayoffersignificantadvantagesovertraditionalbonegraftingtechniques.Withcontinuedresearchanddevelopment,thistechniquehasthepotentialtorevolutionizethefieldoforthopedicsandimprovethequalityoflifeformillionsofpatientsworldwideInconclusion,theuseofvascularizedfascialgraftsforboneregenerationisapromisingapproachthatoffersseveraladvantage