Farklı osteotomi metotlarının sıçan femurlarında kaynama üzerine etkilerinin karşılaştırılması
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Tarih
2022
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Düzce Üniversitesi
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info:eu-repo/semantics/openAccess
Özet
Amaç: Osteotomi, travma ve deformite cerrahisi gibi ortopedide sık kullanılan cerrahi bir prosedürdür. Farklı ostetomi metotlarının enfeksiyon ve ısı nekrozu gibi etkileri olabilmektedir ve bu etmenler kemik iyileşme sürecini etkileyebilmektedir. Bu çalışmada, sıçan femurunda farklı yöntemlerle yapılan osteotomi (cerrahi testere, gigli teli ve cerrahi dril sonrası ostetom) sonrasında kemik iyileşmesi üzerindeki radyolojik, histopatolojik ve biomekanik etkileri değerlendirilmiştir. Gereç ve Yöntem: Bu çalışmada, 2,5 aylık ve ortalama ağırlıkları 250 gram olan 54 adet Wistar-Albino cinsi erkek sıçanda, gigli teli, testere ve dril+osteotom kullanılarak üç farklı yöntemle femoral osteotomi uygulandı. Gigli grubu (grup1, n:18), testere grubu (grup2, n:18) ve diril + osteotom gurubu (grup3, n:18 ) olmak üzere 3 gruba ayrıldı. Tüm gruplar 15, 30 ve 45. günde sakrifiye edilerek radyolojik, histolopatolojik ve biyomekanik açıdan değerlendirilmek üzere 6'şar adet sıçandan oluşan 9 alt gruba ayrıldı. Hayvanlar, kontrollü sıcaklık (23-25°C) ve 12:12 saatlik aydınlık/karanlık döngüsü olacak şekilde kafeste takip edildi. Radyolojik değerlendirmede Lane ve Sandhu'nun, histopatolojik olarak ise Hue ve arkadaşları'nın önerdiği skorlama kullanıldı. Biyomekanik değerlendirme ise BESMAK BMT-E serisi malzeme test cihazında (Besmak, Ankara, Türkiye) yapılan ölçümler (Newton) karşılaştırılmıştır. Sonuçlar: Gigli, testere ve dril+osteotom gruplarının 15 ve 45.gün radyolojik skorlama dağılımları arasında anlamlı farklılık gözlenmemiştir (p=0,393,p=0,758) ancak 30.gün radyolojik skorlama dağılımları arasında anlamlı farklılık gözlenmiştir (p=0,001). Dril+osteotom grubunda kırık hattının kaybolmaya başlaması varlığı gigli ve testere gruplarından yüksek bulunmuştur. Gigli, testere ve dril+osteotom gruplarının 15, 30 ve 45.gün histopatolojik değerleri arasında anlamlı farklılık gözlenmemiştir (p=0,719,p=0,097,p=0,352). Gigli, testere ve dril+osteotom gruplarının 30.Gün biyomekanik değerleri arasında anlamlı farklılık gözlenmiştir (p=0,013). Gigli grubunun biyomekanik değerleri testere ve dril+osteotom gruplarının biyomekanik değerlerinden anlamlı derecede düşük bulunmuştur (p=0,026, p=0,006). Testere ve dril+osteotom gruplarının biyomekanik değerleri arasında anlamlı farklılık gözlenmemiştir (p=0,810). Gigli, testere ve dril+osteotom gruplarının 45.Gün biyomekanik değerleri arasında anlamlı farklılık gözlenmemiştir (p=0,773). Çıkarımlar: Radyolojik olarak dril ve osteotom ile yapılan osteotomi sonrası erken dönemde daha iyi kemik iyileşmesi sağlanmaktadır. Ayrıca gigli teli ile yapılan osteotomi erken dönemde testere veya dril+osteotom ile yapılan osteotomiye göre biyomekanik olarak daha zayıftır.
Objective: Osteotomy is a frequently used surgical procedure in orthopedics, such as trauma and deformity surgery. Different osteotomy methods may have effects such as infection and heat necrosis, and these factors may affect the bone healing process. In this study, radiological, histopathological and biomechanical effects on bone healing were evaluated after osteotomy (surgical saw, gigli wire, osteotom after surgical drill) performed with different methods in the rat femur. Materials and Methods: In this study, femoral osteotomy was performed on 54 Wistar-Albino male rats, 2,5 months old and weighing 250 grams, using three different methods, using a gigli wire, saw and drill+osteotome. They were divided into 3 groups as gigli group (group1, n:18), saw group (group2, n:18), and diril+osteotome group (group3, n:18). All groups were sacrificed on the 15th, 30th and 45th days and divided into 9 subgroups consisting of 6 rats to be evaluated radiologically, histopathologically and biomechanically. Animals were monitored in the cage with controlled temperature (23-25°C) and a 12:12 hour light/dark cycle. The scoring suggested by Lane and Sandhu was used for radiological evaluation, and the scoring recommended by Hue et al. for histopathological evaluation. Biomechanical evaluation was compared with the measurements (Newtons) made on the BESMAK BMT-E series material testing device (Besmak, Ankara, Turkey). Results: No significant difference was observed between the 15th and 45th day radiological scoring distributions of the gigli, saw and drill+osteotome groups (p=0.393,p=0.758), but a significant difference was observed between the 30th day radiological scoring distributions (p=0.001). The disappearance of the fracture line was found to be higher in the drill+osteotome group than in the gigli and saw groups. No significant difference was observed between the histopathological values of the Gigli, saw and drill+osteotome groups at the 15th, 30th and 45th days (p=0.719,p=0.097,p=0.352). A significant difference was observed between the 30th day biomechanical values of the gigli, saw and drill+osteotome groups (p=0.013). The biomechanical values of the gigli group were found to be significantly lower than the biomechanical values of the saw and drill+osteotome groups (p=0.026, p=0.006). No significant difference was observed between the biomechanical values of the saw and drill+osteotome groups (p=0.810). No significant difference was observed between the biomechanical values of gigli, saw and drill+osteotome groups at 45th day (p=0.773) Conclusions: Radiologically, better bone healing is provided in the early period after osteotomy with drill+osteotome. In addition, osteotomy with gigli wire is biomechanically weaker than osteotomy made with saw or drill+osteotome in the early period.
Objective: Osteotomy is a frequently used surgical procedure in orthopedics, such as trauma and deformity surgery. Different osteotomy methods may have effects such as infection and heat necrosis, and these factors may affect the bone healing process. In this study, radiological, histopathological and biomechanical effects on bone healing were evaluated after osteotomy (surgical saw, gigli wire, osteotom after surgical drill) performed with different methods in the rat femur. Materials and Methods: In this study, femoral osteotomy was performed on 54 Wistar-Albino male rats, 2,5 months old and weighing 250 grams, using three different methods, using a gigli wire, saw and drill+osteotome. They were divided into 3 groups as gigli group (group1, n:18), saw group (group2, n:18), and diril+osteotome group (group3, n:18). All groups were sacrificed on the 15th, 30th and 45th days and divided into 9 subgroups consisting of 6 rats to be evaluated radiologically, histopathologically and biomechanically. Animals were monitored in the cage with controlled temperature (23-25°C) and a 12:12 hour light/dark cycle. The scoring suggested by Lane and Sandhu was used for radiological evaluation, and the scoring recommended by Hue et al. for histopathological evaluation. Biomechanical evaluation was compared with the measurements (Newtons) made on the BESMAK BMT-E series material testing device (Besmak, Ankara, Turkey). Results: No significant difference was observed between the 15th and 45th day radiological scoring distributions of the gigli, saw and drill+osteotome groups (p=0.393,p=0.758), but a significant difference was observed between the 30th day radiological scoring distributions (p=0.001). The disappearance of the fracture line was found to be higher in the drill+osteotome group than in the gigli and saw groups. No significant difference was observed between the histopathological values of the Gigli, saw and drill+osteotome groups at the 15th, 30th and 45th days (p=0.719,p=0.097,p=0.352). A significant difference was observed between the 30th day biomechanical values of the gigli, saw and drill+osteotome groups (p=0.013). The biomechanical values of the gigli group were found to be significantly lower than the biomechanical values of the saw and drill+osteotome groups (p=0.026, p=0.006). No significant difference was observed between the biomechanical values of the saw and drill+osteotome groups (p=0.810). No significant difference was observed between the biomechanical values of gigli, saw and drill+osteotome groups at 45th day (p=0.773) Conclusions: Radiologically, better bone healing is provided in the early period after osteotomy with drill+osteotome. In addition, osteotomy with gigli wire is biomechanically weaker than osteotomy made with saw or drill+osteotome in the early period.
Açıklama
Anahtar Kelimeler
Ortopedi ve Travmatoloji, Orthopedics and Traumatology
