Ekstrakorporeal şok dalga tedavisinin periostu sağlam olan ve periostu eksize edilmişsıçan femurlarında kırık iyileşmesine etkisi
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Tarih
2014
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info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmada ekstrakorporeal şok dalga tedavisinin (ESWT) periostu sağlam olan ve periostu eksize edilmiş olan kırıklar üzerine etkisi karşılaştırıldı.Gereç ve yöntemler: Otuz yedi Wistar albino sıçan dört gruba randomize edildi. Ketamin anestezisi altında tüm sağ femurlara osteotomi ve intramedüller olarak Kirschnerteli tespiti uygulandı. İlk grup (n10) kontrol grubu olarak tanımlandı. İkinci grupta (n10), osteotomi hattındaki periost cerrahi sırasında çevresel olarak eksize edildi. Üçüncü grupta (n9), periost sağlam bırakılarak ESWT uygulandı. Dördüncü grupta (n8), tüm sıçanların periostları eksize edildi ve ESWT uygulandı. Tüm kırık hatları iki haftada bir radyolojik olarak ve altıncı haftada histolojik olarak değerlendirildi. Sonuçlar istatistiksel olarak değerlendirildi.Bulgular: Yumuşak doku defektli açık kırık modelini temsil eden, periostu eksize edilen grupta, ESWT uygulaması kırık iyileşmesi üzerinde anlamlı şekilde olumlu bir histolojik etkiye sahipti. Ancak radyolojik değerlendirme periostu sağlam olan ve eksize edilen gruplar arasında istatistiksel olarak anlamlı bir fark göstermedi.Sonuç: Bulgularımıza göre, yumuşak doku ve periost hasarının eşlik ettiği açık kırık tedavisinde, kırık iyileşmesini hızlandırmak ve psödoartroz oluşumunu engellemek amacıyla ESWT kullanılabilir. Ancak ESWT'nin rutin uygulamaya dahil edilebilmesi için daha fazla klinik çalışma gereklidir.
Objectives: The aim of this study is to compare the effect of extracorporeal shock wave therapy (ESWT) on fractures with intact periosteum and excised periosteum. Materials and methods: Thirty-seven Wistar albino rats were randomized into four groups. Osteotomy and intramedullary Kirschner wire fixation were performed on all right femurs under ketamin anesthesia. The first group (n10) was identified as control group. In the second group (n10), periosteum located at the osteotomy site was excised circumferentially during surgery. In the third group (n9), periosteum was left intact and ESWT was applied. In the forth group (n8), periosteums of all rats were excised and ESWT was applied. All fracture lines were evaluated radiographically each two weeks and histologically at the sixth week. Results were evaluated statistically. Results: In periosteum excised group which represents a model of open fractures with soft tissue defect, ESWT application had a significantly positive histologic effect on bone healing. However, radiological evaluation did not reveal any statistically significant difference between groups with intact and excised periosteums. Conclusion: According to our findings, ESWT can be used to improve fracture healing and prevent pseudoarthrosis in the treatment of open fractures with accompanying soft tissue and periosteum damage. However, further clinical studies are required to include ESWT in routine practice.
Objectives: The aim of this study is to compare the effect of extracorporeal shock wave therapy (ESWT) on fractures with intact periosteum and excised periosteum. Materials and methods: Thirty-seven Wistar albino rats were randomized into four groups. Osteotomy and intramedullary Kirschner wire fixation were performed on all right femurs under ketamin anesthesia. The first group (n10) was identified as control group. In the second group (n10), periosteum located at the osteotomy site was excised circumferentially during surgery. In the third group (n9), periosteum was left intact and ESWT was applied. In the forth group (n8), periosteums of all rats were excised and ESWT was applied. All fracture lines were evaluated radiographically each two weeks and histologically at the sixth week. Results were evaluated statistically. Results: In periosteum excised group which represents a model of open fractures with soft tissue defect, ESWT application had a significantly positive histologic effect on bone healing. However, radiological evaluation did not reveal any statistically significant difference between groups with intact and excised periosteums. Conclusion: According to our findings, ESWT can be used to improve fracture healing and prevent pseudoarthrosis in the treatment of open fractures with accompanying soft tissue and periosteum damage. However, further clinical studies are required to include ESWT in routine practice.
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Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.)
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Cilt
25
Sayı
3
