肌肉活动方式对骨痂骨密度及X-线片灰度值的影响
作者：王柯慧 陈训华 程爱华 钟红刚 邢美荣
单位：中国中医研究院骨伤科研究所，北京 100700
关键词：肌肉活动方式；骨折愈合；骨密度
中国骨伤000602 摘 要：目的探讨有利于骨折愈合的肌肉活动方式。方法应用兔实验性骨折复位固定器对18只兔一侧小腿胫腓骨中段骨折进行复位固定，以不同强度的电信号，刺激坐骨神经获得不同肌力的肌肉收缩活动。主要影响因素为应力方式，初始加载时间，日活动量，加载持续时间，做四因素三水平L9(43)正交试验设计，骨折后2、4、6周时取材进行骨痂骨密度和X-线片灰度值测定。结果18例动物L9(43)正交试验设计(K=2)及方差分析结果表明：骨折复位固定后肌肉活动的最佳组合方式为骨折复位固定5天后开始给予被动肌肉活动，日活动量为1天1次或1天2次为佳，肌力为l/2最大非负重状态下肌力或逐渐加大肌力方式，加载持续时间为6周或4周。结论提示骨折复位固定后实施肌肉活动的初始时间不宜过早，应在肢体局部充血肿胀消退以后，且活动量不宜过大。
, 百拇医药
The effects of muscular movement on bone density in the callus and X-ray ash ratio
WANG Ke-hui ,CHEN Xun-hua ,CHEUNG Ai-hua,et al.
(Institute of Orthopaedic and Traumatology,China Academe of Traditional Chinese Medicine(Beijing,100700))
Abstract：Objective To investigate the effects of muscular movement suitable for fracture healing.Methods Tibial and fibular fracture models were produced in 18 rabbits.By stimulating the sciatic nerve with different electric parameters,the relationship between the intensity of the elctric stimulation and the muscular force of the individual muscles were recorded in the animals with the fracture fixed with external fixators.The principal affecting factors were the force form,the commencement of the experimental movement,the dailyamounts and the period of the movement as well as the continuation period of the added loading.Each factor was divided into three levels and the orthogonal experimental design L9(43)was set up.The tests were carriedout in the models at 2,4,6 weeks after fracture.Results The L9(43)orthogonal experiment design and analysis of the variance showed that there was significant difference in the callus bone density in the models subjected to different movement forms(P<0.05).The best form of muscular movement was found to be as follows:the commencement of the movement at the fifth day after fracture;the amount of the movement beingonce or twice daily;the period of experimental movement being 4 or 6 weeks;the muscular force being half of the maximum in loading free condition or the force being increased as fracture healing in progress.Conclusion During the early stage of fracture,the muscular movement should be carried out after the subsidence of the local swelling.The commencement of muscular movement should not be too early and be carried out in a gradu ally increasing pattern in harmony with the progress of fracture healing.
, 百拇医药
Keywords：Muscular movement form Fracture healing Bone density
基金项目：国家自然科学基金资助项目(39500189)
参考文献：
[1]王柯慧，钟红刚，李文荣，等.兔骨骼肌肌力与电刺激强度的相关性研究.中国骨伤，1998,11(3):17-19.
[2]赵玉堂主编.骨矿与临床，河南，黄河出版社.1995:24.
[3]Nilsson BE.Post-traumatic osteopenia.Acta Orthop Scand.Suppl 1966,91:1.
[4]Nichkks,PL,X-ray diagnosis of healing fractures in rabbits.Clin.Orthop,1979,142:234.
, 百拇医药
[5]Perkins,R.Callus formation and the rate healing of femoral fractures in pattents with head injuries.J.Bone Jt.Surg,1987,69B:521.
[6]钱民全，陶祖莱，盛家宁，等，骨折愈合与应力的适应性假设.北京生物医学工程，1984,4(1):28-32.
[7]王亦璁.近年骨折治疗观点的反思.中华创伤杂志，1998,14(1):1-3.
[8]王少军，韩平良，张连生，等.应力促进下肢长骨骨折愈合的探讨.中华骨科杂志，1996,16(9):559-561.
[9]徐莘香，刘一，李长胜，等.当前骨折内固定治疗中的几个基本问题，中华骨科杂志，1996,16(4):204-206.
, http://www.100md.com
[10]顾科民.关于中医伤科“接骨方药”文献整理.上海中医学杂志，1963,(8):31-33.
[11]关继超，钟红刚，董福慧，等.肌肉动力与断端显微位移的动态观察，中国骨伤，1998,11(4):11-13.
[12]Wolf JW,White AA,Panjabi MM,et al.Companson of cyclic loading versus constant compression in the treatment of long bone fracture in rabbits.J Bone and Joint Surg.(Am),1981,43:805-810.
收稿日期：1999-02-20
修稿日期：1999-06-16, 百拇医药
单位：中国中医研究院骨伤科研究所，北京 100700
关键词：肌肉活动方式；骨折愈合；骨密度
中国骨伤000602 摘 要：目的探讨有利于骨折愈合的肌肉活动方式。方法应用兔实验性骨折复位固定器对18只兔一侧小腿胫腓骨中段骨折进行复位固定，以不同强度的电信号，刺激坐骨神经获得不同肌力的肌肉收缩活动。主要影响因素为应力方式，初始加载时间，日活动量，加载持续时间，做四因素三水平L9(43)正交试验设计，骨折后2、4、6周时取材进行骨痂骨密度和X-线片灰度值测定。结果18例动物L9(43)正交试验设计(K=2)及方差分析结果表明：骨折复位固定后肌肉活动的最佳组合方式为骨折复位固定5天后开始给予被动肌肉活动，日活动量为1天1次或1天2次为佳，肌力为l/2最大非负重状态下肌力或逐渐加大肌力方式，加载持续时间为6周或4周。结论提示骨折复位固定后实施肌肉活动的初始时间不宜过早，应在肢体局部充血肿胀消退以后，且活动量不宜过大。
, 百拇医药
The effects of muscular movement on bone density in the callus and X-ray ash ratio
WANG Ke-hui ,CHEN Xun-hua ,CHEUNG Ai-hua,et al.
(Institute of Orthopaedic and Traumatology,China Academe of Traditional Chinese Medicine(Beijing,100700))
Abstract：Objective To investigate the effects of muscular movement suitable for fracture healing.Methods Tibial and fibular fracture models were produced in 18 rabbits.By stimulating the sciatic nerve with different electric parameters,the relationship between the intensity of the elctric stimulation and the muscular force of the individual muscles were recorded in the animals with the fracture fixed with external fixators.The principal affecting factors were the force form,the commencement of the experimental movement,the dailyamounts and the period of the movement as well as the continuation period of the added loading.Each factor was divided into three levels and the orthogonal experimental design L9(43)was set up.The tests were carriedout in the models at 2,4,6 weeks after fracture.Results The L9(43)orthogonal experiment design and analysis of the variance showed that there was significant difference in the callus bone density in the models subjected to different movement forms(P<0.05).The best form of muscular movement was found to be as follows:the commencement of the movement at the fifth day after fracture;the amount of the movement beingonce or twice daily;the period of experimental movement being 4 or 6 weeks;the muscular force being half of the maximum in loading free condition or the force being increased as fracture healing in progress.Conclusion During the early stage of fracture,the muscular movement should be carried out after the subsidence of the local swelling.The commencement of muscular movement should not be too early and be carried out in a gradu ally increasing pattern in harmony with the progress of fracture healing.
, 百拇医药
Keywords：Muscular movement form Fracture healing Bone density
基金项目：国家自然科学基金资助项目(39500189)
参考文献：
[1]王柯慧，钟红刚，李文荣，等.兔骨骼肌肌力与电刺激强度的相关性研究.中国骨伤，1998,11(3):17-19.
[2]赵玉堂主编.骨矿与临床，河南，黄河出版社.1995:24.
[3]Nilsson BE.Post-traumatic osteopenia.Acta Orthop Scand.Suppl 1966,91:1.
[4]Nichkks,PL,X-ray diagnosis of healing fractures in rabbits.Clin.Orthop,1979,142:234.
, 百拇医药
[5]Perkins,R.Callus formation and the rate healing of femoral fractures in pattents with head injuries.J.Bone Jt.Surg,1987,69B:521.
[6]钱民全，陶祖莱，盛家宁，等，骨折愈合与应力的适应性假设.北京生物医学工程，1984,4(1):28-32.
[7]王亦璁.近年骨折治疗观点的反思.中华创伤杂志，1998,14(1):1-3.
[8]王少军，韩平良，张连生，等.应力促进下肢长骨骨折愈合的探讨.中华骨科杂志，1996,16(9):559-561.
[9]徐莘香，刘一，李长胜，等.当前骨折内固定治疗中的几个基本问题，中华骨科杂志，1996,16(4):204-206.
, http://www.100md.com
[10]顾科民.关于中医伤科“接骨方药”文献整理.上海中医学杂志，1963,(8):31-33.
[11]关继超，钟红刚，董福慧，等.肌肉动力与断端显微位移的动态观察，中国骨伤，1998,11(4):11-13.
[12]Wolf JW,White AA,Panjabi MM,et al.Companson of cyclic loading versus constant compression in the treatment of long bone fracture in rabbits.J Bone and Joint Surg.(Am),1981,43:805-810.
收稿日期：1999-02-20
修稿日期：1999-06-16, 百拇医药