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골절부위에 생긴 혈종의 골막하 이식이 골형성에 미치는 영향에 관한 실험적 연구 - 골스캔 소견을 중심으로 -
An Experimental Study on the Effect of Subperiosteal Transplantation of Fracture Site Hematoma : Focus on the Scintigraphic Detection
이명철(Myung Chul Lee),양승오(Seoung Oh Yang),강흥식(Hung Sik Kang),장기현(Kee Hyun Chang),구경회(Kyung Hoi Koo),성상철(Sang Chul Seung),박인애(In Ae Park)
UCI I410-ECN-0102-2009-510-005496325
* 발행 기관의 요청으로 무료로 이용 가능한 자료입니다.

It has been reported that hematoma is one of the most crucial factors in fracture healing since callus formation is disturbed by washing out the hematoma near a fracture site. However, it is not clear why the hamatoma is important and how it plays a role during the fracture healing. In order to investigate the role of hematoma in the process of fracture healing, the osteogenic potential by subperiosteal transplantation have been studied. Experimental fractures by operation were made at the mid-shaft of the tibia in New Zealand white rabbits. Removal of hematoma at the fracture site was done after 2 and 3 days from experimental fracture, and the removed hematoma was transplanted into the subperiosteal area at the mid-shaft of the ulna of each rabbit. As control gorups, we have performed 3 different procedures 1) the hematoma was transplanted into the muscular layers at the thigh and forearm; 2) autologous blood clots were transplanted into the subperiosteal area of the ulna; and 3) sham operation without a transplantation into the subperiosteal area. After transplantation, seria bone scintigraphy and simple radiography were performed at 4 days, 1 week, and 2 weeks to detect an abnormality. The results of bone scintigraphy were positive in 5 of 6 experimental group. However, a11 in three control groups were negative. Histological observation of the positive bone revealed new bone formation with trabeculation. These results suggest the hematoma in fracture site has osteogenic potential in the subperiosteal area which can be demonstrable by bone scintigraphy and histologic findings. Therefore, it is considered that hematoma of the fracture site plays an important role in the process of fracture healing. Further biochemical investigation using various experimentaI models is mandatory to apply this preliminary result to the treatment of clinical delayed union or nonunion.

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