Maffulli N, Cheng J C, Sher A, Ng B K, Ng E
Department of Orthopaedic Surgery, University of Aberdeen Medical School, Scotland.
Bone. 1999 Sep;25(3):333-8. doi: 10.1016/s8756-3282(99)00168-4.
We studied the course of bone mineralization of regenerate bone after callotasis lengthening. Twenty-three patients (eight boys) (mean age at operation 11.5 years, range 4-17 years; leg length discrepancy [LLD] at surgery ranging from 4 to 13 cm) underwent dual-energy X-ray absorptiometry (DEXA) scanning weekly during the distraction phase, at 2 week intervals until removal of the fixator, and at the time of their out-patient visits thereafter, for a mean of 794 +/- 420 days after removal of the apparatus. At removal of the fixator, the bone mineral content (BMC) of the regenerate was nearly 70% of the normal contralateral limb. With time, this value gradually increased, and tended to reach normal values, with no significant difference between femur and tibia. With time, the BMC of the regenerate tends to return to the value of the normal contralateral limb. Probably, once the limb length discrepancy has been equalized, the mechanical stimuli imparted through weight-bearing to the lengthened limb are of the same magnitude bilaterally. In this instance, then, the newly formed bone, responding to these physical stimuli, would normalize its mineral content, confirming that bone remodeling continues well after lengthening is terminated. Mineralization of the regenerate after completion of the lengthening process reaches values significantly greater than at removal of the fixator, with an increase of >50% of the prelengthening values, regardless of the underlying pathology. The final value of this increased BMC is not significantly different than in the normal contralateral unoperated limb. At least part of the increase in bone mineralization following callotasis lengthening is due to the normal process of growth and development.
我们研究了骨痂延长术后再生骨的骨矿化过程。23例患者（8名男性）（手术时平均年龄11.5岁，范围4 - 17岁；手术时腿长差异[LLD]为4至13厘米）在牵张期每周接受双能X线吸收测定（DEXA）扫描，在去除固定器前每隔2周扫描一次，此后在门诊随访时进行扫描，去除器械后平均随访794±420天。去除固定器时，再生骨的骨矿物质含量（BMC）接近对侧正常肢体的70%。随着时间推移，该值逐渐增加，并趋于达到正常水平，股骨和胫骨之间无显著差异。随着时间推移，再生骨的BMC趋于恢复到对侧正常肢体的值。可能一旦肢体长度差异得到平衡，通过负重施加于延长肢体的机械刺激在双侧是相同程度的。在这种情况下，新形成的骨对这些物理刺激作出反应，会使其矿物质含量正常化，这证实了延长终止后骨重塑仍良好地持续进行。延长过程完成后再生骨的矿化程度显著高于去除固定器时，增加幅度超过延长前值的50%，无论潜在病因如何。这种增加的BMC的最终值与对侧未手术的正常肢体相比无显著差异。骨痂延长术后骨矿化增加至少部分归因于正常的生长发育过程。
