Meland N B, Maki S, Chao E Y, Rademaker B
Orthopedics Biomechanics Laboratory, Mayo Clinic, Rochester, Minn.
Plast Reconstr Surg. 1992 Nov;90(5):763-73.
The use of vascularized bone grafts to reconstruct extremity and mandibular defects is now commonplace in reconstructive surgery. Fibula, scapula, iliac crest, rib, and metatarsal as well as the radial forearm osseocutaneous flaps have all been utilized for this purpose. Troublesome spiral fractures of the distal radius are the most common fractures associated with the use of the distal radius as a vascularized bone-graft donor site. This study was proposed to investigate the effect of donor-site bone loss on the strength of the radius under torsional (rotational) loading. Previous clinical series and experimental studies have not examined this aspect of distal radius loading after harvesting the bone graft. Fifty pairs of sheep tibiae were utilized in the experiment. Five pairs were used in a pilot study and 45 pairs were used in the main experiment. Five pairs of human radii were used for the control in the pilot study. The pilot study attempted to make a comparison between the human radius and the sheep tibia for experimental purposes. For the biomechanical study of donor-site defects, four study groups were examined with random assignment and matched pairs. The control group (group 1) had no alteration to the bone. Each test condition included five matched pairs of sheep tibiae. Experiment 1 compared the difference in the depth of the osteotomy defect. In doing this, one-third of the total length of the bone was removed in each of the following specimens to include (1a) 30 percent of the cross-sectional area of the total bone, (1b) 37 percent of the cross-sectional area of the total bone, and (1c) 50 percent of the cross-sectional area of the total bone. In experiment 2, the osteotomy shape was varied. Instead of the ends of the cuts being squared, the ends were beveled or rounded. Experiment 3 compared different lengths of bone removed in the osteotomy defect and included the following: In experiment 3a the diameter of the sheep tibia was measured at the incisura fibularis. This dimension was one diameter of bone, and a one-diameter length of bone was removed. In experiment 3b, a two-diameter length of bone was removed. In experiment 3c, a three-diameter length of bone was removed. In experiment 3d, a four-diameter length of bone was removed.(ABSTRACT TRUNCATED AT 400 WORDS)
在重建手术中，使用带血管蒂骨移植来修复四肢和下颌骨缺损现已很常见。腓骨、肩胛骨、髂嵴、肋骨、跖骨以及桡骨前臂骨皮瓣均已用于此目的。桡骨远端令人棘手的螺旋骨折是将桡骨远端用作带血管蒂骨移植供区时最常见的骨折。本研究旨在探讨供区骨丢失对桡骨在扭转（旋转）负荷下强度的影响。既往的临床系列研究和实验研究均未考察取骨后桡骨远端负荷的这一方面。实验使用了50对绵羊胫骨。5对用于预试验，45对用于主要实验。预试验中使用5对人桡骨作为对照。预试验旨在出于实验目的对人桡骨和绵羊胫骨进行比较。对于供区缺损的生物力学研究，通过随机分组和配对，对四个研究组进行了检查。对照组（第1组）的骨未作改变。每个试验条件包括5对配对的绵羊胫骨。实验1比较了截骨缺损深度的差异。在此过程中，在以下每个标本中去除骨全长的三分之一，以包括（1a）占全骨横截面积的30%，（1b）占全骨横截面积的37%，以及（1c）占全骨横截面积的50%。在实验2中，改变了截骨形状。切口末端不是方形，而是做成斜面或圆形。实验3比较了截骨缺损中去除的不同长度的骨，包括以下内容：在实验3a中，在腓切迹处测量绵羊胫骨的直径。该尺寸为骨的一个直径，去除一个直径长度的骨。在实验3b中，去除两个直径长度的骨。在实验（3c）中，去除三个直径长度的骨。在实验3d中，去除四个直径长度的骨。（摘要截选至400字）
