Karp N S, McCarthy J G, Schreiber J S, Sissons H A, Thorne C H
Institute of Reconstructive Plastic Surgery, New York University Medical Center, NY 10016.
Ann Plast Surg. 1992 Jul;29(1):2-7. doi: 10.1097/00000637-199207000-00002.
Bone lengthening using the process of corticotomy and gradual distraction of callus is applicable to the membranous bone of the canine mandible. In this study the precursors to bone formation, in the area between the distracted bone edges, are analyzed in an attempt to determine the mechanism of bone formation. Ten mongrel dogs 5 months of age were studied. A unilateral, periosteal-preserving angular corticotomy was performed, and an external bone-lengthening device was fixed to the mandible. After 10 days of external fixation, the mandible was lengthened 1 ml per day for 20 days and then held in external fixation for 8 weeks. The dogs were killed for histological and microradiographic study at 10 and 20 days of distraction, and at 14, 28, and 56 days after the completion of distraction. It was observed that the gap between the distracted bone edges is first occupied by fibrous tissue. As distraction proceeds, the fibrous tissue becomes longitudinally oriented in the direction of distraction. Early bone formation advances along the fibrous tissue, starting from the cut bone ends. Eventually the area is converted to mature cortical bone. Bone is formed predominantly by intramembranous ossification. This mechanism is similar to that of bone formation during long bone lengthening.
采用皮质切开术和骨痂逐步牵张的方法进行骨延长适用于犬下颌骨的膜性骨。在本研究中，对牵张骨边缘之间区域的骨形成前体进行分析，以试图确定骨形成的机制。研究了10只5月龄的杂种犬。进行单侧、保留骨膜的角形皮质切开术，并将外部骨延长装置固定于下颌骨。外固定10天后，下颌骨每天延长1毫米，持续20天，然后保持外固定8周。在牵张第10天和第20天，以及牵张完成后第14天、28天和56天处死犬只，进行组织学和显微放射学研究。观察到牵张骨边缘之间的间隙首先被纤维组织占据。随着牵张的进行，纤维组织沿牵张方向纵向排列。早期骨形成从切开的骨端开始，沿着纤维组织推进。最终该区域转化为成熟的皮质骨。骨主要通过膜内成骨形成。该机制与长骨延长过程中的骨形成机制相似。
