Kramer Franz-Josef, Mueller Michal, Rahmstorf Meike, Swennen Gwen, Dempf Rupert, Schierle Hannes
Department of Oral and Maxillofacial Surgery, Medical University of Hannover, Hannover, Germany.
J Craniofac Surg. 2004 Jul;15(4):556-65. doi: 10.1097/00001665-200407000-00006.
Transport osteogenesis is a modified technique of callus distraction appropriate for the reconstruction of extended osseous defects of long or flat bones. The aim of this study was to determine the regenerative potential of this technique related to the degree of mobilization of the transport segment. In 10 adult sheep, critically sized defects of the calvaria were treated by gradual movement of a transport segment consisting of calvarial bone. The transport segments were either corticotomized (n = 5) or osteotomized (n = 5). The latency period was 5 days; the rate of distraction was 1 mm/d, extended for approximately 40 days. The consolidation period was 28 days. Specimens were investigated by conventional radiography, computed tomography scans, immunofluorescence, and histological examination. In both groups, transport osteogenesis resulted in a complete closure of the defect. The volume and thickness of newly formed bone at the defect site did not differ significantly between the groups, nor did the extent of vascularization. Bone formation and remodeling occurred during the entire period of distraction and consolidation. Osteotomized transport segments became smaller during distraction, whereas the volume of corticotomized segments remained relatively constant. In conclusion, transport osteogenesis resulted in reliable closure of extended skull defects in adult organisms; corticotomy and osteotomy of the transport segment led to a similar extent of bone formation.
运输性骨生成是一种改良的骨痂牵张技术，适用于长骨或扁骨大段骨缺损的重建。本研究的目的是确定该技术与运输段移动程度相关的再生潜力。在10只成年绵羊中，通过由颅骨组成的运输段的逐渐移动来治疗颅骨的临界尺寸缺损。运输段要么进行皮质切开术（n = 5），要么进行截骨术（n = 5）。潜伏期为5天；牵张速率为1毫米/天，持续约40天。巩固期为28天。通过传统放射学、计算机断层扫描、免疫荧光和组织学检查对标本进行研究。在两组中，运输性骨生成均导致缺损完全闭合。两组在缺损部位新形成骨的体积和厚度以及血管化程度方面均无显著差异。在整个牵张和巩固期间均发生骨形成和重塑。截骨的运输段在牵张过程中变小，而皮质切开的运输段体积保持相对恒定。总之，运输性骨生成能可靠地闭合成年生物体的颅骨大段缺损；运输段的皮质切开术和截骨术导致的骨形成程度相似。
