Cai Gang, Saleh Michael, Coulton Les, Yang Lang
Academic Unit of Orthopaedic and Traumatic Surgery, Division of Clinical Sciences, University of Sheffield, Northern General Hospital, Sheffield S5 7AU, UK.
Clin Biomech (Bristol). 2004 Aug;19(7):733-7. doi: 10.1016/j.clinbiomech.2004.05.001.
Distraction-resisting force is generated in the soft tissues and callus during limb lengthening. Monitoring this force may offer a method of studying the behaviour of soft tissue and detecting the distraction osteogenesis related problems, and help to prevent complications. Changes in the post distraction period have not been previously investigated and there are no reports on the contribution of gastrocnemius to the distraction-resisting force.
Sixteen immature New Zealand White rabbits underwent 30% (left) tibial diaphyseal lengthening at a rate of two 0.4 mm increments per day. Using an instrumented bilateral fixator, the passive distraction-resisting force and the contribution made by gastrocnemius were measured at the end of lengthening and 5 weeks after lengthening.
The distraction-resisting force at the end of lengthening (mean 44 N (SD 10)) was statistically higher (p < 0.01) than that five weeks after lengthening (mean 20 N (SD 8)), so was the contribution of the gastrocnemius to the force (mean 11 N (SD 5 N) or 25% (SD 7) at the end of lengthening and 3 N (SD 1) or 13% (SD 5.2) five weeks later).
The callus rather than the surrounding muscles generates most of the passive DRF and its share of the force increased during consolidation period.
肢体延长过程中,软组织和骨痂会产生抗牵张阻力。监测这种力量可能提供一种研究软组织行为和检测牵张成骨相关问题的方法,并有助于预防并发症。此前尚未对牵张后阶段的变化进行研究,也没有关于腓肠肌对抗牵张阻力贡献的报道。
16只未成熟的新西兰白兔接受了30%(左侧)胫骨干延长,每天以两次0.4毫米的增量进行。使用带仪器的双侧固定器,在延长结束时和延长后5周测量被动抗牵张阻力以及腓肠肌的贡献。
延长结束时的抗牵张阻力(平均44牛(标准差10))在统计学上高于延长后5周(平均20牛(标准差8))(p<0.01),腓肠肌对该力量的贡献也是如此(延长结束时平均11牛(标准差5牛)或25%(标准差7),5周后为3牛(标准差1)或13%(标准差5.2))。
骨痂而非周围肌肉产生了大部分被动抗牵张阻力,并且在骨痂巩固期其在力量中的占比增加。