Lascombes P, Membre H, Prévot J, Barrat E
Clinique Chirurgicale Infantile Orthopédique, Hôpital d'Enfants de Nancy, Vandoeuvre-les-Nancy.
Rev Chir Orthop Reparatrice Appar Mot. 1991;77(3):141-50.
Eleven biopsies of bone regenerate during bone lengthening following the Ilizarov technique were studied. They concerned 10 patients with a mean age of 13.5 years. The length of the biopsied regenerate was between 14 and 90 mm, and the delay after the initial procedure was 23 to 502 days. The aim of this study was to get informations on the histology of the regenerate, to quantify osseous data and to propose a surgical strategy. These data were obtained by analyze of non decalcified bone, biopsies were included in a methylmetacrylate block. Measure of the mineralisation speed was determined after a double intake of tetracycline. The bony trabeculations were formed very early, as soon as the third week. They were placed like a thread, that means in an anastomotic system which can quickly become resistant. But is was necessary to keep a lengthening speed under 1 mm per day 0.7 to 0.8 mm per day seems to be the best speed in adolescents. The ossification was of membranous type, without cartilaginous stage. Osteoblastic and osteoclastic activities were extremely rich, even after one year or after the bone healing. The main point was the maturity of the regenerate acquired as soon as the 4th month.
对采用伊里扎洛夫技术进行骨延长过程中的11块骨再生活检组织进行了研究。这些活检组织来自10名平均年龄为13.5岁的患者。活检再生组织的长度在14至90毫米之间,初次手术后的间隔时间为23至502天。本研究的目的是获取有关再生组织组织学的信息,量化骨数据并提出手术策略。这些数据通过对未脱钙骨的分析获得,活检组织被包埋在甲基丙烯酸甲酯块中。在两次摄入四环素后测定矿化速度。骨小梁在第三周就很早就形成了。它们呈线状排列,也就是说在一个能迅速变得坚固的吻合系统中。但有必要将延长速度保持在每天1毫米以下,对于青少年来说,每天0.7至0.8毫米似乎是最佳速度。骨化是膜性类型,没有软骨阶段。即使在一年后或骨愈合后,成骨细胞和成骨破骨细胞的活动也极其丰富。关键在于在第4个月时再生组织就获得了成熟。