Kucukdeveci Oguz, Sarisozen Bartu, Atici Teoman, Ozcan Resat
Department of Orthopaedics and Traumatology, Uludag University Faculty of Medicine, Bursa, Turkey.
J Trauma. 2009 Dec;67(6):1376-83. doi: 10.1097/TA.0b013e3181b063f8.
Tobacco smoke contains more than 4,000 constituents, but not all of them are reported to have adverse effects on bone healing after distraction osteogenesis. No research on the systemic administration of nicotine has been done on distraction osteogenesis of the weight-bearing long bones of the lower extremity.
Fourteen New Zealand white male rabbits underwent distraction osteogenesis on the right tibia and lengthening by 1 cm. Transdermal nicotine bands were applied onto the dorsal skin of the rabbits in the study group. Mineral density of the distraction zone was measured at weekly intervals using quantitative computerized tomography. Mechanical properties were assessed by torsional loading, and the regenerated bone tissue was subjected to histopathological examination.
Comparisons of weekly measurements in both groups showed that while the increase in bone density in the nicotine group was higher, relative to the initial values, it was still far behind the average density obtained in the control group at the end of the experiment. Statistical analysis of mechanical data showed significant differences in the gradient of the regression lines and maximum torsional angles between the two groups. The histopathological assessments showed noticeable neovascularization in the study group, which was concluded to be a compensatory mechanism for the negative delaying effect of nicotine on bone healing.
Systemic administration of nicotine can cause delays in the process of healing in distraction osteogenesis by its negative effect on the mineralization of the regenerate. Patients should be made aware of this negative impact of nicotine before the limb-lengthening surgery.
烟草烟雾含有4000多种成分，但并非所有成分都被报道对牵张成骨术后的骨愈合有不良影响。尚未对下肢负重长骨的牵张成骨进行尼古丁全身给药的研究。
14只新西兰雄性白兔在右胫骨进行牵张成骨并延长1厘米。研究组将经皮尼古丁带贴于兔背部皮肤。每周使用定量计算机断层扫描测量牵张区的矿物质密度。通过扭转加载评估力学性能，并对再生骨组织进行组织病理学检查。
两组每周测量结果的比较表明，虽然尼古丁组的骨密度相对于初始值增加较高，但仍远低于实验结束时对照组获得的平均密度。力学数据的统计分析显示，两组之间回归线的斜率和最大扭转角度存在显著差异。组织病理学评估显示研究组有明显的新生血管形成，这被认为是尼古丁对骨愈合的负面延迟作用的一种代偿机制。
尼古丁全身给药可因其对再生骨矿化的负面影响而导致牵张成骨愈合过程延迟。在肢体延长手术前，应让患者了解尼古丁的这种负面影响。
