分析单侧牵引成骨术后下颌骨的生物力学特性。
Analysis of the biomechanical properties of the mandible after unilateral distraction osteogenesis.
机构信息
Ann Arbor, Mich. From the University of Michigan Medical School.
出版信息
Plast Reconstr Surg. 2010 Aug;126(2):533-542. doi: 10.1097/PRS.0b013e3181de2240.
BACKGROUND
The purpose of this study was to establish biomechanical outcomes measures to evaluate how mandibular distraction osteogenesis affects the overall quality of bone healing. Strength and functional integrity of the regenerate were determined quantitatively after unilateral mandibular distraction osteogenesis in comparison with the contralateral mandible and a partially reduced fracture. The authors hypothesized that the breaking load, yield, and stiffness of mandibular distraction osteogenesis would be significantly reduced in comparison with both the contralateral mandible and a partially reduced fracture.
METHODS
Sprague-Dawley rats underwent mandibular distraction osteogenesis (n = 8) or a partially reduced fracture (n = 6). Distraction was performed using 4 days' latency and then 0.3 mm every 12 hours for 8 days (5.1 mm). Partially reduced fractures had gaps fixed postoperatively at 2.1 mm. Both groups underwent 4 weeks of consolidation. The contralateral mandibles were used as controls (n = 14). Mandibles were tension tested at 0.5 mm/second to failure, and then breaking load, yield, and stiffness were determined.
RESULTS
Mandibular distraction osteogenesis had significantly lower breaking load, yield, and stiffness than contralateral mandible, by 40, 30, and 60 percent, respectively. Breaking load was reduced in partially reduced mandibular fractures by 40 percent when compared with distraction osteogenesis.
CONCLUSIONS
Using a standard Ilizarov protocol, the biomechanical properties of breaking load, yield, and stiffness in mandibular distraction osteogenesis were significantly lower than those in contralateral mandibles. Surprisingly, the breaking load of mandibular distraction osteogenesis was significantly greater than that of partially reduced mandibular fracture. These verifiable metrics of regenerate integrity can be used to discern optimal outcomes of mandibular distraction osteogenesis, potentially enhancing the clinical applications of this powerful technique.
背景
本研究旨在建立生物力学评估指标，以评估下颌骨牵引成骨术如何影响整体骨愈合质量。通过单侧下颌骨牵引成骨术与对侧下颌骨和部分复位骨折进行比较，定量测定再生骨的强度和功能完整性。作者假设，与对侧下颌骨和部分复位骨折相比，下颌骨牵引成骨术的断裂载荷、屈服和刚度会显著降低。
方法
Sprague-Dawley 大鼠行下颌骨牵引成骨术（n = 8）或部分复位骨折（n = 6）。牵引采用 4 天潜伏期，然后 0.3mm 每 12 小时 8 天（5.1mm）。部分复位骨折术后固定间隙为 2.1mm。两组均行 4 周愈合期。对侧下颌骨作为对照（n = 14）。下颌骨以 0.5mm/秒的速度拉伸至断裂，然后测定断裂载荷、屈服和刚度。
结果
与对侧下颌骨相比，下颌骨牵引成骨术的断裂载荷、屈服和刚度分别降低了 40%、30%和 60%。与牵引成骨术相比，部分复位下颌骨骨折的断裂载荷降低了 40%。
结论
使用标准的 Ilizarov 方案，下颌骨牵引成骨术的断裂载荷、屈服和刚度的生物力学性能明显低于对侧下颌骨。令人惊讶的是，下颌骨牵引成骨术的断裂载荷明显大于部分复位下颌骨骨折。这些可验证的再生完整性度量标准可用于辨别下颌骨牵引成骨术的最佳结果，从而有可能增强该强大技术的临床应用。
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