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高频快速牵引下的牵张反应。

Responses of distraction regenerate to high-frequency traction at a rapid rate.

机构信息

Discipline of Oral Diagnosis and Polyclinics, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.

出版信息

J Trauma Acute Care Surg. 2012 Apr;72(4):1035-9. doi: 10.1097/TA.0b013e31823cc867.

Abstract

BACKGROUND

Continuous traction is capable of creating an optimal biological environment for bone healing which may finally compensate for the rapid distraction rate in distraction osteogenesis. This study was designed to investigate the response of distraction callus to continuous distraction at a rapid rate using a rabbit model of mandibular lengthening.

METHODS

Thirty adult New Zealand white rabbits were randomly assigned to the intermittent (1 step/d) or continuous distraction (8 steps/s) group, with 15 in each. After osteotomy, manual-driven or autodriven distractor was adapted accordingly. The distraction was activated at a rate of 3.0 mm/d for 4 days. Five rabbits in each group were killed at week 2, week 4, and week 12 of consolidation, respectively. Plain radiography, microcomputed tomography, and histology examinations were used to evaluate the bone regeneration status.

RESULTS

Plain radiographs and histologic studies demonstrated more advanced bone healing in continuous distraction group than that in intermittent distraction group at all the examined time points. Quantitative microcomputed tomography analysis showed significantly higher bone volume in continuous distraction group at week 2 (p < 0.01) and week 4 (p < 0.05) of consolidation.

CONCLUSIONS

Continuous traction by autodriven distractor could be a promising clinical alternative to shorten the treatment course of distraction osteogenesis. Further studies to test its clinical potential using large animals that have similar metabolic rate and muscular resistance with human being are necessary.

摘要

背景

持续牵引能够为骨愈合创造最佳的生物学环境,从而最终弥补牵张成骨中快速牵张的不足。本研究旨在通过兔下颌骨延长模型,研究快速牵张率下连续牵引对牵张骨痂的反应。

方法

30 只成年新西兰白兔随机分为间歇(1 步/天)或连续(8 步/秒)牵引组,每组 15 只。截骨后,相应地采用手动或自动牵开器。以 3.0mm/d 的速度牵张 4 天。每组各有 5 只兔子分别在愈合的第 2、4 和 12 周处死。采用普通放射摄影、微计算机断层扫描和组织学检查来评估骨再生状态。

结果

普通放射摄影和组织学研究表明,在所有检查时间点,连续牵引组的骨愈合进展均优于间歇牵引组。定量微计算机断层扫描分析显示,在愈合的第 2 周(p<0.01)和第 4 周(p<0.05),连续牵引组的骨体积明显更高。

结论

自动牵开器的连续牵引可能是缩短牵张成骨治疗过程的一种有前途的临床替代方法。需要使用代谢率和肌肉阻力与人类相似的大型动物进一步研究其临床潜力。

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