Hassanein Aladdin H, Couto Rafael A, Mulliken John B, Rogers Gary F, Greene Arin K
Department of Plastic and Oral Surgery, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts 02115, USA.
J Craniofac Surg. 2012 Sep;23(5):1499-501. doi: 10.1097/SCS.0b013e31824e6419.
Particulate bone graft (PBG) heals calvarial critical-size defects and is procured from the cranium with a hand-driven bit and brace. The donor sites ossify, and thus PBG potentially could be reharvested from the original areas. The purpose of this study was to determine if PBG obtained from a healed donor site is effective for inlay cranioplasty. A 17 × 17-mm critical-size defect was created in the parietal bones of 8 rabbits and treated with either no implant (group 1) or PBG harvested from the frontal bone (group 2). In 4 animals (group 3), a parietal defect was not created initially; PBG was harvested from the frontal bone and then discarded. Sixteen weeks later after the PBG donor sites had healed, a 17 × 17-mm parietal defect was made and filled with PBG reharvested from the previous donor area. Animals underwent micro-computed tomography 16 weeks after inlay cranioplasty. Critical-size defects in controls (group 1) exhibited partial ossification (35.1% ± 10.5%) compared with those treated with PBG (group 2) (99.1% ± 1.5%) or reharvested PBG (group 3) (99.3% ± 1.5%) (P = 0.02). No difference was found between groups 2 and 3 (P = 0.69). Bony thickness was similar in defects implanted with PBG (1.8 mm ± 1.1 mm) or reharvested PBG (2.1 mm ± 0.5 mm) (P = 0.68). Particulate bone graft reharvested from healed donor sites ossifies inlay cranial defects. Because the donor area for PBG is of partial thickness and less than critical size, reparative osteogenesis theoretically allows an unlimited supply of autologous bone for inlay cranioplasty using PBG.
颗粒骨移植（PBG）可修复颅骨临界尺寸缺损，通过手动钻头和支架从颅骨获取。供区会骨化，因此PBG有可能从原区域再次获取。本研究的目的是确定从愈合的供区获取的PBG用于镶嵌颅骨成形术是否有效。在8只兔子的顶骨上制作一个17×17毫米的临界尺寸缺损，一组不植入任何材料（第1组），另一组用从额骨获取的PBG治疗（第2组）。4只动物（第3组）最初不制作顶骨缺损；从额骨获取PBG后丢弃。PBG供区愈合16周后，制作一个17×17毫米的顶骨缺损，并用从先前供区再次获取的PBG填充。镶嵌颅骨成形术后16周对动物进行微型计算机断层扫描。与用PBG治疗的组（第2组，99.1%±1.5%）或再次获取的PBG治疗的组（第3组，99.3%±1.5%）相比，对照组（第1组）的临界尺寸缺损显示部分骨化（35.1%±10.5%）（P = 0.02）。第2组和第3组之间未发现差异（P = 0.69）。植入PBG的缺损（1.8毫米±1.1毫米）和再次获取的PBG植入的缺损（2.1毫米±0.5毫米）的骨厚度相似（P = 0.68）。从愈合的供区再次获取的颗粒骨移植可使镶嵌颅骨缺损骨化。由于PBG的供区为部分厚度且小于临界尺寸，理论上修复性骨生成可为使用PBG的镶嵌颅骨成形术提供无限量的自体骨供应。
