Slimi Fathia, Bahri Awatef Hadj, Trigui Moez, Guidara Ahmed Racem, Ellouz Zoubeir, Rebai Tarek, Elfeki Hafed, Elfeki Abdelfatteh, Hassib Keskes, Samira Jebahi
Laboratory Cell Therapy and Experimental Surgery of Musculoskeletal System, University of Sfax, LR18SP11, Sfax, Tunisia.
Department of Orthopedic and Trauma Surgery, Military University Hospital of Sfax, Military University Hospital of Sfax, Sfax, Tunisia.
Eur J Orthop Surg Traumatol. 2025 Jun 24;35(1):277. doi: 10.1007/s00590-025-04357-7.
Distraction osteogenesis is an established surgical technique for bone lengthening. The procedure involves making osteotomies, in the bone and using a device to gradually separate, or "distract," the bone fragments. New Zealand white male rabbits underwent distraction osteogenesis on the right tibia and lengthening using external fixators at two different time points: a speed of 1.4 mm/day in 15 days and 2.1 mm/day in 10 days. Radiological analysis was used to determine the distraction osteogenesis rates during tibia lengthening in rabbits. The regenerated callus was carefully removed and subjected to biological and physicochemical analyses, such as scanning electron microscope (SEM), Fourier transform infrared spectroscopy (FTIR), and nuclear magnetic resonance (NMR) analyses. For both groups, quantitative radiography showed that the distraction-induced deficiency was filled over time in a consistent manner. However, the amount of the newly formed tissue in rabbits of the fast-lengthening group was less significant than that of the fast group. For five weeks, FTIR results showed that the mineral phases of the regenerated tissue of two groups were made up of biological apatite crystals, which are defined as carbonated calcium phosphate. The IR spectra confirmed the presence of phosphate (PO), hydroxyl (OH), and carbonate (CO) groups. NMR demonstrated that the PO group of the regenerated bone has practically a homogeneous and unique environment: chain PO-PO which represents the skeleton of the bone mineralization. SEM showed that at the same period of lengthening, endosteal surface evolved to a more homogeneous appearance similar to healthy bone. However, the fast-lengthening group presented a less homogeneous appearance, and a less hard cortical tissue formation; the Haversian aspect was incomplete. Histological analyses demonstrated that ossification took place according to three modalities: endochondral, endoconjunctive, and transchondroid. In conclusion, the bone rearrangement during rapid lengthening is delayed, while for the slow lengthening group, the regenerated bone is strongly ossified. The lamellae are organized into concentric circles, which surround a vertical Haversian canal.
牵张成骨术是一种成熟的骨延长手术技术。该手术包括在骨中进行截骨，并使用一种装置逐渐分离或“牵张”骨碎片。新西兰雄性白兔在两个不同时间点对右胫骨进行牵张成骨术并使用外固定器延长：15天内以1.4毫米/天的速度和10天内以2.1毫米/天的速度。采用放射学分析来确定兔胫骨延长过程中的牵张成骨率。小心地取出再生骨痂并进行生物学和物理化学分析，如扫描电子显微镜（SEM）、傅里叶变换红外光谱（FTIR）和核磁共振（NMR）分析。对于两组，定量放射照相显示牵张引起的缺损随时间以一致的方式被填充。然而，快速延长组兔子中新形成组织的量比快速组的少。五周内，FTIR结果显示两组再生组织的矿物相均由生物磷灰石晶体组成，其被定义为碳酸磷酸钙。红外光谱证实了磷酸根（PO）、羟基（OH）和碳酸根（CO）基团 的存在。NMR表明再生骨的PO基团实际上具有均匀且独特的环境：代表骨矿化骨架的链状PO-PO。SEM显示在延长的同一时期，骨内膜表面演变成更均匀的外观，类似于健康骨骼。然而，快速延长组呈现出较不均匀的外观，皮质组织形成较软；哈弗斯系统方面不完整。组织学分析表明骨化通过三种方式发生：软骨内成骨、骨内联合成骨和经软骨成骨。总之，快速延长过程中的骨重塑延迟，而对于缓慢延长组，再生骨强烈骨化。骨板组织成同心圆，围绕着垂直的哈弗斯管。
