Guédon C, de Vernejoul M C, Gehanno P, Veber F, Morineux C
Ann Otolaryngol Chir Cervicofac. 1984;101(4):313-8.
Most bone cells in homografts fail to survive, and several months are required before live bone tissue structures develop in the graft. Various attempts have been made to preserve or re-establish homograft vascularization. One method involves the use of free bone transfer with revascularization of the supply artery or the total periosteal network, this enabling the majority of the bone cells to survive. Another procedure uses osteomuscular transplants in which the muscle acts as a pedicle for the transplanted bone segment, but whether bone elements in these flaps remain viable is a very debatable point. Experimental and clinical studies were conducted to evaluate, histologically, the viability of bone after osteomuscular transplantation. Fluorescence examination of bone sections from 40 osteomuscular flaps in the rat demonstrated bone formation on the external cortical surface but marked diminution of endosteal moulding in other zones. Examination of bone biopsies from 10 patients treated by mandibular reconstitution using an osteomuscular flap provided data comparable with those obtained during the experimental study. These findings demonstrate that osteomuscular transplantation is responsible for endosteal ischemia, preventing survival of cells other than those lying most externally to the cortex.
同种异体移植物中的大多数骨细胞无法存活，需要数月时间移植物中才能形成有活性的骨组织结构。人们进行了各种尝试来保留或重建同种异体移植物的血管化。一种方法是进行带血管蒂的游离骨移植，使供应动脉或整个骨膜网络重新血管化，这能让大多数骨细胞存活。另一种方法是采用骨肌移植，其中肌肉作为移植骨段的蒂，但这些皮瓣中的骨成分是否仍具活力是一个极具争议的问题。开展了实验和临床研究，从组织学角度评估骨肌移植后骨的活力。对大鼠40个骨肌皮瓣的骨切片进行荧光检查显示，在皮质外表面有骨形成，但其他区域的骨内膜塑形明显减少。对10例采用骨肌皮瓣进行下颌骨重建治疗的患者的骨活检检查结果与实验研究中获得的数据相当。这些发现表明，骨肌移植会导致骨内膜缺血，从而阻止皮质最外层以外的细胞存活。
