Guerrissi J, Ferrentino G, Margulies D, Fiz D
Division of Plastic Surgery, Hospital Cosme Argerich, Buenos Aires, Argentina.
J Craniofac Surg. 1994 Nov;5(5):313-7. doi: 10.1097/00001665-199411000-00010.
The purpose of this experimental work was to lengthen the mandible in rabbits by means of distraction osteogenesis. The excellent results on the lengthening of the extremities with the Ilizarov technique and the unpredictable results in the mobilization of the facial bones by means of osteotomies and grafts are reasons for the application of the gradual distraction method in mandibular lengthening. Bone lengthening was first performed in 1905; but Ilizarov rekindled interest in 1951 when he induced bone neoformation in the extremities by the distraction technique using multiplanar wires and external circular fixators. We lengthened the mandible in 12 New Zealand adult rabbits using different mountings of the Ilizarov apparatus by means of two fixation techniques: transfixion and nontransfixion. In the transfixion group (6 rabbits), the two wires were passed through both mandibular rami. In this group, a 2-cm lengthening was obtained. In the nontransfixion group (6 rabbits), only one mandibular ramus was included with the transfixion wires. In this group, 1-cm lengthening was achieved. Unilateral lengthening was obtained with the nontransfixion technique and the lengthening of both rami with the transfixion technique. The results were evaluated by clinical periodic postoperative radiographs and histological studies of newly formed bone and surrounding soft tissues (masticatory muscles, arteries, and so on). The results demonstrated that lengthening of the mandible is obtained by means of a mature and normal new bone that is produced in the osteotomized area.
本实验研究的目的是通过牵张成骨术延长兔下颌骨。利用伊里扎洛夫技术延长四肢取得了优异成果，而通过截骨术和植骨术来移动面部骨骼的结果却不可预测，这些因素促使人们将渐进性牵张方法应用于下颌骨延长。骨延长术最早于1905年开展；但伊里扎洛夫在1951年重新激发了人们的兴趣，当时他采用多平面金属丝和外固定环架，通过牵张技术诱导四肢骨形成新骨。我们采用两种固定技术，即贯穿固定和非贯穿固定，使用不同安装方式的伊里扎洛夫器械，对12只成年新西兰兔的下颌骨进行延长。在贯穿固定组（6只兔）中，两根金属丝穿过双侧下颌支。该组实现了2厘米的延长。在非贯穿固定组（6只兔）中，金属丝仅穿过一侧下颌支。该组实现了1厘米的延长。非贯穿固定技术实现了单侧延长，贯穿固定技术实现了双侧下颌支的延长。通过术后定期的临床X光片以及对新形成骨和周围软组织（咀嚼肌、动脉等）的组织学研究对结果进行评估。结果表明，下颌骨延长是通过在截骨区域产生的成熟且正常的新骨实现的。
