Fink B, Krieger M, Schneider T, Menkhaus S, Fischer J, Rüther W
Orthopädische Klinik und Poliklinik, Heinrich-Heine-Universität Düsseldorf.
Unfallchirurg. 1995 Dec;98(12):633-9.
We evaluated the X-rays of 36 patients who underwent 50 callus distractions. With the aid of a computerized digitalisation system for analogue films, the relative X-ray density of the distraction area was calculated for each X-ray. These relative X-ray densities were figured graphically for the duration of treatment for each patient. In the consolidation phase, the graph of each patient had a logarithmic relationship. The gradients of the logarithmic density curves were considered an indicator of the quantity of new bone formation. These gradients were correlated to the following clinical parameters: age of the patient, beginning of distraction after corticotomy, average speed of distraction, average weight bearing during the distraction and consolidation phase, location of corticotomy (distal femur versus proximal tibia) and diclofenac medication. Except for the location of the corticotomy and diclofenac, all parameters had an influence on osteoneogenesis by callus distraction. The parameters affecting new bone formation the most were the age of the patient and weight bearing. Patients aged under 18 years (p = 0.005), beginning of distraction later than 8 days (p = 0.109), an average distraction speed below 1 mm/day (p = 0.079), and average weight bearing of more than 30 kg (p = 0.068 for the distraction phase and p = 0.089 for the consolidation phase) showed a quantitatively higher rate of new bone formation by callus distraction than the patients in the other groups. Patients with a shorter leg due to poliomyelitis and one patient with an amniotic leg tie showed a slower increase in X-ray density graphs than the other patients.
我们评估了36例接受50次骨痂牵张术患者的X线片。借助用于模拟胶片的计算机数字化系统,计算每张X线片上牵张区域的相对X线密度。针对每位患者,将这些相对X线密度在治疗期间以图形方式呈现出来。在骨痂巩固期,每位患者的图形呈对数关系。对数密度曲线的斜率被视为新骨形成量的一个指标。这些斜率与以下临床参数相关:患者年龄、截骨术后开始牵张的时间、平均牵张速度、牵张和巩固期的平均负重、截骨位置(股骨远端与胫骨近端)以及双氯芬酸用药情况。除了截骨位置和双氯芬酸外,所有参数均对骨痂牵张诱导的骨生成有影响。对新骨形成影响最大的参数是患者年龄和负重。18岁以下的患者(p = 0.005)、牵张开始时间晚于8天的患者(p = 0.109)、平均牵张速度低于1毫米/天的患者(p = 0.079)以及平均负重超过30千克的患者(牵张期p = 0.068,巩固期p = 0.089),其骨痂牵张诱导的新骨形成量在数量上高于其他组的患者。因小儿麻痹症导致腿部较短的患者以及1例有羊膜带束缚腿部的患者,其X线密度图的增加速度比其他患者慢。