Albanese S A, Spadaro J A, Chase S E, Geel C W
Department of Orthopedic Surgery, S.U.N.Y., Syracuse 13202, USA.
J Orthop Res. 1996 Nov;14(6):921-6. doi: 10.1002/jor.1100140612.
The factors leading to overgrowth following fixation of long-bone fractures in children have never been clearly understood. The amount of trauma and the type of fixation may play a role. A rabbit model was used to investigate the influence of a femoral osteotomy and plate fixation on subsequent growth. Unilateral midshaft femoral osteotomy was performed in 6-week-old rabbits, and the bone was fixed internally with a plate and screws. End-to-end reduction was performed either at full length or with a segment removed. Bone length measurements at the end of growth revealed no significant difference in growth between the control femur and the femur that had undergone osteotomy and plate fixation. Shortened plated femora also showed no tendency to grow longer or faster than full-length fixed femora or controls. Interestingly, in the ipsilateral tibia a small but statistically significant length increase, equivalent to about 2% increase in additional growth, was observed, whereas technetium-99 methylene diphosphonate uptake was reduced in the tibial physes. In the context of the rabbit experimental model chosen, these results suggest that significant femoral over-growth does not occur following femoral osteotomy and plate fixation.
儿童长骨骨折固定后导致过度生长的因素从未被完全理解。创伤程度和固定类型可能起一定作用。采用兔模型研究股骨截骨和钢板固定对后续生长的影响。对6周龄兔子进行单侧股骨干中段截骨，并用钢板和螺钉进行内固定。在全长或去除一段后进行端端复位。生长结束时的骨长度测量显示，对照股骨与接受截骨和钢板固定的股骨之间的生长无显著差异。缩短的钢板固定股骨也没有比全长固定股骨或对照股骨生长得更长或更快的趋势。有趣的是，在同侧胫骨中观察到有小幅但具有统计学意义的长度增加，相当于额外生长约2%，而胫骨骨骺的锝-99亚甲基二膦酸盐摄取减少。在所选择的兔实验模型背景下，这些结果表明股骨截骨和钢板固定后不会发生明显的股骨过度生长。
