Huang S C
Department of Orthopedic Surgery, National Taiwan University Hospital, Taipei, ROC.
J Formos Med Assoc. 1997 Jun;96(6):429-34.
Callus distraction is currently the most widely used technique for limb lengthening. Prolonged treatment time is its main shortcoming. In this study, we tested the effectiveness of electrical stimulation during various stages of lengthening in order to decrease the treatment time. Seventy-five New Zealand white rabbits, about 2 kg in body weight, were divided into five groups. All groups received single level tibial lengthening of 1 cm by callotasis using a mini-lengthener. Group 1 rabbits did not receive electrical stimulation and could move freely in their cages. Group 2 rabbits (sham control), with electrodes on their left legs, were restrained on a wooden frame for 8 hours every day without electrical stimulation. Group 3 rabbits received capacitively coupled electrical stimulation, 60 kHz, 500 mV, on the left leg for 8 hours every day during the distraction period. Group 4 rabbits received electrical stimulation during the neutralization period. Group 5 rabbits received electrical stimulation during both the distraction and neutralization period. All rabbits were restrained during electrical stimulation. Weekly radiographs were taken to determine the time of appearance of at least three neocortices in the lengthening callus. At that time, the fixators were removed. The healing indexes (total time in fixator divided by length gained, days/cm) in the five groups of rabbits were compared. The range of motion of the ipsilateral knees and ankles and complications of treatment were recorded. The results showed that electrical stimulation applied during leg lengthening by callus distraction can significantly reduce the treatment time and the healing indexes, but the electrical stimulation may contribute to decreased motion in the ipsilateral knee and ankle joints.
骨痂牵张术是目前肢体延长最广泛使用的技术。治疗时间长是其主要缺点。在本研究中，我们测试了延长各阶段电刺激的有效性，以缩短治疗时间。75只体重约2kg的新西兰白兔被分为五组。所有组均使用微型延长器通过骨痂牵张术进行单节段胫骨延长1cm。第1组兔子未接受电刺激，可在笼中自由活动。第2组兔子（假手术对照组）左腿放置电极，每天在木架上固定8小时，不进行电刺激。第3组兔子在牵张期每天左腿接受电容耦合电刺激，频率60kHz，电压500mV，持续8小时。第4组兔子在中和期接受电刺激。第5组兔子在牵张期和中和期均接受电刺激。所有兔子在电刺激期间均被固定。每周拍摄X线片以确定延长骨痂中至少三个新皮质出现的时间。此时，拆除固定器。比较五组兔子的愈合指数（固定器总时间除以延长长度，天/cm）。记录同侧膝关节和踝关节的活动范围及治疗并发症。结果表明，骨痂牵张术肢体延长期间施加电刺激可显著缩短治疗时间和愈合指数，但电刺激可能导致同侧膝关节和踝关节活动度降低。
