Ozerdem O R, Kivanç O, Tuncer I, Acartürk S, Göcenler L, Gümürdülü D
Division of Plastic and Reconstructive Surgery, School of Medicine, Cukurova University, Adana, Turkey.
Ann Plast Surg. 1998 Aug;41(2):148-55. doi: 10.1097/00000637-199808000-00006.
Bone lengthening by slow, progressive distraction has gained widespread acceptance. In this study we investigated the possibility of distraction osteogenesis in nonvascularized periosteal bone grafts, and assessed callus formation and callotasis by means of radiological and histological examination with the aim of determining the role of the periosteum. The process of distraction osteogenesis in nonvascularized bone grafts was studied histologically and radiologically in 22 growing rabbits. The metatarsal bone grafts taken from the rabbits were divided into two groups. Group 1 contained 15 bone grafts covered with periosteum and group 2 (the control group) contained 7 bone grafts without periosteum. These grafts were subjected to osteotomy and then placed in the lumbar pocket. After 10 days, distraction was started and continued at 0.5 mm per day for 10 days. Thus an elongation of 4 to 6 mm was achieved in both groups. Radiological examination was performed postoperatively and after 10, 15, 20, and 30 days of starting the distraction. Histological examination was performed after 15, 20, and 30 days. Radiologically, progressive calcification and, histologically, both intramembranous and endochondral ossification were detected in group 1. However, in the control group (group 2), bone lengthening failed. Our study demonstrated the possibility of distraction osteogenesis in periosteal bone grafts, and provides information regarding the importance of periosteum as well as its osteogenic capacity.
通过缓慢、渐进性牵张进行骨延长已得到广泛认可。在本研究中，我们调查了非血管化骨膜骨移植中牵张成骨的可能性，并通过放射学和组织学检查评估骨痂形成和骨痂延长情况，旨在确定骨膜的作用。对22只生长中的兔子的非血管化骨移植中的牵张成骨过程进行了组织学和放射学研究。取自兔子的跖骨移植被分为两组。第1组包含15个覆盖有骨膜的骨移植，第2组（对照组）包含7个无骨膜的骨移植。这些移植进行截骨术，然后置于腰窝处。10天后开始牵张，并以每天0.5毫米的速度持续10天。因此两组均实现了4至6毫米的延长。术后以及开始牵张后10、15、20和30天进行放射学检查。在15、20和30天后进行组织学检查。在放射学上，第1组检测到渐进性钙化，在组织学上，检测到膜内成骨和软骨内成骨。然而，在对照组（第2组）中，骨延长失败。我们的研究证明了骨膜骨移植中牵张成骨的可能性，并提供了有关骨膜的重要性及其成骨能力的信息。
