Ozerdem O R, Yavuz M, Kivanç O, Acartürk S, Tuncer I, Kibar M
Department of Plastic and Reconstructive Surgery, Cukurova Universitesi, Adana, Turkey.
Ann Plast Surg. 1999 Jan;42(1):76-82.
The basis of lengthening bones at their anatomic locations has been defined in detail by many authors. The possibility of distraction osteogenesis in vascularized bone grafts and the role of periosteum was investigated in 35 growing New Zealand White rabbits in four experimental groups: group 1, the scintigraphic assessment group (N = 4); group 2, the distraction group with intact periosteum (N = 15); group 3, the control group without periosteum in the distraction area (N = 6); and group 4, the control group in which the flaps were wrapped in silicone leaves (N = 10). Scintigraphy was used to evaluate the survival of the bone graft. Metatarsal fasciosteal flaps were fixed by external fixators and then subjected to osteotomy. Distraction was started after 10 days of osteotomy and continued at 0.5 mm/24 hr for 10 days, with a total elongation of 4 to 6 mm. Radiological examination at day 10 of starting the distraction, and both radiological and histological examinations at days 15, 20, and 30 were performed. In group 1, positive scintigraphic images of the flaps were obtained. In group 2, progressive calcification was detected radiologically and mixed-type ossification was observed histologically. However, in group 3, distraction failed. Group 4 was excluded from the study due to silicone exposition. The authors demonstrated that vascularized bone segments can be lengthened, and provided information about the importance of periosteum in distraction osteogenesis.
许多作者已详细阐述了在骨骼解剖位置进行延长的基础。在35只生长中的新西兰白兔身上，分四个实验组研究了带血管蒂骨移植中牵张成骨的可能性以及骨膜的作用：第1组为闪烁扫描评估组（N = 4）；第2组为骨膜完整的牵张组（N = 15）；第3组为牵张区域无骨膜的对照组（N = 6）；第4组为皮瓣用硅胶片包裹的对照组（N = 10）。采用闪烁扫描评估骨移植的存活情况。跖筋膜骨膜瓣用外固定器固定，然后进行截骨术。截骨术后10天开始牵张，以0.5 mm/24小时的速度持续牵张10天，总延长4至6 mm。在开始牵张后的第10天进行放射学检查，并在第15、20和30天进行放射学和组织学检查。在第1组中，获得了皮瓣的阳性闪烁扫描图像。在第2组中，放射学检查发现有进行性钙化，组织学观察到混合型骨化。然而，在第3组中，牵张失败。由于硅胶暴露，第4组被排除在研究之外。作者证明了带血管蒂的骨段可以延长，并提供了有关骨膜在牵张成骨中重要性的信息。
