Preliminary Studies of Mineralization During Distraction Osteogenesis

Aronson, James; Good, Barry; Stewart, Charles L.; Harrison, Barry H.; Harp, John H.

doi:10.1097/00003086-199001000-00006

Cited by 204 publications

(128 citation statements)

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“…In their study. the fixator used was ;I rigid unilateral frame and the lag period befure distraction was 10 days instead of the 7 days used i n other studies (Aronson et al 1990. Delloye et al 1900.…”

Section: Discussionmentioning

confidence: 99%

Early bone matrix formation during distraction: A biochemical study in sheep

Kallio

Vauhkonen

Peltonen

et al. 1994

SORT

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Section: Discussionmentioning

confidence: 99%

Early bone matrix formation during distraction: A biochemical study in sheep

Kallio

Vauhkonen

Peltonen

et al. 1994

SORT

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“…The site of the osteotomy also influences callus formation. Fewer complications were observed when the osteotomy was metaphyseal (1,4,7,9,13,(15)(16)(17)(18); this seems to be related to the presence of spongy bone, which consolidates easily; the existence of fewer muscular insertions; and the fact that less damage is done to the vascularization, particularly the medullary artery, which is highly ramified at this point. The latter has been demonstrated by angiographic studies (2,15), which show that diaphyseal corticotomy interrupts the endomedullary vessels in 90% of cases.…”

Section: Discussionmentioning

confidence: 96%

“…The osteotomy should be performed in the least traumatic way possible, with conservation of the periosteum, medullary vascularization, and soft tissues: these are important factors in the formation of high-quality callus, as has been shown in various experimental and clinical reports (1,2,6,12,14,16,17,19,23,25). The site of the osteotomy also influences callus formation.…”

Section: Discussionmentioning

confidence: 96%

Relationship Between Radiologic Morphology of the Bone Lengthening Formation and Its Complications

Forriol¹,

Iglesias²,

Arias³

et al. 1999

Journal of Pediatric Orthopaedics, Part B

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SUMMARYThe objective was to study the different types of lengthened bone regeneration and their development during the various phases of the process to correlate them with patient factors and the surgical technique used, and to establish a possible relation between the development of the bone lengthening formation and the problems or complications. The authors studied the radiographs of a random group of 55 patients taken at three points during the course of treatment. The callus was classified with regard to its transverse diameter and the presence or absence of hypodense areas. The overall callus type was significantly influenced by the etiology, the osteotomy site, and the percentage lengthened. The percentage by which the limb was lengthened at the beginning of the process influences the overall morphology of the callus. Poor callus had been lengthened the most, atrophic callus the least. There was a correlation between the morphology of the overall callus at the end of treatment and the percentage lengthened, and between the percentage lengthened and the presence of bands at the end of treatment. The authors also found a significant correlation between age and the appearance of bands at the end of distraction. A central band was found among younger patients. The type of osteotomy affected the overall callus at the end of distraction and at the end of treatment and also influenced the transverse diameter. All the elongations with poor bone formation at the end of treatment were found to have undergone a diaphyseal osteotomy. The most common complication at the first follow-up and at the end of distraction was angulation. The diameter of the callus and the presence of bands at the end of treatment were significantly related to the complications. Fracture occurred in the first 2 weeks after removal of the external fixator in 88% of cases and in the third and fourth week in the rest. However, the segment had no significant influence on the appearance of complications. Lengthened callus with incomplete trabecular formations and hypodense areas at the end of the treatment has a high risk of fracture at the end of treatment. Callus with axial deviation, hypodense areas, or an insufficient transverse diameter during the lengthening procedure must be manipulated so that it reaches the maturing phase in better condition.

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“…Quantitative methods for evaluation of bone volume and mineral content include dual-energy X-ray absorptiometry (DEXA) and quantitative computed tomography (QCT). These techniques quantify the absolute value or changes in bone mineral density compared to standards, and both DEXA [16,22,30,33] and QCT [2,3,18,26] have been used during the distraction and consolidation periods. However, these techniques (especially QCT) may involve large radiation doses to the patient.…”

mentioning

confidence: 99%

In vivo assessment of regenerate axial stiffness in distraction osteogenesis

Aarnes

Steen

Ludvigsen

et al. 2005

Journal Orthopaedic Research

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This paper presents an in vivo test for assessment of regenerate axial stiffness after the distraction phase of lengthening therapy. The test result supplements radiography in evaluating bone healing and assists in determining when the regenerate stiffness is sufficient for removal of the external fixator. The test is non-invasive and does not require fixator removal. The theoretical basis for the method is that an externally applied load is shared between the fixator and the regenerating bone. The amount of load carried by the regenerate depends on its axial stiffness, which increases with advanced mineralization. By measuring the force in the fixator while applying a known external load to the limb, the load-share ratio between fixator and limb can be assessed. A load-share ratio of 100% indicates that the entire load is carried by the fixator. The ratio decreases as the regenerate structure gradually stiffens. In a clinical trial of 22 individuals with tibia1 lengthening, the fixator was removed when the load-share ratio dropped below 100/0. None of the patients experienced fracture after removal of the fixator.

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Preliminary Studies of Mineralization During Distraction Osteogenesis

Cited by 204 publications

References 0 publications

Early bone matrix formation during distraction: A biochemical study in sheep

Early bone matrix formation during distraction: A biochemical study in sheep

Relationship Between Radiologic Morphology of the Bone Lengthening Formation and Its Complications

In vivo assessment of regenerate axial stiffness in distraction osteogenesis

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