Acute shortening followed by distraction osteogenesis for limb reconstruction

Acute limb shortening to close diaphyseal bone defects after trauma or resection of infected, necrotic or tumor bone may allow early bridging through the approximated fragments [1] [3] [6]. After acute limb shortening, a second operation including a corticotomy for distraction osteogenesis in the metaphyseal area is usually performed [2] [3] [4]. The value of primary limb shortening and secondary distraction osteogenesis from the shortening site to treat diaphyseal bone defects has not been experimentally investigated. Such a proce¿dure, however, would strongly undermine the established principles we learned from Ilizarov. This study was aimed to characterize the properties of regener¿ated bone through acute short¿ening and gradual lengthening in comparison to simple lengthening proced¿ures using the same rabbit model. Mechanical prop¿erties of the biomechanical environment of this model were evaluated and standardized earlier [5]. Different parameters of this method were compared to the simple lengthening procedure. New bone formation was evaluated mechanically, radiologically, by his¿tomorphometry and densitometry. Compartment pressure and muscle function were monitored.

References

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