Distraction-resisting force during tibial diaphyseal lengthening and consolidation--a study on a rabbit model.

Clin Biomech (Bristol)

Academic Unit of Orthopaedic and Traumatic Surgery, Division of Clinical Sciences, University of Sheffield, Northern General Hospital, Sheffield S5 7AU, UK.

Published: August 2004

Background: Distraction-resisting force is generated in the soft tissues and callus during limb lengthening. Monitoring this force may offer a method of studying the behaviour of soft tissue and detecting the distraction osteogenesis related problems, and help to prevent complications. Changes in the post distraction period have not been previously investigated and there are no reports on the contribution of gastrocnemius to the distraction-resisting force.

Methods: Sixteen immature New Zealand White rabbits underwent 30% (left) tibial diaphyseal lengthening at a rate of two 0.4 mm increments per day. Using an instrumented bilateral fixator, the passive distraction-resisting force and the contribution made by gastrocnemius were measured at the end of lengthening and 5 weeks after lengthening.

Findings: The distraction-resisting force at the end of lengthening (mean 44 N (SD 10)) was statistically higher (p < 0.01) than that five weeks after lengthening (mean 20 N (SD 8)), so was the contribution of the gastrocnemius to the force (mean 11 N (SD 5 N) or 25% (SD 7) at the end of lengthening and 3 N (SD 1) or 13% (SD 5.2) five weeks later).

Interpretation: The callus rather than the surrounding muscles generates most of the passive DRF and its share of the force increased during consolidation period.

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http://dx.doi.org/10.1016/j.clinbiomech.2004.05.001DOI Listing

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Article Synopsis
  • The study investigates whether valgus angulation develops during tibial lengthening using the lengthening over nail (LON) technique, contrasting it with the classic Ilizarov method, which is known to produce such deformation due to soft tissue forces.
  • It involved a retrospective analysis of 60 patients with a mean follow-up of 42 months, measuring changes in tibial angles before, during, and after the lengthening process to assess any valgus deviation.
  • Researchers also examined various demographic and surgical factors that might influence the occurrence of valgus deviation during the LON technique.
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The effect of distraction-resisting forces on the tibia during distraction osteogenesis.

J Bone Joint Surg Am

July 2009

Department of Orthopedic Surgery, Rare Disease Institute, Korea University, Guro Hospital, Guro-Gu, Seoul 152-703, South Korea.

Background: Distraction-resisting forces that are generated during distraction osteogenesis can be responsible for complications, including a lag effect on fibular distraction leading to a tibiofibular distraction difference, tibial axial deviation, and distraction at the proximal and distal tibiofibular joints. We investigated the nature of distraction-resisting forces by studying their correlation with these parameters.

Methods: One hundred and eleven tibial lengthening procedures in sixty-three patients were chosen.

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Distraction-resisting force during tibial diaphyseal lengthening and consolidation--a study on a rabbit model.

Clin Biomech (Bristol)

August 2004

Academic Unit of Orthopaedic and Traumatic Surgery, Division of Clinical Sciences, University of Sheffield, Northern General Hospital, Sheffield S5 7AU, UK.

Background: Distraction-resisting force is generated in the soft tissues and callus during limb lengthening. Monitoring this force may offer a method of studying the behaviour of soft tissue and detecting the distraction osteogenesis related problems, and help to prevent complications. Changes in the post distraction period have not been previously investigated and there are no reports on the contribution of gastrocnemius to the distraction-resisting force.

View Article and Find Full Text PDF

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