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Curran, Andrew R.; Kuo, Ken N.; Lubicky, John P.

doi:10.1097/00004694-199905000-00019

Cited by 10 publications

(2 citation statements)

References 12 publications

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“…The new bone formed at the distraction site generally requires a much longer consolidation period than distraction period, resulting in a bone healing index (time in external fixation/length gained) of more than 30 days per centimeter of adult limb lengthening. 6 7 8) A long duration of external fixation for distracting and stabilizing the osteotomy site increases the complications and causes inconvenience to the patients. 9) …”

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confidence: 99%

Demineralized Bone Matrix Injection in Consolidation Phase Enhances Bone Regeneration in Distraction OsteogenesisviaEndochondral Bone Formation

et al. 2015

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BackgroundDistraction osteogenesis (DO) is a promising tool for bone and tissue regeneration. However, prolonged healing time remains a major problem. Various materials including cells, cytokines, and growth factors have been used in an attempt to enhance bone formation. We examined the effect of percutaneous injection of demineralized bone matrix (DBM) during the consolidation phase on bone regeneration after distraction.MethodsThe immature rabbit tibial DO model (20 mm length-gain) was used. Twenty-eight animals received DBM 100 mg percutaneously at the end of distraction. Another 22 animals were left without further procedure (control). Plain radiographs were taken every week. Postmortem bone dual-energy X-ray absorptiometry and micro-computed tomography (micro-CT) studies were performed at the third and sixth weeks of the consolidation period and histological analysis was performed.ResultsThe regenerate bone mineral density was higher in the DBM group when compared with that in the saline injection control group at the third week postdistraction. Quantitative analysis using micro-CT revealed larger trabecular bone volume, higher trabecular number, and less trabecular separation in the DBM group than in the saline injection control group. Cross-sectional area and cortical thickness at the sixth week postdistraction, assessed using micro-CT, were greater in the regenerates of the DBM group compared with the control group. Histological evaluation revealed higher trabecular bone volume and trabecular number in the regenerate of the DBM group. New bone formation was apparently enhanced, via endochondral ossification, at the site and in the vicinity of the injected DBM. DBM was absorbed slowly, but it remained until the sixth postoperative week after injection.ConclusionsDBM administration into the distraction gap at the end of the distraction period resulted in a significantly greater regenerate bone area, trabecular number, and cortical thickness in the rabbit tibial DO model. These data suggest that percutaneous DBM administration at the end of the distraction period or in the early consolidation period may stimulate regenerate bone formation and consolidation in a clinical situation with delayed bone healing during DO.

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confidence: 99%

Demineralized Bone Matrix Injection in Consolidation Phase Enhances Bone Regeneration in Distraction OsteogenesisviaEndochondral Bone Formation

et al. 2015

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“…Curran et al [ 15 ] reported eight paediatric patients who underwent nine simultaneous ipsilateral femoral and tibial lengthenings with the Ilizarov external fixator. Four complications in three patients occurred as a result of the lengthening process.…”

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confidence: 99%

Limb reconstruction in Ollier\'s disease

Madan¹,

Robinson²,

P³

et al. 2015

Strategies in Trauma and Limb Reconstruction

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We present our experience of lengthening and correction of complex deformities in the management of patients with Ollier’s dysplasia (multiple enchondromatosis) from 1985 and 2002. All patients were under 18 years with a minimum follow-up time of 2 years (mean 9.6 years, range 2–15 years). There were a total of ten patients of which seven were male and three female. The mean age at presentation was 10.7 years (range 5–17 years; SD 3.7 years). The total length gain was 42.3 mm (range 30–110 mm; SD 28.9 mm). The number of days in external fixation was 164.8 days (range 76–244 days; SD 42.9 days). The bone healing index was 32.5 days/cm (18–50 days/cm; SD 10.3 days/cm). Patients with Ollier’s disease have limb length inequality and angular deformities and require multiple reconstructive procedures owing to a high incidence of recurrence. We identified a tendency for the osteotomy to prematurely consolidate and advise the latency period after surgery to be 4–5 days and for distraction to proceed at a faster rate.

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