[Factors affecting bone regeneration in Ilizarov callus distraction].
We evaluated the X-rays of 36 patients who underwent 50 callus distractions. With the aid of a computerized digitalisation system for analogue films, the relative X-ray density of the distraction area was calculated for each X-ray. These relative X-ray densities were figured graphically for the duration of treatment for each patient. In the consolidation phase, the graph of each patient had a logarithmic relationship. The gradients of the logarithmic density curves were considered an indicator of the quantity of new bone formation. These gradients were correlated to the following clinical parameters: age of the patient, beginning of distraction after corticotomy, average speed of distraction, average weight bearing during the distraction and consolidation phase, location of corticotomy (distal femur versus proximal tibia) and diclofenac medication. Except for the location of the corticotomy and diclofenac, all parameters had an influence on osteoneogenesis by callus distraction. The parameters affecting new bone formation the most were the age of the patient and weight bearing. Patients aged under 18 years (p = 0.005), beginning of distraction later than 8 days (p = 0.109), an average distraction speed below 1 mm/day (p = 0.079), and average weight bearing of more than 30 kg (p = 0.068 for the distraction phase and p = 0.089 for the consolidation phase) showed a quantitatively higher rate of new bone formation by callus distraction than the patients in the other groups. Patients with a shorter leg due to poliomyelitis and one patient with an amniotic leg tie showed a slower increase in X-ray density graphs than the other patients.
Fink
B
B
Orthopädische Klinik und Poliklinik, Heinrich-Heine-Universität Düsseldorf.
Krieger
M
M
Schneider
T
T
Menkhaus
S
S
Fischer
J
J
Rüther
W
W
D015502:Absorptiometry, Photon; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001852:Bone Lengthening / Q000295:instrumentation*; D001861:Bone Regeneration / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D018889:Ilizarov Technique / Q000295:instrumentation*; D007870:Leg Length Inequality / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016474:Weight-Bearing / Q000502:physiology