TY - JOUR
T1 - A comparison of two types of free bone grafts as transport discs in segmental distraction for reconstruction of calvarial bone defects
T2 - An experimental study
AU - Müller, M. C.
AU - Kramer, F. J.
AU - Swennen, G. R.J.
AU - Rahmsdorf, M.
AU - Haupt, C.
AU - van Griensven, M.
AU - Tschernig, Thomas
AU - Otto, K.
AU - Schierle, H. P.
N1 - Funding Information:
Acknowledgements We wish to thank K. H. Napierski and P. Zerbe from the Department of Laboratory Animal Research of the Medical School of Hannover, the MTAs of the Departments of Neuroradiology and Oral and Maxillofacial Surgery of the Medical School of Hannover, M. Peter from the Department of Functional and Applied Anatomy for excellent technical assistance, and S. Fryk from the Department of Functional and Applied Anatomy for correcting the English text. The study was supported by the German Research Foundation (Schi 447/4–1). The protocol and guidelines for it were approved by the district government of Lower Saxony in Hannover and the local ethical committee.
PY - 2004/12
Y1 - 2004/12
N2 - Introduction: Several investigations over the past few years have shown that the importance of preserving the blood supply of the transport disc during segmental distraction has been overestimated. It was clearly demonstrated that distraction osteogenesis by local bone transportation could be achieved even with free bone grafts. So far, there have been no systematic investigations into how different types of free bone grafts vary in their function and suitability as transport discs in segmental craniofacial distraction. The aim of this study was to develop criteria to aid the clinician in selecting the most suitable free bone graft for distraction purposes. Materials and methods: Under general anesthesia, calvarial defects measuring 6x5 cm were created in 12 adult black head sheep in order to reconstruct them by segmental distraction using two different types of bone grafts as transport discs. Group 1 (n =6) received autotopical membranous bone of the calvarium as the transport segment, while group 2 (n=6) received heterotopical enchondral material from the iliac crest. Distraction was started postoperatively after 5 days at 0.6 mm/day and continued for 7 weeks. After a further 6 weeks of consolidation, the animals were killed and specimens examined macroscopically, radiographically and histologically. Results: The significantly better quality of bone regenerates of group 1 was clearly influenced by the significantly better stability of the transport disc's connection to the distraction device, the calvaria grafts showing better volume stability and better mechanical resistance during transport than the iliac bone. The influence of both types of bone grafts on the macro- and microstructure of the newly formed bone was clearly evident. The mineralization density of group 2 regenerates was significantly lower than that of group 1 specimens. Conclusion: High mechanical stability of the bone graft is a very important point to consider when selecting a free graft for use as transport disc in local bone transport, especially if transport is necessary over long distances.
AB - Introduction: Several investigations over the past few years have shown that the importance of preserving the blood supply of the transport disc during segmental distraction has been overestimated. It was clearly demonstrated that distraction osteogenesis by local bone transportation could be achieved even with free bone grafts. So far, there have been no systematic investigations into how different types of free bone grafts vary in their function and suitability as transport discs in segmental craniofacial distraction. The aim of this study was to develop criteria to aid the clinician in selecting the most suitable free bone graft for distraction purposes. Materials and methods: Under general anesthesia, calvarial defects measuring 6x5 cm were created in 12 adult black head sheep in order to reconstruct them by segmental distraction using two different types of bone grafts as transport discs. Group 1 (n =6) received autotopical membranous bone of the calvarium as the transport segment, while group 2 (n=6) received heterotopical enchondral material from the iliac crest. Distraction was started postoperatively after 5 days at 0.6 mm/day and continued for 7 weeks. After a further 6 weeks of consolidation, the animals were killed and specimens examined macroscopically, radiographically and histologically. Results: The significantly better quality of bone regenerates of group 1 was clearly influenced by the significantly better stability of the transport disc's connection to the distraction device, the calvaria grafts showing better volume stability and better mechanical resistance during transport than the iliac bone. The influence of both types of bone grafts on the macro- and microstructure of the newly formed bone was clearly evident. The mineralization density of group 2 regenerates was significantly lower than that of group 1 specimens. Conclusion: High mechanical stability of the bone graft is a very important point to consider when selecting a free graft for use as transport disc in local bone transport, especially if transport is necessary over long distances.
KW - Bone transplantation
KW - Distraction osteogenesis
KW - Reconstructive procedure
UR - http://www.scopus.com/inward/record.url?scp=11244251796&partnerID=8YFLogxK
U2 - 10.1007/s00402-004-0749-3
DO - 10.1007/s00402-004-0749-3
M3 - Article
C2 - 15602675
AN - SCOPUS:11244251796
SN - 0936-8051
VL - 124
SP - 665
EP - 674
JO - Archives of Orthopaedic and Trauma Surgery
JF - Archives of Orthopaedic and Trauma Surgery
IS - 10
ER -