Objective: To study the effect of vascularized fibular graft on large defects of long bones and the monitoring method for the vascular status of the grafted fibula. Methods: From March 1988 to February 1998, 30 patien...Objective: To study the effect of vascularized fibular graft on large defects of long bones and the monitoring method for the vascular status of the grafted fibula. Methods: From March 1988 to February 1998, 30 patients with long bone defects over 6 cm in length received vascularized fibular graft including a monitoring island flap in our department to monitor the blood circulation of the fibulae. Results: Monitoring island abnormalities were indicated in 6 flaps, which accurately gave the alarm of the circulation crisis of the fibular graft. Surgical exploration was performed timely and the blood supply was recovered instantaneously. All the bone defects were healed at 6 months postoperatively. After 4 years of follow up, all the grafted fibulae were thickened and were just like tibiae. Conclusions: A monitoring island flap is a satisfactory method for repairing large defects of the long bones and a reliable method for assessing the vascular status of the grafted fibulae.展开更多
The presence of large segmental defects of the diaphyseal bone is challenging for orthopedic surgeons. Free vascularized fibular grafting （FVFG） is considered to be a reliable reconstructive procedure. Stress fractu...The presence of large segmental defects of the diaphyseal bone is challenging for orthopedic surgeons. Free vascularized fibular grafting （FVFG） is considered to be a reliable reconstructive procedure. Stress fractures are a common complication following this surgery, and hypertrophy is the main physiological change of the grafted fibula. The exact mechanism of hypertrophy is not completely known. To the best of our knowledge, no studies have examined the possible relationship between stress fractures and hypertrophy. We herein report three cases of patients underwent FVFG. Two of them developed stress fractures and significant hypertrophy, while the remaining patient developed neither stress fractures nor significant hypertrophy. This phenomenon indicates that a relationship may exist between stress frac~ tures and hypertrophy of the grafted fibula, specifically, that the presence of a stress fracture may initiate the process of hypertrophy,展开更多
Objective： To study biomechanical changes of newly formed bones 24 weeks after repairing large defects of long bones of goats using heterogeneous deproteinated bone （DPB） prepared by modified methods as an engineer...Objective： To study biomechanical changes of newly formed bones 24 weeks after repairing large defects of long bones of goats using heterogeneous deproteinated bone （DPB） prepared by modified methods as an engineering scaffold. Methods： According to a fully randomized design, 18 goats were evenly divided into three groups： normal bone control group （Group A）, autologous bone group （Group B） and experimental group （Group C）. Each goat in Groups B and C were subjected to the periosteum and bone defect at middle-lower part of the right tibia （20% of the whole tibia in length）, followed by autologous bone or DPB plus autolognus MSCs ＋ rhBMP2 implantation, respectively and semi- ring slot fixation; while goats in Group A did not perform osteotomy. At 24 weeks after surgery, biomechanical tests were carried out on the tibias. Results： At 24 weeks after surgery, the results of anticompression test on tibias in three groups were recorded by a functional recorder presented as linear pressure-deformation curve. The shapes of the curves and their change tendency were similar among three groups. The ultimate pressure values were 10.74 MPa±1.23 MPa, 10. 11 MPa±1.35 MPa and 10.22 MPa±1.32 MPa and fracture compression rates were 26.82%±0.87%, 27.17%±0.75% and 28.22%±1.12% in Groups A, B and C, respectively. Comparisons of anti-compression ultimate pressures and fracture compression rates among three groups demonstrated no significant difference （PAB=0.415, PBC=0.494）. Three-point antibend test on tibias was recorded as load-deformation curves, and the shapes of the curves and their change tendency were similar among three groups. The ultimate pressure values of the anti-bend test were 481.52 N±12.45 N, 478.34 N±14.68 N and 475.62 N±13.41 N and the fracture bend rates were 2.62 mm±0.12 mm, 2.61 mm±0.15 mm and 2.81 mm±0.13 mm in Groups A, B and C, respectively. There was no significant difference between groups （PAB=0.7, PBc=0.448）. The ultimate anti-torsion torque values were 6.55 N.mi-0.25 N.m, 6.34 N＇m^0.18 N＇m and 6.42 N＇m^0.21 N＇m and fracture torsion rates were 29.51°±1.64°, 28.88±1.46° and 28.81°±1.33° in Groups A, B and C, respectively. There was no significant difference between groups （PAB=0.123, PBc=0.346）. Conclusions： The biomechanical characteristics of newly formed bones from heterogeneous DPB for repairing large segmental long bone defect are comparable to those of normal bones and autologous bones. DPB has the potential for clinical usage as bone graft material.展开更多
Objective： To evaluate the effect of autograft bone, allograft bone, calcium sulfate bone cement, and calcium phosphate bone cement on the repair of tibial plateau defect in rabbits. Methods： We used autograft bone...Objective： To evaluate the effect of autograft bone, allograft bone, calcium sulfate bone cement, and calcium phosphate bone cement on the repair of tibial plateau defect in rabbits. Methods： We used autograft bone, allograft bone, calcium sulfate bone cement, and calcium phosphate bone ce ment to repair tibial plateau defect in rabbits. Gross and histo logic observations, Xray examination, and biomechanical test were conducted at 1, 2, 4, 8 weeks after operation. Results： Xray examination found that the bone den sity was evidently reduced in calcium sulfate group at 8 weeks after operation; there were no marked changes in other groups. The maximal load measurements showed that autograft and allograft groups were greater than calcium sulfate and calcium phosphate groups at 1 and 2 weeks after operation. However at 4 and 8 weeks after operation, no significant difference was found among the four groups. In autograft and allograft groups, there was no significant difference in biomechanical intensity at 2, 4, and 8 weeks,but it was significantly higher than that at 1 week. In cal cium sulfate and calcium phosphate groups, the outcome was ranked in descending order as 1 week〈 2 week〈 4 week =8 week. Histologic examination found a great amount of new bones at 8 week in both autograft and allograft groups. In calcium sulfate group, calcium sulfate was almost absorbed and there were numerous bone trabeculations. There was a large amount of unabsorbed calcium phosphate in calcium phosphate group. Conclusion： At 12 weeks postoperatively, the biome chanical intensity is higher in autograft and allograft groups than calcium sulfate and calcium phosphate groups, but after 48 weeks, there is no significant difference among groups. At 12 weeks, the biomechanical intensity in all groups is increased, but at 48 weeks, there is no significant increase. The rates of absorption and bone formation are quicker in calcium sulfate group than calcium phosphate group.展开更多
基金MajorPlanningProjectsofScienceandTechnologyofGuangzhouCity (No .96 Z 70 2 )
文摘Objective: To study the effect of vascularized fibular graft on large defects of long bones and the monitoring method for the vascular status of the grafted fibula. Methods: From March 1988 to February 1998, 30 patients with long bone defects over 6 cm in length received vascularized fibular graft including a monitoring island flap in our department to monitor the blood circulation of the fibulae. Results: Monitoring island abnormalities were indicated in 6 flaps, which accurately gave the alarm of the circulation crisis of the fibular graft. Surgical exploration was performed timely and the blood supply was recovered instantaneously. All the bone defects were healed at 6 months postoperatively. After 4 years of follow up, all the grafted fibulae were thickened and were just like tibiae. Conclusions: A monitoring island flap is a satisfactory method for repairing large defects of the long bones and a reliable method for assessing the vascular status of the grafted fibulae.
文摘The presence of large segmental defects of the diaphyseal bone is challenging for orthopedic surgeons. Free vascularized fibular grafting （FVFG） is considered to be a reliable reconstructive procedure. Stress fractures are a common complication following this surgery, and hypertrophy is the main physiological change of the grafted fibula. The exact mechanism of hypertrophy is not completely known. To the best of our knowledge, no studies have examined the possible relationship between stress fractures and hypertrophy. We herein report three cases of patients underwent FVFG. Two of them developed stress fractures and significant hypertrophy, while the remaining patient developed neither stress fractures nor significant hypertrophy. This phenomenon indicates that a relationship may exist between stress frac~ tures and hypertrophy of the grafted fibula, specifically, that the presence of a stress fracture may initiate the process of hypertrophy,
文摘Objective： To study biomechanical changes of newly formed bones 24 weeks after repairing large defects of long bones of goats using heterogeneous deproteinated bone （DPB） prepared by modified methods as an engineering scaffold. Methods： According to a fully randomized design, 18 goats were evenly divided into three groups： normal bone control group （Group A）, autologous bone group （Group B） and experimental group （Group C）. Each goat in Groups B and C were subjected to the periosteum and bone defect at middle-lower part of the right tibia （20% of the whole tibia in length）, followed by autologous bone or DPB plus autolognus MSCs ＋ rhBMP2 implantation, respectively and semi- ring slot fixation; while goats in Group A did not perform osteotomy. At 24 weeks after surgery, biomechanical tests were carried out on the tibias. Results： At 24 weeks after surgery, the results of anticompression test on tibias in three groups were recorded by a functional recorder presented as linear pressure-deformation curve. The shapes of the curves and their change tendency were similar among three groups. The ultimate pressure values were 10.74 MPa±1.23 MPa, 10. 11 MPa±1.35 MPa and 10.22 MPa±1.32 MPa and fracture compression rates were 26.82%±0.87%, 27.17%±0.75% and 28.22%±1.12% in Groups A, B and C, respectively. Comparisons of anti-compression ultimate pressures and fracture compression rates among three groups demonstrated no significant difference （PAB=0.415, PBC=0.494）. Three-point antibend test on tibias was recorded as load-deformation curves, and the shapes of the curves and their change tendency were similar among three groups. The ultimate pressure values of the anti-bend test were 481.52 N±12.45 N, 478.34 N±14.68 N and 475.62 N±13.41 N and the fracture bend rates were 2.62 mm±0.12 mm, 2.61 mm±0.15 mm and 2.81 mm±0.13 mm in Groups A, B and C, respectively. There was no significant difference between groups （PAB=0.7, PBc=0.448）. The ultimate anti-torsion torque values were 6.55 N.mi-0.25 N.m, 6.34 N＇m^0.18 N＇m and 6.42 N＇m^0.21 N＇m and fracture torsion rates were 29.51°±1.64°, 28.88±1.46° and 28.81°±1.33° in Groups A, B and C, respectively. There was no significant difference between groups （PAB=0.123, PBc=0.346）. Conclusions： The biomechanical characteristics of newly formed bones from heterogeneous DPB for repairing large segmental long bone defect are comparable to those of normal bones and autologous bones. DPB has the potential for clinical usage as bone graft material.
文摘Objective： To evaluate the effect of autograft bone, allograft bone, calcium sulfate bone cement, and calcium phosphate bone cement on the repair of tibial plateau defect in rabbits. Methods： We used autograft bone, allograft bone, calcium sulfate bone cement, and calcium phosphate bone ce ment to repair tibial plateau defect in rabbits. Gross and histo logic observations, Xray examination, and biomechanical test were conducted at 1, 2, 4, 8 weeks after operation. Results： Xray examination found that the bone den sity was evidently reduced in calcium sulfate group at 8 weeks after operation; there were no marked changes in other groups. The maximal load measurements showed that autograft and allograft groups were greater than calcium sulfate and calcium phosphate groups at 1 and 2 weeks after operation. However at 4 and 8 weeks after operation, no significant difference was found among the four groups. In autograft and allograft groups, there was no significant difference in biomechanical intensity at 2, 4, and 8 weeks,but it was significantly higher than that at 1 week. In cal cium sulfate and calcium phosphate groups, the outcome was ranked in descending order as 1 week〈 2 week〈 4 week =8 week. Histologic examination found a great amount of new bones at 8 week in both autograft and allograft groups. In calcium sulfate group, calcium sulfate was almost absorbed and there were numerous bone trabeculations. There was a large amount of unabsorbed calcium phosphate in calcium phosphate group. Conclusion： At 12 weeks postoperatively, the biome chanical intensity is higher in autograft and allograft groups than calcium sulfate and calcium phosphate groups, but after 48 weeks, there is no significant difference among groups. At 12 weeks, the biomechanical intensity in all groups is increased, but at 48 weeks, there is no significant increase. The rates of absorption and bone formation are quicker in calcium sulfate group than calcium phosphate group.
