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Biomedical subjects

G Monticelli

Publications and source records attributed to G Monticelli.

43 records · Page 3Linked to original sources
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Distraction epiphysiolysis as a method of limb lengthening. II. Morphologic investigations.

Distraction epiphysiolysis as a means of lengthening bone has been studied in sheep tibiae by histologic, histochemical and microradiographic and electron microscopic methods. The tibiae have been studied 1, 2, 3 and 4 weeks and 2, 4, 6 and 12 months after the induction of this procedure. Distraction epiphysiolysis occurs in the following stages: development of a fracture along a line dividing the maturing from the hypertrophic chondrocytes, with the formation of a hematoma between the fracture surfaces; downward displacement of the metaphyseal cartilaginous fragment and gradual resorption of the hematoma, which is replaced by fibrous tissue; elongation of the fibrous tissue; with the formation of collagen bundles oriented parallel to the tensile force of distraction; calcification and ossification of these bundles, with the formation of longitudinal and parallel bone trabeculae; development of periosteal bone, which becomes a new diaphyseal shaft. The results show that distraction epiphysiolysis actually lengthens the bone segments; bone structure is completely restored, without serious changes occurring in the soft tissues. Restoration of endochondral ossification in the epiphysis tends to be unpredictable, however, so that the procedure is reliable only in subjects that have almost reached skeletal maturity.

Animals↗
PubMedDate not supplied

Distraction epiphysiolysis as a method of limb lengthening. I. Experimental study.

The tibiae of 41 growing sheep were lengthened by distraction epiphysiolysis. The distraction apparatus was applied for varying periods of time to the proximal epiphysis of a tibia; the contralateral tibia was used as the control. Daily application of the distraction force initially induced a fracture within the growing cartilage, and then progressively increased the distance between epiphysis and metaphysis. In the newly created space, new bone tissue gradually formed, which in time developed into a neometaphysis with a new cortex. This neometaphysis gradually acquired radiographic characteristics resembling those of control tibia, and they were capable of supporting normal body weight. Elongation of the bone ranged between 30 and 100 mm. Except in one incident of sepsis, no significant changes were observed in the structures adjoining the elongation area, nor in the soft tissue. In general, bone growth was not affected, although premature fusion of the epiphysis occurred in a few cases.

Animals↗
PubMedDate not supplied

Distraction epiphysiolysis as a method of limb lengthening. III. Clinical applications.

In 16 patients still in growth stage who were suffering from a shortened limb from 5 to 12 cm attributable to a varied etiology, the tibia was lengthened by distraction, hence, achieving separation of the epiphysis (distraction epiphysiolysis). Lengthening of the tibia from 5 to 10 cm was attained with remarkably minor and infrequent complications. The fact that distraction epiphysiolysis is a blood less procedure, that it allows the formation of a bone segment which is qualitatively and quantitatively suitable to its functional needs, and that all of this is achieved in a reasonably short period, justifies the conclusion that this method is a valuable addition to the accepted techniques for limb lengthening.

Adolescent↗