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At least 1,423 records · Page 79Linked to original sources
PubMed2003

Protective effects of growth hormone on physeal distraction: an experimental study on rabbits.

The objective of this study is to evaluate the effects of growth hormone on physeal distraction. We performed physeal distraction of the proximal tibia physis on 32 immature New Zealand white rabbits. The rabbits were randomly allocated into receiving either saline (test 1) or growth hormone (test 2), injected subcutaneously around the physis. Physeal distraction was performed from day 3 to day 28. The animals were sacrificed on day 42. Average net lengthenings achieved as compared with the non-distracted contralateral tibiae were 4+/-2 mm (test 1) and 6+/-2.8 mm (test 2). The difference was of borderline significance (P=0.07). The difference in bone mineral density (BMD) between test 1 and control 1 was -0.019+/-0.021 g/cm2 (P<0.0001). The difference in BMD between test 2 and control 2 was 0.027+/-0.017 g/cm2 (P<0.0001). Histology revealed good trabecular bone formation in all groups. Physeal fractures were present in four rabbits in the saline group (test 1). All rabbits in the growth hormone group achieved lengthening via increased physeal thickness without fracture. New bone formation could be accelerated during physeal distraction by administration of growth hormone. By enhancing physeal cellular activity, growth hormone facilitates lengthening without fracture and may reduce risk of premature physeal closure. Growth hormone may also reduce osteoporosis of the regenerate bone during physeal distraction.

Animals↗
PubMed2004

[Predictability of maxillary distraction with the trans-sinusoidal distractor].

INTRODUCTION: This work was conducted to evaluate a new maxillary distractor with an activating system introduced into the maxilary sinus. PATIENTS AND METHOD: Fourteen patients age 8 to 55 Years with severe maxillary and midfacial hypoplasia were treated in our center. A trans-sinusoidal maxillary distractor (TS-MD, developed by Dr. N. Nadjmi in cooperation with Martin, Tuttlingen, Germany) was placed intra-orally at each side of the maxilla. The distraction vector was predicted with devoted software (Medicim N.V Belgium), and was transferred to the patients using stereolithographic models and individual templates. A high Lefort I type osteotomy was performed. RESULTS: Forward maxillary movement at distractor level varied from 7 to 22 mm. Soft and hard tIssue formation resulted in complete healing across the distraction gaps. The maxillary movements and new bone formation in the sagittal, horizontal, and vertical planes could be predicted and achieved. Distractors were designed to allow clockwise rotation of the maxilla during the distraction phase allowing the correction of the anterior open-bite in all patients with this skeletal deformity. The distractors were almost completely submerged, and could be left in place as long as necessary to avoid relapse. DISCUSSION: The TS-MD distractor has the advantage of good tolerance since the most voluminous part is placed within the maxilary sinus. Implantation via an exclusively oral approach is a further advantage. The devise does not interfere with the patient's social life and does not require alveolodental fixation. The TS-MD distractor can also aleviate the need for bone grafting in cases with major advancement. Correct position of the vector is crucial but one-sided catch-up distraction is possible.

Adolescent↗
PubMed2005

Effects of distraction forces and frequency of distraction on bony regeneration.

The rate and frequency of distraction have a decisive influence on the regenerative process. We tested a newly developed hydraulic osteodistractor in 12 pigs, which were assigned to have continuous and intermittent osteodistraction of the mandible after osteotomy. The forces necessary to distract the mandible were recorded during intermittent distraction. These data were then used for continuous distraction of the bone. Continuous osteodistraction resulted in intramembranous regeneration of bone, whereas intermittent osteodistraction caused chondroid ossification in the regeneration of the bone. Continuous osteodistraction caused speedier regeneration, and distraction forces were lower than with intermittent distraction.

Animals↗
PubMed1998

Temporal articular tubercle as a support of craniofacial distraction.

Craniomaxillofacial monobloc or segmental distractions are effective procedures to correct retruded maxilla, especially in patients with airway obstruction and feeding difficulties or severe craniofaciostenosis and orbitostenosis with corneal problems. Several bone distraction devices have been described--external and subcutaneous--and fixed to the calvaria with miniscrews. Searching for an area of firm, safe posterior support on the calvaria to locate the miniscrews, we chose the temporal articular tubercle and the anterior root of the zygomatic arch. It is thick enough to receive screws and support the pressure of the distraction.

Adolescent↗
PubMed2004

Direct skeletal traction for Le Fort I halo distraction replacing an intraoral dental splint and connecting traction hook.

To obviate dental inconveniences after Le Fort I halo distraction using an intraoral dental splint and connecting traction hook, the authors initiated direct skeletal traction using an traction wire at the parapyriformis buttress area. Halo distraction using this procedure was conducted for 11 cleft lip and palate patients (age range, 13-21 years; 6 females and 5 males). Distraction amount ranged from 11 to 15 mm. A satisfactory occlusion was obtained in all patients. All 11 patients complained of pain during the distraction period, but it was controlled by regular oral intake of the usual amount of analgesics. No other particular complications were encountered during the postoperative follow-up of 8 to 18 months. This form of direct skeletal traction proves effective for Le Fort I halo distraction.

Adolescent↗
PubMed1999

[Laboratory monitoring of distraction bone formation].

The course of the early period of bone formation during distraction osteosynthesis can be safely, rapidly, and objectively monitored and predicted by hematological and immunological parameters (lymphocytes, rosette-forming cells, monocytes, immunoglobulin A, heterophilic hemagglutinins), which are tested before and after surgery on days 1 and 7-10 and on day 10 of distraction.

Bone Regeneration↗
PubMed2005

Cranial reshaping employing distraction and contraction in the treatment of sagittal synostosis.

We treated four patients with scaphocephaly using a combination of distraction and contraction techniques and achieved satisfactory results. Radial osteotomies in the frontal and occipital bones flattened these abnormal bossing bones and accelerated the disappearance of bony bumps created by distraction. This technique facilitates the achievement of the desired shape of the skull through fine adjustments of the distraction and contraction devices.

Craniosynostoses↗
PubMed1999

Craniofacial distraction with a modular internal distraction system: evolution of design and surgical techniques.

The present report summarizes the evolution of design for a modular internal distraction system that is applicable throughout the craniofacial region. Eleven patients (5 boys, 6 girls), whose ages ranged from 4 months to 10 years at the time of distraction, constitute the basis for this study. The clinical indications for distraction were exorbitism with corneal exposure (n = 1), obstructive sleep apnea (n = 4), tracheostomy decannulation (n = 1), severe maxillary hypoplasia with class III malocclusion (n = 3), severe vertical and sagittal maxillary deficiency with anophthalmia (n = 1), and relapse following frontoorbital advancement in a case of rare craniofacial clefting (n = 1). Twenty-two distraction devices were used in these 11 patients. Two initial prototypes were tested (prototype 1 = 8 devices; prototype 2 = 2 devices) until the modular internal distraction system (MIDS, Howmedica-Leibinger, Inc.) was developed (n = 12 devices). The craniofacial osteotomies used were Le Fort III (n = 4), monobloc (n = 3), mandibular (n = 3), Le Fort I (n = 2), and cranial (n = 1). The distraction distances ranged from 11 to 28 mm. One patient undergoing mandibular distraction developed transient swelling in the left mandibular region, which responded to antibiotics. There were no other complications. Depending on the age of the patient and the length of distraction, the distraction gap was allowed to consolidate from 6 weeks to 3 months. The devices were then removed on either an outpatient or a 23-hour-stay basis. The modular internal distraction system permits widespread application of easily customizable, buried distraction devices throughout the craniofacial region.

Child↗