1995 Fiscal Year Final Research Report Summary
Experimental and Clinical Follow-up Studies of Vascularized Bone Grafts
| Project/Area Number |
05454406
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| Research Category |
Grant-in-Aid for General Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Research Field |
Orthopaedic surgery
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| Research Institution | Hirosaki University |
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Principal Investigator |
TOH Satoshi Hirosaki Univ.School of Medicine, Associate Prof., 医学部, 助教授 (30142863)
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| Co-Investigator(Kenkyū-buntansha) |
INOUE Sadahiro Hirosaki Univ.School of Medicine, Assistant, 医学部附属病院, 助手 (30241459)
TSUBO Kenji Hirosaki Univ.School of Medicine, Assistant, 医学部, 助手 (20180044)
NARITA Shunsuke Hirosaki Univ.School of Medicine, Assistant, 医学部附属病院, 助手 (00261446)
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| Project Period (FY) |
1993 – 1995
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| Keywords | Vascularized Bone Graft / Fibula / Iliac Bone / Aseptic Necrosis of the Femoral head / Congenital Pseudoarthrosis / Tibia / Hypertrophy / Muscle Sleeve |
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| Research Abstract |
1).Osseous Changes in Muscle Sleeves Attached to Vascularized Bone Grafts
a) Experimental Study : Following transplantation, muscle sleeves lapsed into degeneration such as fatty change and fibrosis, interposing between grafted bones and graft floors, and interfering with bony fusion. However, free bone grafts between graft floors and muscle sleeves induced new bone formation around the vascularized grafted bone, leading to hypertrophy of the grafted bone and obvious bony fusion between vascularized bones and graft floors. Bony fusion between grafted bones and graft floors was apparently promoted through the muscle sleeves when free bone was grafted around the circumference of the vascularized grafted bone.
b) Clinical Study : When an allo or autograft was closely placed parallel to the vascularized fibula or the vascularized fibula was close to the intramedullary surface of the recipient bone, new bone formed from the parallel bone or recipient bone, developing to the edges and nearest
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points of the vascularized fibula. Bony fusion was also achieved in one case of iliac bone chips packed between the vascularized fibula and recipient bone.
2).Hypertrophy of the Grafted Fibula
Clinical study showed proper stress to the grafted bone helps achieve hypertrophy of the grafted fibula. Using external fixation for postoperative immobilaization is preferable, even in congenital pseudoarthrosis of the tibia.
3).Pediculated Vascularized lliac Bone Graft for Aseptic Necrosis of the Femoral Head (ANFH)
joint preserving operations for ANFH have unresolved problems. Our procedure using a pediculated vascularized iliac bone graft with deep cicumflex iliac artery was evaluated. Meticulous division of the vascular pedicle of the iliac bone, and proper direction and depth of the grafted bone are very important for good results.
Indications are Stage I and Stage II cases which are involved, and Stage III cases with wide lesion areas. For these Stage III cases, combining this method with transtrochanteric rotational osteotomy is recommended. Less
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