E.N. Gorbach, M.A. Stepanov, T.N. Varsegova, T.A. Stupina, E.S. Gorbach

Restorative Traumatology and Orthopedics named after academician G.A. Ilizarov of the Ministry of Health of the Russian Federation, Kurgan, Russian Federation

  Contact details:

Gorbach E.N. – Ph. D. (medicine), Leading Research Associate of the Laboratory of Morphology

Address: 6 M.Ulyanovoy St., Kurgan, Russian Federation, 640014, tel.: +7 (3522) 41-52-73, e-mail: gorbach.e@mail.ru

One of the drawbacks of operative limb lengthening by the method of transosseous distraction osteosynthesis is the duration of treatment, therefore, in order to reduce the hardware stages in Russian Scientific Center “Restorative Traumatology and Orthopedics named after academician G.A. Ilizarov” the development of new technologies with the use of an increased daily rate in combination with various options for stimulating the reparative processes is in progress.

Purpose. To study the functional state of the limb, dynamics of the formation of the regenerate of the tibia, histostructural changes of the articular cartilage and soft tissues under conditions of automatic highly detailed elongation of the tibia using the method of transosseous distraction osteosynthesis with a rate of 3 mm and using a preliminary Z-shaped achillotomy.

Material and methods. 27 adult mongrel dogs carried out leg lengthening using the method of transosseous distraction osteosynthesis according to Ilizarov with a daily rate of 3 mm for 120 receptions in automatic mode in combination with a Z-shaped achillotomy. Using the methods of light microscopy, morphometry and X-ray electron probe microanalysis during periods of 10 days of distraction, 30 days of limb fixation in the device and 30 days after dismantling the device, were studied the distraction regenerate of the tibial bone, articular cartilage adjacent to the lengthened segment of the joints, tibial nerve and more and tibial muscle.

Results. During the hardware period of the experiment, the absence of equinus foot setting, improvement of flexion-extension function in adjacent joints, formation of a normotrophic bone regenerate with a large proportion of the bone component, and preservation of the normal structure and numerical density of most nerve conductors were observed. However, there were signs of weak hypo- and atrophy of muscle fibers and signs of early stages of development of osteoarthritis of the joints. In the post-equipment period, the structural and dimensional characteristics of all studied objects were comparable to the norm.

Conclusion. It has been revealed that the use of achillotomy allows preventing overstretching of the tissues of the tibial bed, improves microcirculation, creates more favorable conditions for osteogenesis, and contributes to the preservation of joint tissues under conditions of automatic lengthening of the tibia with a high daily rate.

Key words: achillotomy, transosseous distraction osteosynthesis, automatic distractor, reparative osteogenesis, articular cartilage, tibial nerve, tibial muscle.

References

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