Background

In distraction osteogenesis (DO) of long bones, new bone tissue is formed and distracted to lengthen limbs or reconstruct bone defects. However, certain anthropometric quantities relevant for biomechanical modelling of DO are unknown, such as areas where new bone tissue is formed. We developed a novel method to facilitate the determination of these distraction areas (DA), which we applied in the tibia and fibula of adults for longitudinal and transverse DO to advance knowledge of anatomical boundary conditions.

Methods

CT data sets of 21 adult human tibiae and 24 fibulae were selected for investigation. Volumetric models were created utilizing image segmentation. The DA for longitudinal DO was determined in a CAD environment using the total bone cross section in the proximal, central and distal diaphysis of the tibia and fibula. Additionally, the medullary canal area was determined in the fibula. Furthermore, we measured the total DA and medullary canal DA for transverse distraction using a longitudinally split fibula with an osteotomy length of 8, 12, 16 and 20 cm. The osteotomy plane was oriented in medial and anteromedial direction. Finally, Spearman analyses were conducted to assess the correlation between bone length and DA.

Results

For longitudinal DO, the mean total DAs were 878, 535 and 482 mm² in the tibia and 132, 153, 124 mm² in the fibula for the proximal, central and distal diaphysis, respectively. Regarding transverse distraction, the mean total DAs for a medial and anteromedial osteotomy plane orientation were 962, 1423, 1868 and 2306 mm² as well as 925, 1387, 1844, 2279 mm² for an osteotomy length of 8, 12, 16 and 20 cm, respectively. Weak, positive, and non-significant correlations were observed when correlating bone length and DA in the tibia and fibula.

Conclusions

Quantification of DAs and hence distracted callus tissue in DO advances anatomical knowledge and improves biomechanical modelling by adding a parameter which cannot be approximated based on bone length.

中文翻译：

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确定与纵向和横向牵引成骨相关的骨尺寸的新方法及其在人胫腓骨中的应用

背景

在长骨的牵引成骨 (DO) 中，新的骨组织形成并牵引以延长四肢或重建骨缺损。然而，与 DO 的生物力学建模相关的某些人体测量量是未知的，例如形成新骨组织的区域。我们开发了一种新方法来促进这些牵张区域 (DA) 的确定，我们将其应用于成人胫骨和腓骨的纵向和横向 DO，以提高对解剖边界条件的了解。

方法

选择了 21 条成人胫骨和 24 条腓骨的 CT 数据集进行调查。体积模型是利用图像分割创建的。纵向 DO 的 DA 在 CAD 环境中使用胫骨和腓骨的近端、中央和远端骨干中的总骨横截面确定。此外，在腓骨中确定了髓管区域。此外，我们使用截骨长度为 8、12、16 和 20 厘米的纵向分裂腓骨测量了横向牵引的总 DA 和髓管 DA。截骨平面朝向内侧和前内侧方向。最后，进行 Spearman 分析以评估骨长度和 DA 之间的相关性。

结果

对于纵向DO，平均总的DA是878，535和482毫米²在胫骨和132，153，124毫米²在腓骨用于近端，中心和远端骨干，分别。关于横向牵张，内侧和前内侧截骨平面方向的平均总 DA 为 962、1423、1868 和 2306 mm ²以及 925、1387、1844、2279 mm ²截骨长度为8、12、16和 2厘米，分别。当将胫骨和腓骨中的骨长度和 DA 相关联时，观察到弱、正和非显着相关性。

结论

DA 的量化以及 DO 中分散的愈伤组织组织通过添加无法基于骨骼长度近似的参数来提高解剖学知识并改进生物力学建模。