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일단계 골연장술시의 연장길이가 혈류량에 미치는 영향에 관한 실험적연구
권성택 大韓成形外科學會 1995 Archives of Plastic Surgery Vol.22 No.4
Gradual distraction techniques according to Ilizarov have recently gained popularity around the world. However, there should be a safe limit of lenthening, which might recollect the classical one stage lengthening with bone graft. Nerve and muscle changes are the main concern of most investigators. But the changes of blood flow might be the first step in determining the method of lengthing in certain clinical cases, especially in hand and foot. This study investigated the changes of blood flow in relation to the percentage of lengthening of the Sprague-Dawley rat's tibia by one stage bone lengthenig. Lengthening procedure was devided into 4 stages, Stage 0(0% lengthened initial status),Stage I(12.5% lengthened status), Stage II(25% lengthened state) and finally Stage III(31.25% lengthened stage) to make it close to the clinical situation of one stage lengthening. 15 minutes went for each stage including 15 seconds of acute lengthening at the beginning of every stage. Blood flow on the dorsum of the foot were measured every minute and changes were recorded as ratios of measured flow to that of Stage 0. The changes of blood flow in Stage I[0.79±0.117(mean±SD)] did not appear to affect the circulation. Changes in Stage II[0.16±0.002(mean±SD)] might compromise the distal circulation, but circulation was effective enough to maintain a viable skin flap. Stage III[0.016±0.023(mean±SD)] showed definite changes beyond the point of safety. Though an animal experiment, these results might bear author's suggestion that in some clinical cases one stage lengthening technique can find its place as long as careful monitoring of blood flow is secured.