Effect of Distraction Osteogenesis on the Peripheral Nerve: Experimental Study in the Rat

Distraction osteogenesis is the current method of choice for bone lengthening. Despite the gain in experience, various complications are reported, among them, adverse effects on peripheral-nerve function. In order to thoroughly investigate the effect of distraction on neural tissue, a distraction osteogenesis model in the rat was established, using the femur of 30 Sprague-Dawley rats. The animals were randomized in three groups, following different rates of distraction (0.5 mm, 1.0 mm, and 1.5 mm/day) for 50, 25, and 16 days, respectively, so that the final length of distraction was the same in all groups. The mean sciatic function index ranged near normal in all groups. All groups demonstrated decrease of conduction velocity and the area under the curve of the compound action potential, while morphologic alterations consisted of decrease in the number of axons and evidence of active degeneration. Animals in Groups 1 (0.5 mm/day) and 2 (1 mm/day) displayed comparable changes, while in Group 3 animals (1.5 mm/day), changes were significantly more adversely dramatic. The safest and fastest rate of distraction in this rat model was determined to be 1 mm/day.

[1]  T. Chuang,et al.  Neuromuscular injury during limb lengthening: a longitudinal follow-up by rabbit tibial model. , 1995, Archives of physical medicine and rehabilitation.

[2]  E. Ippolito,et al.  HISTOLOGY AND ULTRASTRUCTURE OF ARTERIES, VEINS, AND PERIPHERAL NERVES DURING LIMB LENGTHENING , 1995 .

[3]  P. Farsetti,et al.  Histology and ultrastructure of arteries, veins, and peripheral nerves during limb lengthening. , 1994, Clinical orthopaedics and related research.

[4]  M. Block,et al.  Changes in the inferior alveolar nerve following mandibular lengthening in the dog using distraction osteogenesis. , 1993, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[5]  S. Chung,et al.  Changes in somatosensory-evoked potentials in limb lengthening. An experimental study on rabbits' tibiae. , 1992, Clinical orthopaedics and related research.

[6]  E. Dellon,et al.  Functional assessment of neurologic impairment: track analysis in diabetic and compression neuropathies. , 1991, Plastic and reconstructive surgery.

[7]  S. Woo,et al.  Stress relaxation of a peripheral nerve. , 1991, The Journal of hand surgery.

[8]  P. V. van Roermund,et al.  Complications of leg lengthening. 46 procedures in 28 patients. , 1991, Acta orthopaedica Scandinavica.

[9]  G A Ilizarov,et al.  The tension-stress effect on the genesis and growth of tissues: Part II. The influence of the rate and frequency of distraction. , 1989, Clinical orthopaedics and related research.

[10]  K. Ogata,et al.  Blood flow of peripheral nerve effects of dissection, stretching and compression. , 1986, Journal of hand surgery.

[11]  W. Freed,et al.  An index of the functional condition of rat sciatic nerve based on measurements made from walking tracks , 1982, Experimental Neurology.

[12]  R. Dykes,et al.  Electrophysiological recordings in peripheral nerve surgery: a review. , 1976, The Journal of hand surgery.

[13]  G Lundborg,et al.  Effects of stretching the tibial nerve of the rabbit. A preliminary study of the intraneural circulation and the barrier function of the perineurium. , 1973, The Journal of bone and joint surgery. British volume.

[14]  J Haftek,et al.  Stretch injury of peripheral nerve. Acute effects of stretching on rabbit nerve. , 1970, The Journal of bone and joint surgery. British volume.

[15]  S. Sunderland,et al.  STRESS-STRAIN PHENOMENA IN HUMAN PERIPHERAL NERVE TRUNKS , 1961 .

[16]  A Codivilla,et al.  On the means of lengthening, in the lower limbs, the muscles and tissues which are shortened through deformity. 1904. , 1905, Clinical orthopaedics and related research.

[17]  K. Takagi,et al.  Tibial nerve function during tibial lengthening. Measurement of nerve conduction and blood flow in rabbits. , 1995, Acta orthopaedica Scandinavica.

[18]  J. Massie,et al.  Experimental stretch neuropathy. Changes in nerve conduction under tension. , 1992, The Journal of bone and joint surgery. British volume.

[19]  J. C. Eldridge,et al.  Problems with substantial limb lengthening. , 1991, The Orthopedic clinics of North America.

[20]  D. Paley,et al.  Problems, obstacles, and complications of limb lengthening by the Ilizarov technique. , 1990, Clinical orthopaedics and related research.

[21]  G. Comi,et al.  Peripheral nerve damage during limb lengthening. Neurophysiology in five cases of bilateral tibial lengthening. , 1990, The Journal of bone and joint surgery. British volume.

[22]  M. Catagni,et al.  Lengthening of the humerus using the Ilizarov technique. Description of the method and report of 43 cases. , 1990, Clinical orthopaedics and related research.

[23]  J. Black,et al.  The biomechanical responses to tension in a peripheral nerve. , 1980, The Journal of hand surgery.