الفهرس 
Bone LengtheningOnly 14 pages are availabe for public view
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Abstract
D
istraction osteogenesis with external fixators, originally devised by Ilizarov, enables limb lengthening or bone defect repair by eliciting callus formation at the defect generated by gradual distraction.
The advantage of bone lengthening is that bone defects can be repaired without autografting, which requires procurement of healthy bone and is associated with subsequent morbidity, leg shortening, and deformation.
Therefore, new techniques are required to accelerate distraction osteogenesis so that the distraction period may be shortened and the efficacy of the treatment can be improved, including bone marrow injection in the distraction site.
Bone marrow contains a variety of osteoconductive growth factors that may play a role in the proliferation and differentiation of osteoprogenitor cells and thereby enhances new bone formation during distraction osteogenesis.
A variety of BMPs in bone marrow aspirate play an active role in osteogenesis, including recruitment of stem cells, cellular proliferation and differentiation, and bone formation.
In the present study, we aimed to clarify whether the application of autologous bone marrow aspirate would significantly improve consolidation of the distraction callus by accelerating bone healing and reducing the time of application of the external fixator.
The result of management of non united fractures in long bones with shortening by external fixator in the literatures, and the evolution of ideas for treatment over the last twenty years were reviewed to apply a treatment strategy for shortening the time of application of the external fixator.
Our results suggest that the application of bone marrow aspirate significantly reduces distraction callus consolidation time compared with the older distraction method without injection.
This study involved 30 patients who were classified into two main groups, one group was injected with bone marrow aspirate at the end of distraction period, and the other group was not injected.
The analysis confirmed the homogenesity of all patients in both groups as there were no significant differences in terms of patient age, sex, or reason for surgery.
There were no significant differences among both groups in terms of the type of external fixator used, the location of the defect, and the length of distraction.
In group (1) successful consolidation at the distraction callus was achieved in an average time of 19 weeks.
In group (2) successful consolidation at the distraction callus was achieved in an average time of 27 weeks.
Statistical analysis in this study showed that the time of consolidation in the non injected group is longer than the injected group, and there were relatively less complications in the injected group in comparison with the non injected group.