Radiological and clinical investigaton of osteotomy and classic osteotomy performed in Z shape (oblique) in models constructed via using experimental extension models

Radiological and Clinical Investigaton of Osteotomy and Classic Osteotomy Performed in Z Shape (Oblique) in Models Constructed Via Using Experimental Extension Models, Specialty thesis in medicine, Department of Orthopedics and Traumatology, Gaziantep, 2023Distraction osteogenesis is a valuable clinical technique used to treat skeletal deformities and defects caused by congenital diseases, trauma, and tumor. During distraction, the forces generated at the osteotomy site can be precisely controlled, making this technique very useful for in vivo studies of biological responses to mechanical stimulation. Callus stiffness increases during the fracture healing process, thus allowing increased transmission of loads through the callus. As the amount of callus increases, weight bearing and returning to normal life become easier. It can also be used as a healing indicator. Therefore, the most physiological external fixator or osteosynthesis device should be able to adjust its stiffness according to the bone healing state to achieve faster fracture healing. As fusion progresses, the callus itself contributes to the rigidity of the bone fixator assembly and some of the load is carried through the fracture, thereby reducing the load through the fixator. The aim of our research was to examine the development of callus axial stiffness and histological development times between osteotomies in externally fixed transverse and oblique osteotomies under both rigid and dynamic conditions. Our study will consist of two main groups and 3 subgroups of each 2 main groups. On the first day, after placing the fixator on the right tibia of the rats and creating a classical osteotomy model for one group and oblique osteotomy for the other group, tibia lengthening will be started on the 7th day. Tibia lengthening will be done at regular intervals in a determined amount for 7 days. The clinical appearance, x-ray will be taken from the rats after 2 weeks, 4 weeks and 6 weeks of consolidation waiting. After the consolidation period, the rats will be sacrificed. At the last stage, the tibia bone forming the extension model will be taken for the histological examination of the sacrificed rats. The radiological imaging results of the rats in each group at 2.4 and 6 weeks after the end of the distraction were compared and scored. Rats in Groups I, II and III were scored according to the Modified Lane and Sandhu Scoring System. A significant effect of time and surgery was observed on the Modified Lane and Sandhu Radiological Scoring scores. While group 3 was statistically significant according to modified lane and sandle radiological scoring from group 2 and group 1, there was no statistically significant difference between group 1 and group 2. A statistically significant difference was observed between oblique and straight osteotomy when looking at the surgical technique based on the Modified Lane and Sandhu Radiological Scoring scores. Rats in each group 2 weeks, 4 weeks and 6 weeks after the end of the distraction Heiple et al. According to the Lane and Sandhu histological evaluation system modified by Group I, group II and group III were also compared within themselves on a time basis. When the groups were evaluated weekly among themselves, there was a statistically significant difference in terms of Modified Lane and Sandhu Histological Scoring. Tibias were examined before rats were sacrificed. These were evaluated according to the presence of infection, necrosis, reduction problem, nonunion and manipulation. Each group was examined on its own. When the presence of infection was compared between oblique and straight surgical methods at different times, there was no statistically significant difference in group I and group II, but there was a significant difference between oblique osteotomy and straight osteotomy in group III. When the presence of superficial necrosis was compared between oblique and straight surgical methods at different times, no statistically significant difference was found between group I, group II and group III. When the presence of reduction problem was compared between oblique and straight surgical methods at different times, there was a statistically significant difference in group I, while there was no statistically significant difference in group II and group III. When the presence of union was compared between oblique osteotomy and straight osteotomy surgical methods at different times, there was a statistically significant difference in group I and group II, while there was no significant difference between oblique osteotomy and straight osteotomy in group III. When the surgical technique of manipulation is compared, there is a significant difference between oblique osteotomy and straight osteotomy. As a result of our study, we observed that when straight and oblique osteotomies made from the rat tibia metaphyseal region were investigated on a weekly basis, oblique osteotomy provided better bone healing in terms of radiological and histopathology. At the same time, we found that oblique osteotomy was superior when evaluated in terms of macroscopic and complications. We suggest using oblique osteotomy in lengthening models from the rat tibial metaphyseal region because of fewer complications and better radiological and histological results.