Morphological characteristics of tibial muscles in the conditions of high rate distraction osteosynthesis in combination with itramedullary hydrohyapatite-coated titanium nail

The purpose of this work is to compare of the morphofunctional characteristics of the lower leg muscles in conditions of transosseous distraction osteosynthesis by high-rate and high-fractional automated destraction and in combination with intraosseous reinforcement with a titanium. The main experiments were performed on mongrel dogs of both sexes at the age of skeletal maturity, lengthening of the tibia was performed with a daily autodistractor at a rate of 3.0 mm for 10 days. In the animals of group No. 1, the autodistractor step was 0.025 mm at 120 times. At the general anesthesia, intramedullary reinforcement of the tibia was a 1.8- mm titanium (Ti6Al 4V) coated with hydroxyapatite by microarc oxidation technology. Next, osteosynthesis with an Ilizarov apparatus and transverse osteotomy of the tibia were produced. In the group No. 2, the autodistractor step was 0.017 mm at 180 times, тhe fixation period was 30 days. At the end of the distraction and 3 months after the removal of the apparatus, the tibial muscles were examined. Animals of the group No. 1 actively used the limb from the first days of distraction. The period of fixation decreased twice. Macro-preparations of muscles of dogs in group No. 1 did not significantly differ in the experimental and contralateral limbs. The histostructure of the muscles in both groups was characterized by signs of activation of angiogenesis and myogistogenesis, but in the group No. 1 the volume density of microvessels was 3 times higher in the period of elongation. It was concluded that the method of high-speed limb auto-extrusion in combination with intramedullary reinforcement of titanium wire with hydroxyapatite spraying has an activating effect on angiogenesis and myogenesis. The histostructural characteristics of the tibial muscle testify to the predominance of the processes of reparative regeneration by the type of restitution. As a result, the functional activity of the limb remains from the first days of distraction, the period of fixation is reduced by 2 times.

muscles, automated distraction, intramedular reinforcement, hydroxyapatite coating

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