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IN VIVO MEASUREMENT OF TIBIAL BLOOD FLOW DURING DISTRACTION OSTEOGENESIS USING DOPPLER ULTRSASONOGRAPHY



Abstract

Introduction: It is unknown what effect distraction osteogenesis has on bone blood flow to the affected limb. Our study analyzed in vivo measurement of tibial blood flow during distraction osteogenesis using Doppler ultrasonography.

Materials and Methods: Blood flow was measured in the femoral artery, with Doppler ultrasonography in five people treated with bi-focal tibial distraction osteogenesis. The normal leg was used as the control to correct for differences in cardiac output. Measurements for each leg were taken and means recorded preoperatively, at 1 week postoperatively, and at subsequent intervals up to 6 months.

Results: Preoperative blood flow varied from 0.5 – 2.25. All treated legs demonstrated increases in flow from 2.25 – 5.75, with peaks in the first weeks following osteotomy. Significant increases in blood flow during treatment with distraction osteogenesis, confirming previous experimental studies.

Discussion: Blood flow plays a significant role in the successful outcome of this treatment. Compression of the non-union at the time of peak blood flow gives more reliable union than bone transport methods, where docking takes place when blood flow has returned towards the control limb.

Editorial Secretaries: Lynne C. Jones, Ph.D.* and Michael A. Mont, M.D. Address for Correspondence: *Lynne C. Jones, Ph.D., Suite 201 GSH POB, 5601 Loch Raven Blvd., Baltimore, MD 21239, USA. Email: ljones3@jhmi.edu