Механические способы стимуляции дистракционного регенерата: мини-обзор современных концепций
https://doi.org/10.18019/1028-4427-2023-29-6-656-661
EDN: MOXATQ
Аннотация
Введение. Серьезным ограничением применения дистракционного остеогенеза является риск отсутствия или задержки формирования дистракционного регенерата, что ведет к значительному увеличению сроков лечения аппаратом внешней фиксации.
Цель. Рассмотреть различные способы стимуляции дистракционного регенерата (ДР) с акцентом на модуляцию механической среды, необходимой для формирования и созревания ДР.
Материалы и методы. При подготовке обзора для поиска информации использованы научные платформы PubMed, Scopus, ResearchGate, RSCI. Поисковыми словами и словосочетаниями были: mechanical bone union stimulation, axial dynamization, distraction regenerate. Результаты. Последние достижения в области механобиологии доказывают эффективность осевой нагрузки и механической стимуляции образования костной мозоли при сращении переломов. Дальнейшие исследования требуют разработки надлежащих протоколов и способов применения инвазивной и неинвазивной стимуляции ДР. Понимание роли динамизации как метода механической стимуляции невозможно без консенсуса по использованию терминов и протоколов.
Обсуждение. Мы предлагаем определять осевую динамизацию как возможность обеспечения осевой нагрузки на костный регенерат с минимальным смещением по ширине или изгибающими усилиями. Осевая динамизация может осуществляться через непосредственную стимуляцию регенерата осевыми циклическими нагрузками и исключением изгибающих и смещающих усилий.
Заключение. Осевая динамизация наряду с другими неинвазивными методами механической стимуляции дистракционного регенерата должна стать стандартным компонентом протоколов удлинения конечностей.
Об авторе
А. Черкашин
Texas Scottish Rite Hospital for Children
Соединённые Штаты Америки
Соединённые Штаты Америки
Alexander Cherkashin – MD, PhD, Co-Director Center for Excellence in Limb Lengthening and Reconstruction
Dallas, Texas
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Рецензия
Для цитирования:
Черкашин А. Механические способы стимуляции дистракционного регенерата: мини-обзор современных концепций. Гений ортопедии. 2023;29(6):656-661. https://doi.org/10.18019/1028-4427-2023-29-6-656-661. EDN: MOXATQ
For citation:
Cherkashin A. Mechanical stimulation of distraction regenerate. Mini-review of current concepts. Genij Ortopedii. 2023;29(6):656-661. https://doi.org/10.18019/1028-4427-2023-29-6-656-661. EDN: MOXATQ
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