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资料包括： 论文(4页3030字)
说明：
牵引成骨术(Distraction Osteogenesis,DO)的研究经历了从肢体骨的牵引延长到颅颌骨的牵引、从动物实验研究到临床应用、从外置式牵引装置到内置式牵引装置、从粗糙到精细的漫长发展过程［1］，1973年，Synde等率先应用口外装置延长狗下颌骨取得成功［2］。此后，McCarthy等［3］在对下颌骨延长术做了大量、系统的实验研究的基础上，于1992年首先成功地将此技术应用于治疗先天性颅面部发育不良的下颌骨畸形。
1 牵引成骨术的组织学基础：
牵引成骨术依靠渐进性的牵引而延长且不损伤血管的支持［4］。它主要包括两个过程，第一步是骨痂的形成，第二步是牵引后新骨的再生。牵引在骨痂组织产生拉力从而刺激新骨形成(平行于牵引轴)［5］。牵引成骨术的生物学规律表现在骨延长时，在外周固定器的作用下，骨牵开缺损区很快由骨痂新生填充，继之形成致密骨质，此为张力-应力作用的结果，由于张力-应力刺激，促进了成纤维细胞化骨及膜内成骨过程。重要的是牵引力同时作用于周围软组织产生适应性的组织生成［6］。在张力的影响下，各种组织生成被激活，骨延长过程中，发生相应生物学改变，如全皮肤层增厚、横纹肌变粗、肌纤维新生、血管中弹力纤维增生、神经轴突雪旺氏细胞增多这些骨延长过程中生物学组织的改变，已在病人的治疗观察中得到证明。这种适应性的软组织改变，可允许大量的骨移动，并减少像一期正颌手术中潜在的复发危险。
目录：
1 牵引成骨术的组织学基础：
2 截骨的方式及保存骨质血供的范围：
3 牵引成骨的技术参数：
4 牵引器械：
参考文献：
1.Tavakolik,Stewart KJ.Pool MD.Distraction osteogenesis in cranifacial surgery:A review.Ann Plast Surg,1998,40(1):88
2.Snyder CC,Levine GA,Swanson HM,Browne EZ,JR.Mandibular lengthening by gradual distraction:a preliminary report.Plast Reconsstr Surg 1973;51:506~508
3.McCarthy JG,Schreiber JS,Karp NS,et al.Lengthening the human mandible by gradual distraction.Plast Reconstr Surg,1992;89:1
4.Yasui N,Kojimoto H,Shiomura Y.The effect of distraction upon bone,Muscle and periosteum.Orthop Clin North Am,1991;22:563~567
5.Ilizarov GA.The tensionstress effect on the genesis and growth of tissues:Part II,the influence of the rate and frequency of distraction.Clin Orthop Rel Res,1989;239:263~285
6.Samchukov ML,Cherkashin AM,Cope JB.Distraction osteogenesis:origins and evolution.In:McMamara JA Jr,Trotman CA,eds.Advances in Craniofacial Orthopedics.Volume 34.Craniofacial Growth Series.Ann Arbor:Center for human Growth and Development,University of Michigan:1998:1~35
7.Ilizarov GA.The principles of the Ilizarov Method.Bull Hosp J Dis Orthop Inst,1988;48:1
8.Kojimoto H,Yasui N.Bone lengthening in rabbit by callus distraction:the role of perosteum and endosteum.J Bone Joint Surg,1988;70B:543
9.Constantino PD,Shybut G,Friedman CD,et al.Segmental mandibular regeneration by distraction osteogenesis:an experimental study.Arch Otolaryngol Head Neck Surg,1973;51:506
10.Sugyihara T,kawashima K,Lgawa H,et al.Mandibular lengthening by gradual distraction in humans.Eur J Plast Surg,1981;67:591
11.Karp NS,Thorne CHM,McCarthy JG,et al.Bone lengthening in the craniofacial skeleton.Ann Plast Surg,1990;24:231
12.Costantino PD,Friedman CD,Shindo ML,et al.Experimental mandibular regrowth by distraction osteogenesis(longterm results).Arch Otolaryngol Head Neck Surg,1993;119:511
13.Costantino PD,Shybut G,Friedman CD,et al.Yerofeyev SA.Morphological characteristics of angiogenesis in a myofascial tissues of the limb elongated by the Ilizarov method.Bull Hosp Jt Dis,1995;54:76~84
14.张震康，张熙恩主编.正颌外科学.北京：人民卫生出版社，1994，27~28
15.Bell WH,Harper RP,Gonzalez M,Cherkashin AM,Samchukov ML.Distraction osteogenesis to widen the mandible.Br J Oral Maxillofac Surg,1997;35:11~19
16.White,Kenwright.The timing of distraction of an osteotomy.J Bone Jt Surg(Br),1990,72:356
17.De Bastiani G,Aldegheri R,RenziBrivio L,et al.Limb lengthening by callus distraction.(callotasis).J pediatr Orthop,1987,7:129
18.Ilizarov GA.Clinical application of the tensionstress effect for limb lengthening.Clin Orthop,1990,250:8
19.Corcoran J,Hubli EH,Salyer KE.Distraction osteogenesis of costochondral neomandibles:a clinical experimence.Plast Reconstr Surg 1997;100:311~315
20.Panjaba MM,Lindsey RW,Walter SD,White AA.The clinician‘s ability to evaluate the strength of healing fractures for plain radiographs.J Orthop Traum 1989;3:29~32
21.Micheli S,Miotti B.Lengthening of mandibular body by gradual surgicalorthodontic distraction.J Oral Surg 1977;35:187
22.Diner PA,Kollar EM,Viguier E,Maurin N,Vasquez MP.Intraoral submerged bidriectional device for mandibular distraction.International Congress on Cranial and facial Bone Distraction Processes.Paris.France 1997:017
23.Guerrero C,Bell WH,Flores A,Modugno VL,Contasti G,Rodriguez AM,et al.Distraction osteogenica mandibular intraoral.Odontol Dia 1995;11:116~132
24.Razdolsky Y,Pensler JM,Dessner S.Skeletal distraction for mandibular lengthening with a completely intraoral toothborn distractor.In:McNamara JA Jr.Trotman CA.eds.Advances in craniofactial orthopedics.Volume 34.Craniofacial Growth Series.Ann Arbor:Center for Human Growth and Development.University of Michigan;1998;117:40
25.Schmelzeinsen R,Neumann G,von der Fecht R.Distraction osteogenesis in the mandible with a motordiven plate:a preliminary animal study.Br J Oral Maxillofac Surg,1996,34:375
