Kalıcı ve geçici epifizyodez tekniklerinin incelenmesi: Tavşan modelli deneysel çalışma

Year 2013, Volume: 47 Issue: 1, 48 - 54, 05.04.2013

Baran Komur Melike Coskun Ahmet Komur Aylin Oral

Abstract

Amaç: Bu çalışmanın amacı kalıcı epifizyodez olarak tanımlanan Phemister tekniği ile stapler ile geçici epifizyodezi karşılaştırmak ve staplerin çıkarılması sonrası epifiz plağı aktivitesinin derecesini radyolojik, sintigrafik ve histopatolojik olarak değerlendirirken, kemik sintigrafisinin beklenen fizis aktivitesi hakkında bilgi verip vermeyeceğini incelemek idi.
Çalışma planı: Çalışmada her bir grupta sekizer adet tavşan olacak şekilde üç grupta toplam 24 adet Yeni Zelanda tavşanı değerlendirildi. Birinci gruba Phemister tekniği ile epifizyodez, ikinci gruba stapler ile epifizyodez ve üçüncü gruba staplerler 3. hafta sonunda alınacak şekilde stapler ile epifizyodez uygulandı. Üçüncü ve altıncı haftalarda tüm hayvanların radyolojik ve sintigrafik bilgileri kaydedildi. Yine üçüncü ve altıncı haftalarda hayvanların uzuv uzunlukları ölçüldü ve sintigrafik değerlendirme ile büyüme plağı aktivitesi kaydedildi. Kalitatif ve kantitatif yöntemler ile büyüme plağının histopatolojik ölçümleri yapıldı. Tüm veriler opere edilmeyen sağ taraf ile karşılaştırıldı.
Bulgular: Diğer gruplarla karşılaştırıldığında, birinci grubun sintigrafik, radyolojik ve histopatolojik sonuçlarının daha etkili olduğu saptandı (p<0.05). Üçüncü grupta büyüme plağı aktivitesi normal fizis aktivitesinden daha yüksek saptandı (p<0.05).
Çıkarımlar: Radyolojik değerlendirmeyle birlikte ameliyat öncesi ve sonrası uygulanacak sintigrafinin büyüme plağı geri dönüş aktivitesi hakkında bir fikir verebileceği söylenebilir.

Keywords

Büyüme plağı; epifizyodez; Phemister tekniği; stapler; sintigrafi.

Permanent and temporary epiphysiodesis: an experimental study in a rabbit model

Abstract

Objective: The aim of this study was to compare the Phemister technique (permanent epiphysiodesis) with temporary epiphysiodesis with stapling and evaluate the degree of epiphyseal plate activity following staple removal using radiographic, scintigraphic and histopathologic methods and to investigate whether bone scintigraphy could provide clues on expected physis activity.
Methods: This study included 24 New Zealand rabbits divided into three groups of 8. Group 1 underwent Phemister’s epiphysiodesis; Group 2, epiphysiodesis with stapling; and Group 3, epiphysiodesis stapling group with staples removed in the 3rd week. Radiological and scintigraphic data were recorded in the 3rd and 6th weeks. All animals were sacrificed for histopathological evaluation at the 6th week. Limb length was calculated using radiological assessment and their growth plate activation recorded from scintigraphic region of interest (ROI) assessment in the 3rd and 6th weeks. Histopathological findings of the growth plate were measured using qualitative and quantitative methods. All data were compared to the non-operated right side.
Results: Group 1 had effective scintigraphic, radiologic and histopathological findings than the other groups (p<0.05). In Group 3, growth plate activation was detected to be higher than the regular physis activity (p<0.05).
Conclusion: Preoperative and postoperative scintigraphy combined with radiological assessment can provide an idea on the reversibility of growth plate activation.

Keywords

Epiphysiodesis, growth plate, Phemister technique, stapler, scintigraphy

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