Factors affecting the process of callus distraction in limb lengthenin
g include the type of osteotomy, timing and rate of distraction, and s
tability of fixation. Thirty-two rabbits were studied to evaluate the
reliability of transverse osteotomy and delayed distraction and to exa
mine the appropriate rates of distraction. Rabbit tibiae were osteotom
ized subperiosteally and were subjected to slow distraction using a ri
gid monolateral external fixator. There was a ten-day waiting period b
efore distraction. The animals were divided into three groups accordin
g to the rate of distraction (0.35 mm/12 hours, 0.7 mm/12 hours, 1.4 m
m/12 hours). The process of callus formation was monitored by soft x-r
av. The reliability of delayed distraction after transverse osteotomy
was demonstrated by microangiographic study. Even though intramedullar
vessels were interrupted by osteotomy at surgery, blood circulation r
ecovered during the waiting period before distraction. Bone lengthenin
g was successful when distraction was carried out at rates of 0.35 mm/
12 hours or 0.7 mm/12 hours. The callus filling a distraction gap show
ed a characteristic zone structure, i.e., one central radiolucent zone
and two adjacent sclerotic zones. Microangiographic study demonstrate
d the continuity of blood vessels, under these rates of distraction. B
ased on the results of these experiments and clinical experiences on 1
80 bone lengthenings, the authors believe that a waiting period after
osteotomy is more practical than achieving immediate distraction after
uncertain corticotomy.