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Oliver Keast-Butler, Yathish Shenava, Samuel Rajaratnam, Sarah Phillips, Graeme Groom, David Goss
Kings College Hospital, Lead author Oliver Keast-Butler, 10 Osmers Hill, Wadhurst, East Sussex TN5 6QJ, oliverkeastbutler@hotmail.com
We measured blood flow 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. 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. We have demonstrated significant increases in blood flow during treatment with distraction osteogenesis, confirming previous experimental studies. We feel blood flow plays a significant role in the successful outcome of this treatment. We believe that 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.