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KMID : 0350519920450020533
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Journal of Catholic Medical College
1992 Volume.45 No. 2 p.533 ~ p.543
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The Effect of Arteriovenous fistula, Narrowing of Femoral Artery and Sciatic Nerve Resection on Long Bone Growth in Growing Rats
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Abstract
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The limb length discrepancy due to vascular insufficiency or nerve damage in children are not rar, but the exact mechanism and their proper treatment are still not well known. The present sutdy was performed to clarify the effects of
arteriovenous
fistula, narrowing of the femoral artery and sciatic nerve resection on lower limb growth in growing rats. We fashioned an arteriovenous fistula between the femoral artery and vein in group I, partial narrowing of the femoral artery in group II
and
a
segmental resection of the sciatic nerve in group III in the left lower limb in each rat. Angiography was performed to check altered blood flow, patncy of arteriovenous fistula and parrowing of vessels. The limb length discrepancy was measured
radiographically. Histological changes of bone and muscle were observed microscopicaly. The right lower limb was used as control in each animal and follow up study was carried out for 16 weeks after experiments.
@ES The results obtained were as follows:
@EN 1. In group I, arteriovenous fistula accelerated both the longitudinal and appositional growth of the long bone and increased the total blood flow. The length of the left femur withan arteiovenous fistula was 36.35*0.70mm and that of the
right
control femur was 35.66*0.81mm(P<0.05).
The length of the left tibia was 37.99*1.04mm and the of the rigth tibia was 37.42*0.93mm(P>0.05). The limb length discropancy between both lower extremities was 0.69 mm in the femur and 0.57 mm in the tibia. The histology showed thickening of
the
periosteum and cortical bone, but the internal architecture of bone and muscle remained unchanged.
2. In group II, neither limb length discrepancy nor bone change was found, but partial collateral circulation was noted. The length of the left femur with partial narrowing of the femoral artery was 35.22*1.17 mm and that of the right control
femur was
35.37*1.09 mm(P>0.05). The length of the left tibia was 38.26*0.50 mm and that of the right tibia was 38.24*0.61 mm (P>0.05).
3. In group III, the blood flow was decreased presumably due to muscle atrophy, but neither limb length discrepancy nor boen change was observed. The length of the left femur with a segmental resection of the sciatic nerve was 33.04*3.57 mm and
that of
the right control femur was 33.13*3.58 mm(P>0.05). The length of the left tibia was 35.72*3.94 mm and thet of the right tibia was 35.39*3.75 mm(P>0.05).
The results suggest that nerve resection and narrowing of the femoralartery in growing rat do not affect the growth of bone in a short period of time, but increased blood flow due to arteriovenous fistula accelerated bone growth even in a
relatively
short period of time.
It is concluded that vascular injury in growing children should be treated earlier to prevent limb length discrepancy later.
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KEYWORD
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