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Methods to Enhance Bone Formation in Distraction Osteogenesis

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Pediatric Lower Limb Deformities

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Abstract

Though distraction osteogenesis is one of the most anabolic processes known, it too has its limitations leading to the failure of the regenerate. Many mechanical, biological, and pharmacological methods have been developed to improve the quantity and quality of the new bone formation. In this chapter we describe various methods to monitor the regenerate, including the easy-to-use and objective pixel value ratio method. Physical stimulation techniques, including mechanical, ultrasound, and electromagnetic stimulation, have been in practice for quite some time. We have given special emphasis to the biological methods, including platelet-rich plasma, bone morphogenetic protein, stem cells, and growth factors, which are the current fields of research. A wide range of pharmacological agents from bisphosphonates to experimental drugs are being researched. But until now there has been no ideal foolproof option, and most of these methods are still in an experimental stage. The best treatment option is to identify the basic problem in every patient—poor anabolism or excessive catabolism—and treat accordingly with the available arsenal of mechanical, biological, and pharmacological methods.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Korea University Medical Center, Guro Hospital, #80, Guro-Dong, Guro-Gu, Seoul, 152703, Republic of Korea

    Hae-Ryong Song MD, PhD

  2. Department of Orthopedic Surgery, Severance Children’s Hospital, 134, Sinchon-Dong, Seodaemun-gu, Seoul, 120752, Republic of Korea

    Dong Hoon Lee MD, PhD

  3. Department of Orthopedic Surgery, KEPCO Medical Center, 308, Uicheon-ro, Dobong-Gu, Seoul, 132703, Republic of Korea

    Seung-Ju Kim MD, PhD

  4. Department of Orthopedic Surgery, Madurai Medical College, 1/c, S.Kodikulam North Main Street, K.Pudur, Madurai, Tamil Nadu, 625007, India

    Ashok Kumar Ramanathan MBBS, MS(Ortho)

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  1. Hae-Ryong Song MD, PhD
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  2. Dong Hoon Lee MD, PhD
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  3. Seung-Ju Kim MD, PhD
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  4. Ashok Kumar Ramanathan MBBS, MS(Ortho)
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Correspondence to Hae-Ryong Song MD, PhD .

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  1. Professor, Department of Orthopedics; Chief, Division of Pediatric Orthopedics, Rutgers-New Jersey Medical School, Newark, New Jersey, USA

    Sanjeev Sabharwal

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Song, HR., Lee, D.H., Kim, SJ., Ramanathan, A.K. (2016). Methods to Enhance Bone Formation in Distraction Osteogenesis. In: Sabharwal, S. (eds) Pediatric Lower Limb Deformities. Springer, Cham. https://doi.org/10.1007/978-3-319-17097-8_28

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