The Journal of Bone and Joint Surgery, Vol 73, Issue 9 1323-1330, Copyright © 1991 by Journal of Bone and Joint Surgery, Inc
A comparison of the effects of skin coverage and muscle flap coverage on the early strength of union at the site of osteotomy after devascularization of a segment of canine tibia
RR Richards, MD McKee, CB Paitich, GI Anderson and JT Bertoia
Musculoskeletal Research Laboratory, St. Michael's Hospital, Toronto, Ontario, Canada.
A study was done to compare the effects of coverage with skin and those of
coverage with a muscle flap on the early return of strength at the site of
an osteotomy after interposition of a devascularized segmental autogenous
graft, two centimeters long, from a canine tibia. The bone was fixed with a
plate. Thirty-two animals were randomized into two groups, one of which was
treated with skin coverage and the other of which was treated with muscle
flap coverage. Half of the animals from each group were killed at eight
weeks and half, at twelve weeks postoperatively. The tibiae were tested to
failure in four-point bending. Failure occurred primarily through the site
of the distal osteotomy. Maximum bending load (p = 0.0002) and energy
absorbed to failure (p less than 0.02) increased significantly between
eight and twelve weeks postoperatively in the group in which a muscle flap
had been used for coverage. Bending stiffness was significantly greater at
eight weeks in the group in which a muscle flap had been used for coverage
than in the group in which skin had been used (p less than 0.03). Maximum
bending load was also significantly increased at twelve weeks in the group
in which a muscle flap had been used compared with the group in which skin
had been used (p less than 0.05).
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