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Journal of Bone and Joint Surgery - British Volume, Vol 88-B, Issue 12, 1666-1669.
doi: 10.1302/0301-620X.88B12.17850  
Copyright © 2006 by British Editorial Society of Bone and Joint Surgery
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Relative ability of young and mature muscles to respond to limb lengthening

T. Shisha, MD, PhD candidate, General Practitioner1; S. Kiss, MD, Orthopaedic Surgeon1; K. Pap, MD, PhD candidate, General Practitioner1; H. Simpson, MD, PhD, DM(Oxon), Professor, Orthopaedic Surgeon2; and G. Szöke, MD, PhD, MSc(Oxon), Assistant Professor, Orthopaedic Surgeon1

1 Department of Orthopaedic Surgery, Semmelweis University, Karolina ut 27, H-1113 Budapest, Hungary.
2 Musculoskeletal Tissue Engineering Collaboration, University of Edinburgh Medical School, Chancellor’s Building, 49 Little France Crescent, Edinburgh EH16 4SB, UK.

Correspondence should be sent to Dr T. Shisha; e-mail: tamas_shisha{at}hotmail.com

The response of the muscle is critical in determining the functional outcome of limb lengthening. We hypothesised that muscle response would vary with age and therefore studied the response of the muscles during tibial lengthening in ten young and ten mature rabbits. A bromodeoxyuridine technique was used to identify the dividing cells.

The young rabbits demonstrated a significantly greater proliferative response to the distraction stimulus than the mature ones. This was particularly pronounced at the myotendinous junction, but was also evident within the muscle belly.

Younger muscle adapted better to lengthening, suggesting that in patients in whom a large degree of muscle lengthening is required it may be beneficial to carry out this procedure when they are young, in order to achieve the optimal functional result.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General