The principle underlying Ilizarov's method of limb lengthening — distraction osteogenesis — is based on which biological concept?
- A Periosteal stripping stimulates endochondral ossification to fill defects
- B Corticotomy destroys the medullary vascularity, triggering BMP-mediated bone induction
- C Tension-stress effect: slow, rhythmic traction on living tissues stimulates and maintains regeneration and active growth ✓
- D Intramedullary pressure created by the ring fixator forces mesenchymal cells to differentiate into osteoblasts
Explanation
Ilizarov's 'law of tension-stress' states that slow, rhythmic distraction (1 mm/day in 4 increments of 0.25 mm each) applied to living tissue after corticotomy stimulates and maintains active growth of bone, periosteum, vessels, nerves, skin, and muscle — a phenomenon termed distraction osteogenesis. The corticotomy preserves the endosteal blood supply and periosteum, allowing regenerate bone formation in the distraction gap. The distraction rate and rhythm are critical — too fast causes fibrous union; too slow causes premature consolidation. This principle enables simultaneous deformity correction and lengthening in a single frame.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
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Written and medically reviewed by the StethoPrep medical team.