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Review of Orthopaedics, 5th Edition by Mark D. Miller

By Mark D. Miller

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Thyroid hormones—Affect bone resorption more than bone formation, leading to osteoporosis (large [thyroid-suppressive] doses of thyroxine can lead to osteoporosis). Regulates skeletal growth at the physis by stimulating chondrocyte growth, type X collagen synthesis, and alkaline phosphatase activity. Growth hormone—Causes positive calcium balance by increasing gut absorption of calcium more than it increases urinary excretion. Insulin and somatomedins participate in this effect. Growth factors—TGF-β, PDGF, and mono-/lymphokines have roles in bone and cartilage repair (discussed elsewhere in this chapter).

C. Histologic phases (1) Latency phase (5-7 days) (2) Distraction phase (1 mm per day [approximately 1 inch per month]) (3) Consolidation phase (typically twice as long as the distraction phase) 33 34 4. D. Conditions that promote optimal bone formation during distraction osteogenesis a. Low-energy corticotomy/osteotomy b. Minimal soft tissue stripping at the corticotomy site (preserves blood supply) c. Stable external fixation to eliminate torsion, shear, and bending moments d. Latency period (no lengthening) of 5-7 days e.

Alternate-day therapy may reduce the effects. Thyroid hormones—Affect bone resorption more than bone formation, leading to osteoporosis (large [thyroid-suppressive] doses of thyroxine can lead to osteoporosis). Regulates skeletal growth at the physis by stimulating chondrocyte growth, type X collagen synthesis, and alkaline phosphatase activity. Growth hormone—Causes positive calcium balance by increasing gut absorption of calcium more than it increases urinary excretion. Insulin and somatomedins participate in this effect.

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