Abstract
Fracture or periosteal elevation near epiphysis induces inflammatory vascularity which is reported in early bone lengthening literature. In this study, corticotomy and periosteal elevation were put to use to induce new inflammatory vessels as collaterals in an ischaemic limb. In this prospective investigation between May 1990 and May 2000, seventy-two patients suffering from severe occlusive arterial disease (44 TAO, 13 atherosclerosis, 11 Raynaud’s disease, and 4 diabetics), who had not responded to previous non-surgical or failed surgical treatment, and had progressively deteriorating ischemic limbs, were subjected to corticotomy near major neurovascular bundles and the periosteal elevation along the whole length of the bone. There was complete relief from rest pain and an indefinite postponement of amputation in sixty-one out of seventy two patients. Longest follow up is ten years and shortest is six months. This new approach is based on principle of inflammation which is the universal reparative biological process. Digital Subtraction Angiography (DSA) studies before and after operation convincingly showed the continuance of a new vascular collateral network across the affected arteries, a process, which saved the ischemic limbs from certain amputation. This new Inflammatory vascular leash acts as a biological ‘bypass’ and appears to be an answer to small and diffuse artery disease, where vascular reconstruction is otherwise impossible.
The abstracts were prepared by Professor Jegan Krishnan. Correspondence should be addressed to him at the Flinders Medical Centre, Bedford Park 5047, Australia.
