Abstract
Purpose
Experimental studies of the effects of various mechanical conditions and stimuli on
bone healing have disclosed an improvement potential in bone fracture mineralization
and biomechanical properties. We therefore evaluated the effect of a clinically practicable
application of a mechanical compressive interfragmentary stimulus on the healing of
experimental tibial diaphyseal fractures.
Methods
Sixty Male rats received a standardized tibial shaft osteotomy stabilized with a unilateral
external fixator with a zero interfragmentary distance, and then randomly assigned
to the compression (N = 20), control (N = 20) or distraction (N = 20) group. From days 4 to day 14, the external fixator was either tightened (compression
group) or loosened (distraction group) once daily to gradually induce a total axial
displacement of the external fixator pin clamps of 1.25 mm. Evaluation at 30 and 60 days post-osteotomy included radiography, dual-energy
X-ray absorptiometry (DXA), quantitative CT and mechanical testing.
Results
All fractures healed radiographically with sparse callus. At 60 days, the compression
and control groups exhibited significantly less amount of mineralized callus in terms
of DXA measured callus area and bone mineral content (BMC) compared to the distraction
group. These groups also demonstrated a smaller volume of low-mineralized bone tissue
(callus) and a larger volume of highly mineralized bone tissue (cortical bone) measured
by QCT than in the distraction group. Both mechanical strength and stiffness was significantly
higher in the compression and control groups than in the distraction group at 60 days.
Discussion
Compression did not enhance fracture healing in terms of mineralization, bending strength,
or stiffness at the time of union, compared with the control condition. The compression
and control groups exhibited improved healing in terms of mechanical strength and
stiffness and a more mature callus mineralization compared with the distraction group.
Keywords
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Article info
Publication history
Accepted:
August 18,
2010
Identification
Copyright
© 2010 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
