The effective dose of ZnCl2 augmentation for the enhancement of fracture healing in rats was reduced 3-fold in this study compared with previous findings. Furthermore, CaSO4 acted synergistically with ZnCl2 to increase the mechanical strength and stability at the fracture site.
This study investigated the effects of local delivery of manganese chloride (MnCl 2 ), an insulin-mimetic compound, upon fracture healing using a rat femoral fracture model. Mechanical testing, histomorphometry, and immunohistochemistry were performed to assess early and late parameters of fracture healing. At 4 weeks post-fracture, maximum torque to failure was 70% higher (P < 0.05) and maximum torsional rigidity increased 133% (P < 0.05) in animals treated with 0.125 mg/kg MnCl 2 compared to saline controls. Histological analysis of the fracture callus revealed percent new mineralized tissue was 17% higher (P < 0.05) at day 10. Immunohistochemical analysis of the 0.125 mg/kg MnCl 2 treated group, compared to saline controls, showed a 379% increase in the density of VEGF-Cþ cells. In addition, compared to saline controls, the 0.125 mg/kg MnCl 2 treated group showed a 233% and 150% increase in blood vessel density in the subperiosteal region at day 10 post-fracture as assessed by detection of PECAM and smooth muscle a actin, respectively. The results suggest that local MnCl 2 treatment accelerates fracture healing by increasing mechanical parameters via a potential mechanism of amplified early angiogenesis leading to increased osteogenesis. Therefore, local administration of MnCl 2 is a potential therapeutic adjunct for fracture healing. ß
Exploration into the molecular aspects of the healing process has led to the development of autologous and recombinant biologic agents. These products, collectively known as orthobiologics, have the potential to optimize favorable outcomes with respect to bone and soft-tissue restoration and to maximize the natural healing response. These orthobiologics include platelet-derived growth factor, bone morphogenetic proteins, and platelet-rich plasma. Although the usefulness of these growth factors is well described in various fields of surgery, few data exist to support or oppose the specific application of growth factors in foot and ankle surgery.
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