An experimental model for non-union using a muscle tissue interposition without osteotomy in rats

Fujita, Masahiro; Matsui, Noriko; Tsunoda, Masaya; Saura, R; Nose, Naohiro; Mizuno, Kosaku

doi:10.1097/00005131-199905000-00071

Cited by 7 publications

(9 citation statements)

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“…For example, removing periosteum and restricting its re-growth, coupled with reaming the marrow cavity and placing an intramedullary nail, can cause non-unions [25]. Combining reaming, periosteal cauterization and rotational instability also produce nonunions [17], as does creating local inflammation and infection through placement of various materials in the musculature adjacent to a fracture [5,13]. Large segmental defects have also been used to create delays in union [lo].…”

Section: Discussionmentioning

confidence: 99%

Cellular and molecular characterization of a murine non‐union model

Choi

Ogilvie

Thompson

et al. 2004

Journal Orthopaedic Research

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Purpose. We have developed a method to study the molecular and cellular events underlying delayed skeletal repair in a model that utilizes distraction osteogenesis.Methods. The clinical states of delayed union and non-union were reproduced in this murine model by altering distraction parameters such as the inclusion and exclusion of a latency phase and variations in the rate and rhythm of distraction. Radiographic, cellular, and molecular analyses were performed on the distraction tissues.Results. Eliminating the latency period delayed bony union, but did not appreciably alter the extent of platelet endothelial cell adhesion marker (PECAM) immunostaining. Following elimination of a latency phase and a threefold increase in the rate of distraction, there was a further delay in bone regeneration and a higher rate of non-union (60%). Instead of bone, the distraction gap was comprised of adipose or fibrous tissue. Once again, despite the rigorous distraction protocol, we detected equivalent PECAM staining within the distraction gap. In a minority of cases, cartilage and osseous tissues occupied the distraction gap likely by a prolonged process of endochondral ossification.Conclusions. Here, we have altered the mechanical environment in such a way to reproducibly create delays in skeletal regeneration. These delays in skeletal tissue regeneration appear to develop even in the presence of endothelial cells, which suggests that mechanisms other than a disruption to the vascular network can account for some cases of non-union.

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Section: Discussionmentioning

confidence: 99%

Cellular and molecular characterization of a murine non‐union model

Choi

Ogilvie

Thompson

et al. 2004

Journal Orthopaedic Research

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“…Because it has been noted that the healing time for rat fractures is 3 weeks, this model is regarded as a nonunion model. 20 Our Institutional Animal Care and Use Committee approved all procedures.…”

Section: Experimental Nonunion Modelmentioning

confidence: 99%

“…This method is simple and reproducible. 20 Using our rat nonunion fracture model, we assessed the effect of LIPUS on the rate of nonunion fracture healing in rat tibias. Our rat nonunion fracture model showed healing at a high rate as a result of the LIPUS exposure.…”

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confidence: 99%

Low‐intensity pulsed ultrasound initiates bone healing in rat nonunion fracture model.

Takikawa

Matsui

Kokubu

et al. 2001

J of Ultrasound Medicine

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Low-intensity pulsed ultrasound exposure has been shown clinically to shorten the fracture repair process and to induce healing of nonunions in humans, but its mechanism of action remains unclear. In this study we investigated the effect and mechanism of low-intensity pulsed ultrasound on nonunion fracture healing in rat tibias. A consistently reproducible nonunion was produced in rat tibias by muscle interposition without osteotomy. This model was produced by creating a closed tibial fracture with only the distal end of the tibialis anterior muscle interposed into the fracture site. One limb was noninvasively exposed to low-intensity pulsed ultrasound (a 200-millisecond burst of sine waves of 1.5 MHz, repeating at 1.0 kHz) for 20 minutes daily. The incident intensity was approximately 30 mW/cm2. Rats were killed at intervals between 2 and 6 weeks. The events were assessed by radiographs, microfocus X-ray computed tomograms, and histologic examination. After 6 weeks of exposure, 7 of 14 nonunion fractures showed healing on radiologic assessment. The results of three-dimensional microfocus X-ray computed tomographic reconstruction and histologic examination also supported this finding. On the other hand, all control tibias remained in a state of nonunion during the same period. These results indicate that low-intensity pulsed ultrasound promotes healing in the rat nonunion fracture model.

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“…A 3 cm incision above the medial malleolus was made and a low profile anatomically pre-contoured 3.5/4.5 mm locking compression plate (LCP; Synthes®, Oberdorf, Switzerland) was subcutaneously inserted in a retro- ated with fracture reduction difficulties, non-operative treatment failure, injury to the incarcerated structure and compromised bone union [1,2,[9][10][11][15][16][17][18][19][20][21]. Experimental studies show that muscle interposition in an animal fracture model prevents callus formation by creating a gap at the fracture site and is a predictable way to obtain intentional non-union [1,2,20,21]. In the human model, fractures treated conservatively may evolve towards non-union more frequently than those surgically fixed partly due to unrecognized loss of proper bone-tobone contact [16].…”

Section: Surgical Techniquementioning

confidence: 99%

Fixation of a Distal Diaphyseal Tibia Fracture with Neurovascular Tissue Incarceration: Surgical Technique Using a Lesser Invasive Approach

Belaieff¹

2017

Trauma Cases Rev

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Soft tissue incarceration in a distal diaphyseal tibia fracture may predispose to adverse fracture healing. Incarcerated soft tissue may include nerves and/or vessels, with the potential for neurovascular complications. Meticulous neurovascular examination of the extremity is mandatory, and, when in doubt, Doppler ultrasound of the fracture area should be obtained, in addition to computed tomography angiography if neurovascular structures are involved. In order to address this situation, a surgical technique combining the advantages of minimally invasive plate osteosynthesis and limited fracture line exposition is described, exemplified with the case of a 65 y/o male who sustained a low-energy right closed distal diaphyseal tibio-peroneal fracture (AO/ OTA type 42-B2) with anterior tibial artery and deep peroneal nerve entrapment.

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An experimental model for non-union using a muscle tissue interposition without osteotomy in rats

Cited by 7 publications

References 0 publications

Cellular and molecular characterization of a murine non‐union model

Cellular and molecular characterization of a murine non‐union model

Low‐intensity pulsed ultrasound initiates bone healing in rat nonunion fracture model.

Fixation of a Distal Diaphyseal Tibia Fracture with Neurovascular Tissue Incarceration: Surgical Technique Using a Lesser Invasive Approach

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