Effects of Axial Dynamization on Bone Healing

Egger, Erick L.; Gottsauner‐Wolf, Florian; Palmer, J. Foster; Aro, Hannu T.; Chao, Edmund Y.S.

doi:10.1097/00005373-199302000-00001

Cited by 123 publications

(43 citation statements)

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“…Previous studies, mostly in large animal models, have demonstrated that controlled loading can profoundly affect bone regeneration. [2][3][4][5][6][7][8][9][10][11][12][13] For example, cyclic compression of fractures leads to earlier and stronger callus formation, 6,8,11,[13][14][15][16] with early dynamization of external fixation leading to accelerated fracture healing compared to rigid fixation. 6,8,13,17 Conversely, static force across a fracture site, even when superimposed with cyclic compression, does not accelerate fracture repair.…”

Section: Introductionmentioning

confidence: 99%

In vivo cyclic axial compression affects bone healing in the mouse tibia

Gardner

Meulen

Demetrakopoulos

et al. 2006

Journal Orthopaedic Research

128

113

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Abundant evidence exists that fracture healing can be influenced by mechanical loading. However, the specific loading parameters that are osteogenic remain unknown. We hypothesized that the bone healing response in mouse tibial osteotomies would be different with a short delay before loading compared to immediate load application, as well as with higher and lower load magnitudes applied. Eighty 12-week-old mice underwent osteotomy of the left tibia followed by intramedullary nailing. Mice were divided into six groups based on days delayed until application of load (0 days or 4 days) and amplitude of cyclic load (0.5N, 1N, or 2N). Loading regimens were applied at 1 Hz for 100 cycles per day, 5 days per week for 2 weeks, using an external device that applied axial compression to the tibia. Bone healing was assessed by both microcomputed tomography (CT) and four-point bend testing. A short delay followed by cyclic application of a relatively low load led to improved fracture healing, as determined by increased callus strength, but this enhancement disappeared as load amplitudes increased. Load initiation immediately following fracture inhibited healing, regardless of the magnitude of load applied. MicroCT measurements of calluses in the early healing stage did not predict the mechanical strength of the fractures. These findings confirm that controlled, noninvasive cyclic loading can improve the strength of healing callus. However, application of load immediately after fracture appears to be detrimental to healing. Load magnitude also plays a critical role, and must be taken into account in future studies and clinical applications. As the loading parameters necessary to enhance fracture healing become refined, external compression may be used as a potent stimulus for treating fractures with decreased biological capacity. ß

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Section: Introductionmentioning

confidence: 99%

In vivo cyclic axial compression affects bone healing in the mouse tibia

Gardner

Meulen

Demetrakopoulos

et al. 2006

Journal Orthopaedic Research

128

113

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“…From fracture healing, it is well known that weight bearing promotes bone healing after stable fixation, 13 and because osteotomies can be viewed as controlled fractures, the bone healing rate may be increased by weight bearing too. Early full weight bearing (EFWB) starting within or at 2 weeks after open wedge HTO fixed with internal fixator plates has been proved safe, not leading to correction loss, and has a bone healing time similar to that in patients rehabilitated with a standard 6-week rehabilitation protocol.…”

mentioning

confidence: 99%

Smoking and Unstable Hinge Fractures Cause Delayed Gap Filling Irrespective of Early Weight Bearing After Open Wedge Osteotomy

Schröter

Freude

Kopp

et al. 2015

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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“…The fact that some investigators formed the basis of the present study 5,9 . Later it was thought that mechanical stimulation of fractures should start after the appearance of callus 12 .…”

Section: Discussionmentioning

confidence: 88%

The effect of manually controlled dynamization on the lengthened callus – preliminary results

Berki¹,

Szabó²,

Pap³

2010

Biomech Hung

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The present study evaluated the radiological changes in normal and dynamized callus after limb lengthening in New Zealand White rabbits. The aims of the study were to create a lengthening device that allows axial controlled manual dynamization and to examine the effect of the maximal amount of dynamization on the healing, lengthened callus. 10 male domestic white rabbits were divided into two groups (normal distraction group (NDG) and dynamized distraction group (DDG)). Osteotomy was followed by distraction at the same rate and total length in both groups, but in the dynamized distraction group 1 mm manual dynamization was performed for ten minutes three times a day prior to lengthening. Callus formation and lengthening were analysed on the X-ray pictures and on the three-dimensional CT image respectively. Neither malposition of the pins nor maluninon were found during or after the distraction period. No signifi cant difference was found in the amount of the callus between the NDG and DDG. A lengthening device was created that allows axial controlled manual dynamization and prevents instability in the other two axes and our results showed that this large amount of dynamization did not decrease the formation and quality of the callus.

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Effects of Axial Dynamization on Bone Healing

Cited by 123 publications

References 0 publications

In vivo cyclic axial compression affects bone healing in the mouse tibia

In vivo cyclic axial compression affects bone healing in the mouse tibia

Smoking and Unstable Hinge Fractures Cause Delayed Gap Filling Irrespective of Early Weight Bearing After Open Wedge Osteotomy

The effect of manually controlled dynamization on the lengthened callus – preliminary results

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