Hyperbaric Hyperoxia Accelerates Fracture Healing in Mice

Abstract

Increased oxygen tension influences bone metabolism. This study comprised two main experiments: one aimed to determine the bone mineral apposition and bone formation rates in vivo under hyperbaric hyperoxia (HBO), and the other aimed to evaluate the effects of exposure to HBO on fracture healing. In experiment 1, male mice were exposed to HBO [90 min/day at 90% O2 at 2 atmospheres absolute (ATA) for 5 days]. In experiment 2, an open femur fracture model was created in mice, followed by exposure to HBO 5 times/week (90 min/day at 90% O2 at 2 ATA) for 6 weeks after surgery. In experiment 1, HBO treatment significantly increased the mineral apposition and bone formation rates in the lumbar vertebra and femur and type 1 collagen alpha 1 and alkaline phosphatase mRNA expression in the lumbar vertebra. In experiment 2, at 2 weeks after fracture, the fracture callus was significantly larger in the HBO group than in the non-HBO group. Furthermore, at 4 and 6 weeks after fracture, radiographic findings showed accelerated fracture healing in the HBO group. At 6 weeks after fracture, femur stiffness and maximum load were significantly higher in the HBO group than in the non-HBO group. Urinary 8-hydroxy-2′-deoxyguanosine and plasma calcium concentrations were not significantly different between groups. These results suggest that exposure to HBO enhances bone anabolism and accelerates fracture healing without causing oxidative DNA damage or disruption of plasma calcium homeostasis.

Comparison of plaque and Distally-Wedged Tibial Nail in the treatment of extraarticular distal tibia fractures

“…Preservation of fracture haematoma, respectful surgery to soft tissueespecially periosteum around fracture site, proper fixation and surgical approach choice, fighting against infections peroperatively, micromovement of fracture site after stabilization contributes healing. Hyperbaric oxygen therapy for selected patients may contribute and experimental researches exist in the literature (25,26).…”

Influence of hyperbaric oxygen on the initial stages of bone healing

“…Although HBO is an established modality in the treatment of many disorders and has been successfully used in clinical conditions related to ischemia and/or hypoxia [4,5,6], HBO therapy is still under investigation.…”

“…HBO therapy has already been successfully used to improve bone healing [4,5,6] because it also stimulates angiogenesis and osteogenesis [4,7]. The molecular mechanisms of HBO on bone formation may be mediated via increased osteogenic differentiation, which is related to Runx2 production [8].…”

“…Although HBO is considered a valuable adjunct on the healing of bone defects [4,5,6], the current knowledge about its influence on initial stages of bone healing is limited. Therefore, the aim of this study was to evaluate the effect of HBO on the healing of experimental defects created in normal bone, at the first 7 days, in a rat model.…”

Transient Osteoporosis of the Hip and Hyperbaric Oxygen Therapy: A Report of Two Cases

“…The increasing effect of HBO on the bone formation and repair can be demonstrated as another action of mechanism. It has been revealed that HBO, which speeds up fracture healing, increases type 1 collagen formation from osteoblasts and alkaline phosphatase activity (11).…”