Role of fracture hematoma and periosteum during fracture healing in rats: interaction of fracture hematoma and the periosteum in the initial step of the healing process

Ozaki, Akihiro; Tsunoda, Masaya; Kinoshita, Seiji; Saura, Ryuichi

doi:10.1007/s007760050010

Cited by 162 publications

(131 citation statements)

References 21 publications

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“…The fracture hematoma, formed during the induction stage [3], plays one of the most important roles in the healing process. by way of releasing signaling molecules that have the capacity to initiate the cascade of cellular events that is characteristic of the early phases of the fracture healing process [5,6,11,12,15,18]. Although prevention of infection by repeat irrigation and debridement is an essential component in the treatment of open fractures, it is necessary to clarify its potential influence on the biology of the fracture site, in order to provide insight into optimizing the treatment of such difficult cases.…”

Section: Resultsmentioning

confidence: 99%

Effect of repeated irrigation and debridement on fracture healing in an animal model

Park

Silva

Bahk

et al. 2002

Journal Orthopaedic Research

112

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The initial management of open fractures often requires repeated irrigation and debridement of the open wound and stabilization of the fracture. However, washing out the fracture hematoma could delay the early healing process of stable fractures. Because delayed union and non-union are serious complications, the effect of repeated irrigation and debridement on the fracture healing process was investigated.Twenty-four rabbits received unilateral, transverse, mid-tibia1 open osteotomies with a 3 mm gap. The osteotomy site was thoroughly irrigated and stabilized with double-bar external fixators. The osteotomy sites in the study groups underwent repeat irrigation and debridement on either the third day (Group II), the fourth day (Group HI), or consecutively on the first and second days (Group IV) after the index procedure. The bone healing was assessed with weekly radiographs and peripheral quantitative computerized tomographs.In Group I (control), all osteotomies healed radiographically before the tenth week. In Group 11, five out of six osteotomies healed radiographically before the tenth week. In Group 111, only two of five osteotomies healed before the tenth week. In Group IV, none of the osteotomies had healed by week fifteen. All of the non-healed osteotomies exhibited atrophic non-unions at fifteen weeks. Compared to the control group at the tenth week, the average bone mineral content at the osteotomy site and the area of high mineral density callus (2 890 mg/cm3) were significantly lower in Groups I11 (63% p = 0.002 and 95%, p = 0.05, respectively) and IV (99Y0, p < 0.001 and loo%, p = 0.05, respectively).The results of this study suggest that repeated irrigation and debridement, associated with persistent rigid immobilization, may contribute to the development of delayed unions or atrophic non-unions.

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Section: Resultsmentioning

confidence: 99%

Effect of repeated irrigation and debridement on fracture healing in an animal model

Park

Silva

Bahk

et al. 2002

Journal Orthopaedic Research

112

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“…Removal of the periosteum causes the time to cartilage formation at the fracture site to double. 19 Another group confirmed that osteoblasts involved in fracture repair come from the periosteum by tracing their lineage via alpha smooth muscle actin (aSMA)-Cre expression. This group of investigators has demonstrated that aSMA-Cre, while not specific for MSCs, is a useful marker for precursors that will develop into both chondrocytes and adipocytes.…”

Section: Mscs During Bone Regenerationmentioning

confidence: 98%

“…Bone marrow is known to contribute to bone repair after an injury as its removal delays fracture repair, but the mechanism by which this occurs is debated. 19 Taguchi et al created a green fluorescent protein (GFP)-chimeric mouse, having received a bone marrow transplant (BMT) from a GFP transgenic mouse. After transverse femoral fracture, GFPpositive cells were incorporated into the fracture callus (but not in the uninjured bone), and were more plentiful centrally in the callus where the osteocalcin-positive osteoblasts were located.…”

Section: Mscs During Bone Regenerationmentioning

confidence: 99%

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Mesenchymal Stem Cells in Bone Regeneration

Knight

Hankenson

2013

Advances in Wound Care

248

191

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“…The outer bone is covered by the periosteum that has a contributing role in the osteogenesis and the removal of the periosteum delays significantly the bone repair (1). The inner part of the bone is a mesh-like cancellous bone containing bone marrow (BM) where various cell types including multipotential stromal cells (MSCs) exist (2).…”

Section: Introductionmentioning

confidence: 99%

Interactions Between Multipotential Stromal Cells (MSCs) and Immune Cells During Bone Healing

El-Jawhari

Jones

McGonagle

et al. 2016

Recent Advances in Stem Cells

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Abstract:The physiological process of bone healing takes place in three sequential stages: inflammation, repair and remodelling. Multipotential stromal cells (MSCs) are the key progenitor cells for osteoblasts and chondrocytes and are also imbued with immunomodulatory capabilities.Although MSCs are well known to be involved in osteogenesis during the later stages of repair, their role during the inflammatory phase and precise interactions with immune cells remain poorly understood. This chapter describes the current knowledge on cellular interactions during the bone repair as well as cytokines and growth factors mediating these processes. The roles of emerging innate immune cell populations, innate lymphoid cells are also discussed.Based on this current knowledge, we conclude that in addition to their differentiation during later bone repair stages, MSCs are likely to have a substantial involvement in the initial stage of bone healing by controlling the fate of inflammation. An improved understanding of complex cell interactions during bone repair has broad implications on optimising the treatment of the fracture complications including non-union.

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Role of fracture hematoma and periosteum during fracture healing in rats: interaction of fracture hematoma and the periosteum in the initial step of the healing process

Cited by 162 publications

References 21 publications

Effect of repeated irrigation and debridement on fracture healing in an animal model

Effect of repeated irrigation and debridement on fracture healing in an animal model

Mesenchymal Stem Cells in Bone Regeneration

Interactions Between Multipotential Stromal Cells (MSCs) and Immune Cells During Bone Healing

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