The Vascular Response to Fracture Micromovement

Wallace, Angus; Draper, E. R. C.; Strachan, R. K.; McCarthy, I. D.; Hughes, Sean

doi:10.1097/00003086-199404000-00044

Cited by 88 publications

(59 citation statements)

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“…This conclusion is, however, often related to the (2003) 6 6 2 4 6 [mm'] 140-bone densty [%] ' mineralized bone area [mmz] connective tissue area [mm'] application of defined movements to stimulate fracture healing [2,6,8,10,33].…”

Section: Discussionmentioning

confidence: 99%

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The initial phase of fracture healing is specifically sensitive to mechanical conditions

Klein¹,

Schell²,

Streitparth³

et al. 2003

Journal Orthopaedic Research

235

148

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Interfragmentary movements affect the quality and quantity of callus formation. The mounting plane of monolateral external fixators may give direction to those movements. Therefore, the aim of this study was to determine the influence of the fixator mounting plane on the process of fracture healing.Identically configured fixators were mounted either niedially or anteromedially on the tibiae of sheep. Interfragmentary movements and ground reaction forces were evaluated in vivo during a nine week period. Histomorphological and biomechanical parameters described the bone healing processes.Changing only the mounting plane led to a modification of interfragmentary movements in the initial healing phase. The difference in interfragmentary movements between the groups was only significant during the first post-operative period. However, these initial diferences in mechanical conditions influenced callus tissue formation significantly. The group with the anteromedially mounted fixator. initially showing significantly more interfragmentary movements, ended up with a significantly smaller callus diameter and a significantly higher callus stiffness as a result of advanced fracture healing. This demonstrates that the initial phase of healing is sensitive to mechanical conditions and influences the course of healing. Therefore, initial mechanical stability of an osteosynthesis should be considered an important factor in clinical fracture treatment.

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Section: Discussionmentioning

confidence: 99%

“…On the other hand, interfragmentary shear movements seem to allow, at least partially, regular bone consolidation [27]. These conclusions are, however, often related to the application of defined movements throughout the healing process [2,6,8,10,33].…”

Section: Introductionmentioning

confidence: 99%

The initial phase of fracture healing is specifically sensitive to mechanical conditions

Klein¹,

Schell²,

Streitparth³

et al. 2003

Journal Orthopaedic Research

235

148

View full text Add to dashboard Cite

show abstract

“…They are mechanically protected by the surrounding mineralized trabecular structure of the bony callus and are not subjected to the IFS which mainly takes place in the non-mineralized part of the callus [6,7]. The influence of the IFM on the vascularization of the callus area seems to be different in the early and late healing phase, as shown by Wallace et al [15]. Whereas in the early healing phase, more IFM seems to promote vascularization in the later phase the more stable fixation seems to be better.…”

Section: Discussionmentioning

confidence: 99%

“…They showed that, in the early healing phase, larger IFMs led to more corticomedullary blood supply, than smaller IFMs. After six weeks, however an approximately 50'% higher blood supply was found in the periosteal callus for the more stable group [15].…”

mentioning

confidence: 84%

The effect of mechanical stability on local vascularization and tissue differentiation in callus healing

Claes

Eckert-Hübner

Augat

2002

Journal Orthopaedic Research

236

135

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To investigate the influence of the stability of an osteotomy fixation on the local vascularization and tissue differentiation in callus healing, a transverse osteotomy of the right metatarsal with a gap size of 2 mm was performed in 10 sheep and stabilized with an external fixator. This fixator permitted a defined axial movement. Two groups of 5 sheep were each operated upon to allow 0.2 mm (group A) or 1 mm (group B) of axial movement. Nine weeks after surgery, the callus was dissected and histological sections prepared. The type of tissue and the vessel distribution were determined.Larger interfragmentary movements led to significantly more fibrocartilage (small axial movement A: 6.2%, large axial movement B: 21.6%) and significantly less bone formation (A: 38.2%, B: 26.3%). On average, and particularly close to the periosteum the number of vessels in the callus healing area was greater in the group with smaller movements than in the group with larger movements. There was a significant difference between the distribution of small (<20 Fin) and large (>40 pm) vessels across the whole healing area for both groups. Whereas the large vessels showed maximum density in the medullary cavity, the small vessels showed the highest frequency in the peripheral part of the periosteal callus.

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“…1) [17]. Daily loading was begun after a 4-day fracture consolidation period to allow for stabilization of the hematoma and early angiogenesis [19,34] and continued for 5 days per week for 2 weeks. One group had 100 load cycles applied daily at a rate of 1 Hz.…”

Section: Methodsmentioning

confidence: 99%

Pause Insertions During Cyclic In Vivo Loading Affect Bone Healing

Gardner

Ricciardi

Wright

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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Fracture repair is influenced by the mechanical environment, particularly when cyclic loads are applied across the fracture site. However, the specific mechanical loading parameters that accelerate fracture healing are unknown. Intact bone adaptation studies show enhanced bone formation with pauses inserted between loading cycles. We hypothesized pause-inserted noninvasive external loading to mouse tibial fractures would lead to accelerated healing. Eighty mice underwent tibial osteotomies with intramedullary stabilization and were divided into four loading protocol groups: (1) repetitive loading (100 cycles, 1 Hz); (2) pause/time-equivalent (10 cycles, 0

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The Vascular Response to Fracture Micromovement

Cited by 88 publications

References 0 publications

The initial phase of fracture healing is specifically sensitive to mechanical conditions

The initial phase of fracture healing is specifically sensitive to mechanical conditions

The effect of mechanical stability on local vascularization and tissue differentiation in callus healing

Pause Insertions During Cyclic In Vivo Loading Affect Bone Healing

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