title: Laser doppler flow imaging of open lower leg fractures in an animal experimental model.
abstract: OBJECTIVE
  Open lower leg fractures are frequently associated with severe soft tissue damage, followed by osteomyelitis. Using an animal experimental model, we investigated the effect of timing of coverage of a tibial fracture with a local muscle flap.
  
  
  METHODS
  80 rabbits had a tibial fracture induced in a standardised fashion, which was stabilised by screw osteosynthesis. After 3 (group A; n=40) and 7 days (group B; n=40), respectively, the tissue defect was covered by a local gastrocnemius flap. In increasing intervals from 1 to 2, 4, 8, and 16 weeks, the rabbits from each group were killed and the bone fracture was analysed histomorphologically. Cortical microcirculation was measured by 2-channel laser doppler flowmetry.
  
  
  RESULTS
  Muscle flaps after 3 days improved perfusion significantly as compared with 7 days (24 Flux [standard error, 5 Flux] versus 10 Flux [3 Flux]; baseline, 1.4 Flux). Group A animals also displayed a lower rate of necrosis (0 versus 38). The incidence of osteomyelitis was higher in group B than in group A (24% versus 0%).
  
  
  CONCLUSIONS
  Laser doppler flowmetry was proven to be a reliable, minimally invasive means for identifying avital tissue, leading to reduction in the loss of vital bone tissue in experimental settings.
authors.affiliation: Division of Trauma and Plastic Surgery, Department of Surgery, Heidelberg University, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany. JT8@ix.urz.uni-heidelberg.de
authors.forename: L
authors.initials: L
authors.lastname: Herzog
authors.forename: F X
authors.initials: FX
authors.lastname: Huber
authors.forename: P J
authors.initials: PJ
authors.lastname: Meeder
authors.forename: G
authors.initials: G
authors.lastname: Muhr
authors.forename: J
authors.initials: J
authors.lastname: Buchholz
mesh_terms: D000818:Animals; D001863:Bone Screws; D004195:Disease Models, Animal; D017078:Laser-Doppler Flowmetry; D008833:Microcirculation; D009132:Muscles / Q000637:transplantation; D009336:Necrosis; D010019:Osteomyelitis / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology; D011817:Rabbits; D012039:Regional Blood Flow; D013524:Surgical Flaps / Q000098:blood supply*; D013977:Tibia / Q000098:blood supply* / Q000601:surgery; D013978:Tibial Fractures / Q000601:surgery*