Experimental study on the effect of mechanical stimulation on the early stage of fracture healing.
In an attempt to ascertain the effects of mechanical stimulation on callus in the early stage of bone fracture healing, a tibial fracture was induced in rats and mechanical stimulation applied to the fractures. The callus was then measured quantitatively, while the fractures were analyzed both radiographically and histologically. Following the induction of a closed transverse fracture in the tibia, external anchors were applied and the rats raised by suspending the fractured leg. The rats were divided into two main groups: a Stimulation Group (S Group) and a Control Group (C Group) without the application of any mechanical stimulation. The S Group was further divided into the following three subgroups: an axial compression group (Sc Group) receiving stimulation in the positive direction; an axial distraction group (Sd Group) receiving stimulation in the negative direction; and an axial dynamization group (Sdy Group) receiving stimulation in both directions alternately. For mechanical stimulation, 1.4-N sine waves were applied continuously for 30 minutes a day, three times a week, starting 2 days after fracture-inducing surgery. At 3, 7, and 14 days after surgery, transverse sections of each fractured bone sample were prepared. At 14 days after surgery, each transverse section was divided into two peripheral and central regions to permit calculation of the area ratio of callus. Radiographically, no marked differences were observed among the groups; histologically, differences were seen 7 days after surgery, suggesting that mechanical stimulation facilitated bone healing soon after surgery. At 14 days after surgery, the amount of callus for the C Group was less than that for all three stimulation groups. In the C Group, the amount of callus in the peripheral region was greater than in the central region, and in the Sc Group, the results were the same: callus in the peripheral region was greater than in the central region. In the Sd Group, callus was greater in the central region than in peripheral regions. In the Sdy Group, favorable callus was observed in both the central and peripheral regions. These findings suggest that axial compression facilitates callus primarily in the peripheral region, while axial distraction facilitates callus primarily in the central region. When axial compression and distraction were alternated (dynamization), callus was significantly facilitated in both the central and peripheral regions. Of the three axial stimulation techniques, dynamization was the most effective in facilitating callus in the early stage of bone fracture healing.
Department of Orthopedic Surgery, Nippon Medical School, Tokyo, Japan. orth-tom@pc4.so-net.ne.jp
Tomomichi
T
Takeda
Tetsuya
T
Narita
Hiromoto
H
Ito
D000818:Animals; D017102:Fracture Healing / Q000502:physiology*; D008297:Male; D010812:Physical Stimulation; D051381:Rats; D017207:Rats, Sprague-Dawley; D013978:Tibial Fractures / Q000503:physiopathology