The effect of intermittent pneumatic compression on fracture healing.
OBJECTIVE
Continuously increased venous pressure has been shown to enhance bone growth, stimulate fracture healing, and prevent bone loss, but also causes soft-tissue breakdown as a result of chronic edema. This study was designed to test the hypothesis that intermittently increased venous pressure improves fracture healing without injuring soft tissue.


METHODS
An ostectomy was created in the right radius of 30 skeletally mature male beagles. On postoperative day 7, a pneumatic cuff was placed around the forelimb of each dog. In experimental animals (n = 13), the cuff compressed for 5 minutes followed by no compression for 2.5 minutes. This cycle was repeated 100 times per day for 8 weeks. Control animals (n = 15) wore a nonfunctional cuff. Fracture healing was assessed with dual-energy x-ray absorptiometry, histologic analysis, and biomechanical testing.


RESULTS
No soft-tissue complications were noted. Bone mineral content at the ostectomy increased significantly more in the experimental group than in the control group (P < 0.05). Histology revealed that the bone defects in the experimental group were significantly more healed than those in the control group (P < 0.005). No differences were noted between groups in the biomechanical properties of the healing bones.


CONCLUSIONS
Intermittently increased venous pressure proximal to a bone defect seems to enhance the formation of new bone without soft-tissue complications. These findings can potentially be applied to the clinical treatment of "difficult to heal" fractures. Further work is necessary to determine the most effective ratio of the presence and absence of pneumatic compression.
Hewitt
John D
JD
Orthopaedic Research Laboratories, Division of Orthopaedic Surgery, Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA.
Harrelson
John M
JM
Dailiana
Zoe
Z
Guilak
Farshid
F
Fink
Christian
C
D015502:Absorptiometry, Photon; D000818:Animals; D001696:Biomechanical Phenomena; D015519:Bone Density; D002146:Bony Callus / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D004195:Disease Models, Animal; D004285:Dogs; D017102:Fracture Healing; D048228:Intermittent Pneumatic Compression Devices; D008297:Male; D010027:Osteotomy; D011885:Radius Fractures / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*