title: Local application of VEGF compensates callus deficiency after acute soft tissue trauma--results using a limb-shortening distraction procedure in rabbit tibia.
abstract: Acute soft tissue trauma influences callus formation and fracture healing. Several studies showed a relationship between angiogenesis and bone formation during distraction osteogenesis. The purpose of this study was to investigate the influence of controlled release of vascular endothelial growth factor (VEGF) on callus formation in a limb-shortening distraction procedure after acute compartment syndrome. Acute soft tissue trauma with critical increased compartment pressure was generated in 22 rabbits, and the limb was shortened simulating fracture site debridement. In the test group (n=11), a VEGF-coated collagen matrix was locally applied around the fracture, while no collagen was applied in the control group (n=11). Following 10 days in limb shortening, a gradual distraction of 0.5 mm/12 h was performed using an external fixation device and followed up for 40 days. Osseous consolidation occurred in all animals. Average callus diameter (1.54 ± 0.8 vs. 1.27 ± 0.14 mm) and torsional strength (72% vs. 46% of normal) were significantly higher in the test versus the control group. Blood vessel formation increased with a significantly higher number of vessels (6.3 vs. 3.81/mm2 ) and larger cross-sectional area (>40 µm, 90.5% vs. 86%) in the test versus control group. The results showed that locally applied VEGF stimulates fracture healing after acute soft tissue trauma and might be an option for fracture treatment in cases with severe soft tissue damage.
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Hospital, Westfälische Wilhelms University, Waldeyerstr. 1, D-48149 Muenster, Germany. ochman@uni-muenster.de
authors.forename: Sabine
authors.initials: S
authors.lastname: Ochman
authors.forename: Sönke
authors.initials: S
authors.lastname: Frey
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Raschke
authors.forename: Jehan N
authors.initials: JN
authors.lastname: Deventer
authors.forename: Rainer H
authors.initials: RH
authors.lastname: Meffert
mesh_terms: D000818:Animals; D001696:Biomechanical Phenomena / Q000187:drug effects / Q000502:physiology; D002146:Bony Callus / Q000187:drug effects* / Q000502:physiology; D017102:Fracture Healing / Q000187:drug effects* / Q000502:physiology; D018919:Neovascularization, Physiologic / Q000187:drug effects / Q000502:physiology; D019857:Osteogenesis, Distraction; D011817:Rabbits; D017695:Soft Tissue Injuries / Q000188:drug therapy* / Q000503:physiopathology; D013977:Tibia / Q000098:blood supply / Q000293:injuries / Q000601:surgery; D013978:Tibial Fractures / Q000188:drug therapy* / Q000503:physiopathology; D054159:Torsion, Mechanical; D042461:Vascular Endothelial Growth Factor A / Q000494:pharmacology*
chemical_list: D042461:Vascular Endothelial Growth Factor A