title: Evaluation of bone remodeling in regard to the age of scaphoid non-unions.
abstract: OBJECTIVE
  To analyse bone remodeling in regard to the age of scaphoid non-unions (SNU) with immunohistochemistry.
  
  
  METHODS
  Thirty-six patients with symptomatic SNU underwent surgery with resection of the pseudarthrosis. The resected material was evaluated histologically after staining with hematoxylin-eosin (HE), tartrate resistant acid phosphatase (TRAP), CD 68, osteocalcin (OC) and osteopontin (OP). Histological examination was performed in a blinded fashion.
  
  
  RESULTS
  The number of multinuclear osteoclasts in the TRAP-staining correlated with the age of the SNU and was significantly higher in younger SNU (P = 0.034; r = 0.75). A higher number of OP-immunoreactive osteoblasts significantly correlated with a higher number of OC-immunoreactive osteoblasts (P = 0.001; r = 0.55). Furthermore, a greater number of OP-immunoreactive osteoblasts correlated significantly with a higher number of OP-immunoreactive multinuclear osteoclasts (P = 0.008; r = 0.43). SNU older than 6 mo showed a significant decrease of the number of fibroblasts (P = 0.04). Smoking and the age of the patients had no influence on bone remodeling in SNU.
  
  
  CONCLUSIONS
  Multinuclear osteoclasts showed a significant decrease in relation to the age of SNU. However, most of the immunhistochemical findings of bone remodeling do not correlate with the age of the SNU. This indicates a permanent imbalance of bone formation and resorption as indicated by a concurrent increase in both osteoblast and osteoclast numbers. A clear histological differentiation into phases of bone remodeling in SNU is not possible.
authors.affiliation: Susanne Rein, Department of Plastic and Hand Surgery, Burn Unit, Trauma Center Bergmannstrost, 06112 Halle (Saale), Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Rein
authors.affiliation: Susanne Rein, Department of Plastic and Hand Surgery, Burn Unit, Trauma Center Bergmannstrost, 06112 Halle (Saale), Germany.
authors.forename: Uwe
authors.initials: U
authors.lastname: Hanisch
authors.affiliation: Susanne Rein, Department of Plastic and Hand Surgery, Burn Unit, Trauma Center Bergmannstrost, 06112 Halle (Saale), Germany.
authors.forename: Hans-Eberhard
authors.initials: HE
authors.lastname: Schaller
authors.affiliation: Susanne Rein, Department of Plastic and Hand Surgery, Burn Unit, Trauma Center Bergmannstrost, 06112 Halle (Saale), Germany.
authors.forename: Hans
authors.initials: H
authors.lastname: Zwipp
authors.affiliation: Susanne Rein, Department of Plastic and Hand Surgery, Burn Unit, Trauma Center Bergmannstrost, 06112 Halle (Saale), Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Rammelt
authors.affiliation: Susanne Rein, Department of Plastic and Hand Surgery, Burn Unit, Trauma Center Bergmannstrost, 06112 Halle (Saale), Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Weindel
keywords: Bone remodeling; Histology; Immunohistological staining; Scaphoid; Scaphoid non-union; Wrist joint