The influence of intermittent external dynamic pressure and tension forceson the healing of an epiphyseal fracture

Citation
E. Breburda et al., The influence of intermittent external dynamic pressure and tension forceson the healing of an epiphyseal fracture, ARCH ORTHOP, 121(8), 2001, pp. 443-449
Citations number
30
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Ortopedics, Rehabilitation & Sport Medicine
Journal title
ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY
ISSN journal
0936-8051 → ACNP
Volume
121
Issue
8
Year of publication
2001
Pages
443 - 449
Database
ISI
SICI code
0936-8051(200109)121:8<443:TIOIED>2.0.ZU;2-L
Abstract
In vitro studies about the regenerative capacity of chondrocytes located in the growth plate of long bones revealed a potential for reparation. A meas urable advance in the understanding of the physiologic processes in the bon e growth plate and their modifications after defined lesions is based on th e recognition of the role of the vascular architecture. Newly formed bridgi ng arteries crossing from the metaphysis to the epiphysis through the growt h plate are thought to be responsible for the cell proliferation observed a fter Salter-Harris I and II lesions. We aimed to examine the influence of m echanical microstimulations on the growth or inhibition of the proliferatio n of the chondrocytes in the tibial growth plate. We studied 22 tibial bone fractures, which were stabilized with a dynamic or a stable external fixat eur. Proliferative changes in the bone tissue were examined by immunohistoc hemical classification using bromodeoxyuridine (BUdR), a thymidine analogue . Radiologic studies, computer tomography, and magnetic resonance imaging d ocumented the results in comparison with histological examination. Cell pro liferation in the growth plate was not stimulated in the I st week after di straction. The histological studies revealed an initial increase in prolife ration of chondrocytes, especially between the 2nd and the 4th week. This w as more clearly seen with the use of the dynamic fixator. We conclude that a temporary ischemia with a reactive hyperemia takes place, which we could document by histological analysis and MRI. These results could modify the c urrent clinical therapy of growth plate fractures.