Early Dynamization by Reduced Fixation Stiffness Does Not Improve Fracture Healing in a Rat Femoral Osteotomy Model

被引:87
作者
Claes, Lutz [1 ]
Blakytny, Robert [1 ]
Goeckelmann, Melanie [1 ]
Schoen, Marcus [1 ]
Ignatius, Anita [1 ]
Willie, Bettina [1 ]
机构
[1] Univ Ulm, Inst Orthopaed Res & Biomech, D-89081 Ulm, Germany
关键词
fracture healing; dynamization; biomechanics; computed tomography; EXTERNAL FIXATION; DIAPHYSEAL OSTEOTOMIES; MECHANICAL STIMULATION; AXIAL DYNAMIZATION; MOUSE TIBIA; BONE; INSTABILITY; STABILITY; GAP; PSEUDOARTHROSIS;
D O I
10.1002/jor.20712
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
100224 [整形外科学];
摘要
Dynamization of fracture fixation is used clinically to improve the bone healing process. However, the effect of early dynamization remains controversial. This study evaluated the effect of early dynamization, by reduced stillness of fixation on callus stiffness and size after 5 weeks of healing in a rat diaphyseal femoral osteotomy. An external unilateral fixator allowed either a rigid (R-group; n = 8) or a flexible (D-group; n = 8) fixation. The dynamized group (D-group: n = 8) had a rigid fixation for 1 week, and then a flexible fixation for the remaining 4 weeks. The pre- and postoperative activity of the rats was measured. After 5 weeks, the rats were sacrificed, and healing was evaluated by biomechanical and densitometric methods. The R-group had a higher activity more closely approaching preoperative levels, compared to the D-group throughout all time points measured. This difference was significant after 14 days and 21 days. The flexural rigidity of the R-group was 82% (tested in the anterior-posterior direction; p=0.01) and 93% (tested in the medial-lateral direction; p=0.002) greater than the flexural rigidity of the D-group. The rigid fixation led to a stiffer callus with a smaller callus volume, but better mineralized tissue in the whole callus and at the level of the ostcotomy gap than the flexible or the dynamized fixation. Early dynamization did not improve healing compared to rigid or flexible fixation in a rat femoral osteotomy model. (C) 2008 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 27:22-27, 2009
引用
收藏
页码:22 / 27
页数:6
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