A special healing pattern in stable metaphyseal fractures
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Published on: August 16, 2018
Wen Tao Chen1, Da Cheng Han, Pei Xun Zhang
1Department of Trauma and Orthopaedics , Peking University People's Hospital, Xicheng District, Beijing , P. R. China.
Background And Purpose:
Metaphyseal fractures heal in a rapid fashion that is different from the bone shaft healing process. Animal studies have focused on diaphyseal fractures. We investigated the metaphyseal fracture-healing process in rabbits.
Animals And Methods:
60 rabbits (divided into 12 groups) underwent proximal tibial osteotomy, anatomical reduction, and fixation with screws. After surgery, the proximal tibiae were harvested at different time points for histology.
Results:
No obvious osteonecrosis or bone resorption were found 2 weeks after surgery. From day 5 to week 5, woven bone or new trabeculae formed. From week 2, remodeling into lamellar bone started and reached a peak at week 6. These 3 stages overlapped. Histomorphometry showed that the structure changed as a unimodal curve.
Interpretation:
The healing process of metaphyseal fractures appears to differ from the commonly studied healing process in diaphyseal fractures. It is rapid, and can be divided into 4 histological stages: cellular activation and differentiation, formation of woven bone, transformation of woven bone into lamellar bone, and further remodeling.
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