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Fracture blister formation: a laboratory study

C P Giordano1, D Scott, K J Koval

  • 1Hospital for Joint Diseases, Orthopaedic Institute, New York, New York 10003, USA.

The Journal of Trauma
|June 1, 1995
PubMed
Summary
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Fracture blisters may form due to skin strain during bone fractures. This biomechanical study on cadaver skin supports the hypothesis that high levels of skin deformation can cause dermal-epidermal separation, mimicking fracture blisters.

Area of Science:

  • Biomechanics
  • Dermatology
  • Orthopedics

Background:

  • Fracture blisters are a clinical sign associated with fractures.
  • The exact mechanism of fracture blister formation remains unclear.
  • A proposed mechanism involves mechanical strain on the skin.

Purpose of the Study:

  • To investigate the biomechanical mechanism of fracture blister formation.
  • To determine if skin strain can induce dermal-epidermal separation consistent with fracture blisters.

Main Methods:

  • A biomechanical study was conducted using 60 cadaver ankle skin specimens.
  • Specimens were subjected to varying levels of uniaxial strain.
  • Histological examination was performed to assess tissue changes.

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Main Results:

  • Dermal-epidermal separation patterns were observed in specimens strained at 152% and above.
  • These histological findings resemble those previously reported in biopsied fracture blisters.
  • The results indicate a direct correlation between high strain levels and blister-like separation.

Conclusions:

  • The study supports the hypothesis that fracture blisters result from skin strain during fracture.
  • High levels of uniaxial skin strain can induce dermal-epidermal separation.
  • This provides a biomechanical explanation for fracture blister formation.