Temporary distraction and compression of a diaphyseal osteotomy accelerates bone healing

J Orthop Res. 2008 Jun;26(6):772-7. doi: 10.1002/jor.20588.

Abstract

Mechanical strain during callus distraction is known to stimulate osteogenesis. It is unclear whether this stimulus could be used to enhance the healing of a normal fracture without lengthening the bone. This study tested the hypothesis that a slow temporary distraction and compression of a diaphyseal osteotomy accelerates fracture healing. Fourteen sheep underwent a middiaphyseal osteotomy of the right tibia, stabilized by external fixation. An external fixator allowed either a temporary axial distraction (TD group; n = 6) or a constant fixation (C group; n = 8). Distraction began 7 days postoperatively at a rate of 0.5 mm twice per day for 2 days with subsequent shortening of 1.0 mm twice on the third day. The procedure was repeated four times. Fluorochrome labeling was performed postoperatively. After 8 weeks the sheep were sacrificed and healing was evaluated using densitometric, biomechanical, and histological methods. Bending stiffness of the tibiae after 8 weeks was 58% higher in the TD group than in the C group. The volume of the periosteal callus was significantly (p = 0.05) higher in the TD group (3.9 cm(3)) than in the C group (2.7 cm(3)). There was 20% more bone in the fracture gap of the TD group than the C group. There was a significantly higher bone formation rate in the TD group than in the C group. This study demonstrated the feasibility of fracture healing stimulation by the temporary application of distraction and compression.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Compressive Strength
  • Diaphyses / diagnostic imaging
  • Diaphyses / injuries
  • Diaphyses / physiology*
  • Disease Models, Animal
  • Female
  • Fracture Healing / physiology*
  • Osteogenesis / physiology*
  • Osteotomy*
  • Sheep
  • Stress, Mechanical
  • Tibial Fractures / diagnostic imaging
  • Tibial Fractures / physiopathology*
  • Tomography, X-Ray Computed