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Weight bearing: its lack of effect on fracture healing

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Summary

The load transmitted through fresh fractures of the tarsometatarsus of adult chickens was varied by 40% more, or less, than the body weight to determine the effect of load-bearing on fracture healing. The healing fracture was examined for size and strength at 14 days, but no significant differences were detected in any group. The technique was sensitive enough to detect the differences between healing fractures at 7, 10 and 14 days. In this experiment load transmission was not found to be an important factor in fracture healing.

Résumé

L'expérience clinique ainsi que les données de laboratoire montrent que la marche favorise la consolidation des fracutres. Mais est-ce l'utilisation physiologique du membre ou bien les forces réellement transmises par celui-ci qui sont importantes? Nos données expérimentales nous permettent de soutenir que l'usage du membre est le facteur déterminant, et non les forces transmises par ce membre.

Des poulets ont été fixés à des harnais leur permettant de se mouvoir tandis que le poids de leur corps sur leurs pattes était allégé de 40%. D'autres étaient soumis à une force centrifuge qui augmentait ce poids de 40%. On réalisa alors une fracture fermée du tarso-métatarse dont on surveilla l'évolution. Lors du contrôle, la qualité de la soudure osseuse fut évaluée par comparaison avec le côté sain en mesurant la résistance à la torsion. On mesura également le poids et le volume du cal et on compara les aspects radiologiques et histologiques. Sur le plan statistique les différences ne furent considérées comme significatives que lorsque p était égal ou inférieur à 0,5.

Bien que les examens utilisés aient permis de distinguer les fractures datant de 7, 10 ou 14 jours, ils n'ont pas mis en évidence de différences dues à une variation de 80% du poids supporté.

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Riggins, R.S., Simanonok, C., Lewis, D.W. et al. Weight bearing: its lack of effect on fracture healing. International Orthopaedics 9, 199–203 (1985). https://doi.org/10.1007/BF00268171

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