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Differential fracture healing resulting from fixation stiffness variability: a mouse model

  • Original article
  • Published:
Journal of Orthopaedic Science

Abstract

Background

The mechanisms underlying the interaction between the local mechanical environment and fracture healing are not known. We developed a mouse femoral fracture model with implants of different stiffness, and hypothesized that differential fracture healing would result.

Methods

Femoral shaft fractures were created in 70 mice, and were treated with an intramedullary nail made of either tungsten (Young’s modulus = 410 GPa) or aluminium (Young’s modulus = 70 GPa). Mice were then sacrificed at 2 or 5 weeks. Fracture calluses were analyzed using standard microCT, histological, and biomechanical methods.

Results

At 2 weeks, callus volume was significantly greater in the aluminium group than in the tungsten group (61.2 vs. 40.5 mm3, p = 0.016), yet bone volume within the calluses was no different between the groups (13.2 vs. 12.3 mm3). Calluses from the tungsten group were stiffer on mechanical testing (18.7 vs. 9.7 N/mm, p = 0.01). The percent cartilage in the callus was 31.6% in the aluminium group and 22.9% in the tungsten group (p = 0.40). At 5 weeks, there were no differences between any of the healed femora.

Conclusions

In this study, fracture implants of different stiffness led to different fracture healing in this mouse fracture model. Fractures treated with a stiffer implant had more advanced healing at 2 weeks, but still healed by callus formation. Although this concept has been well documented previously, this particular model could be a valuable research tool to study the healing consequences of altered fixation stiffness, which may provide insight into the pathogenesis and ideal treatment of fractures and non-unions.

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Acknowledgments

We thank Tarpit Patel, M.S., for assistance with microCT analysis and mechanical testing, which were supported in part by NIH/NIAMS grants P30AR057235 (Washington University Core Center for Musculoskeletal Biology and Medicine).

Conflict of interest

MJG is a consultant for Synthes, Amgen, and DGIMed. No outside funding was received in support of this work.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Washington University School of Medicine, 660 S. Euclid Ave, Campus Box 8233, St. Louis, MO, 63110, USA

    Michael J. Gardner, Sara M. Putnam, Ambrose Wong, Philipp N. Streubel, Akhilesh Kotiya & Matthew J. Silva

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  1. Michael J. Gardner
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  2. Sara M. Putnam
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  3. Ambrose Wong
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  4. Philipp N. Streubel
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  5. Akhilesh Kotiya
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  6. Matthew J. Silva
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Corresponding author

Correspondence to Michael J. Gardner.

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Gardner, M.J., Putnam, S.M., Wong, A. et al. Differential fracture healing resulting from fixation stiffness variability: a mouse model. J Orthop Sci 16, 298–303 (2011). https://doi.org/10.1007/s00776-011-0051-5

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  • DOI: https://doi.org/10.1007/s00776-011-0051-5

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