Experimental Blunt Chest Trauma Impairs Fracture Healing in Rats
Experimental Blunt Chest Trauma Impairs Fracture Healing in Rats
复制标题
DOI：
10.1002/jor.21299
复制
发表时间：
2011-05-01
影响因子：
2.8
通讯作者：
Ignatius, Anita
中科院分区：
文献类型：
--
作者：
Recknagel, Stefan;Bindl, Ronny;Ignatius, Anita
在多发伤患者中，钝性胸部创伤是创伤后全身炎症反应的重要触发因素。有临床证据表明此类患者骨折愈合延迟，但缺乏实验数据。因此，我们在大鼠模型中研究了胸部创伤对骨折愈合的影响。雄性 Wistar 大鼠接受钝性胸部创伤联合股骨截骨术或孤立截骨术。使用更刚性或更灵活的外固定器来稳定骨折，以分析胸部创伤对正常愈合的影响是否不同以及机械引起的骨延迟愈合是否不同。钝性胸部创伤在 6 小时和 24 小时后引起 IL-6 血清水平显着升高，表明诱导了全身炎症，而孤立性骨折则没有影响。在更坚固的固定下，胸部创伤在 35 天后显着损害骨折愈合，反映在弯曲刚度显着降低（三点弯曲测试），以及骨痂体积、惯性矩和相对骨表面显着减小（μ CT 分析）。在证实临床证据时，这项研究首次报告说，钝性胸部创伤会严重损害骨愈合，可能是通过诱发的全身炎症与局部炎症过程的相互作用来实现的。 (C) 2010 年骨科研究学会。出版者：Wiley periodicals, Inc. J Orthop Res 29:734-739, 2011
In poly-traumatic patients a blunt chest trauma is an important trigger of the posttraumatic systemic inflammatory response. There is clinical evidence that fracture healing is delayed in such patients, however, experimental data are lacking. Therefore, we investigated the influence of a thoracic trauma on fracture healing in a rat model. Male Wistar rats received either a blunt chest trauma combined with a femur osteotomy or an isolated osteotomy. A more rigid or a more flexible external fixator was used for fracture stabilization to analyze whether the thoracic trauma influences regular healing and mechanically induced delayed bone healing differently. The blunt chest trauma induced a significant increase of IL-6 serum levels after 6 and 24 h, suggesting the induction of a systemic inflammation, whereas the isolated fracture had no effect. Under a more rigid fixation the thoracic trauma considerably impaired fracture healing after 35 days, reflected by a significantly reduced flexural rigidity (three-point-bending test), as well as a significantly diminished callus volume, moment of inertia, and relative bone surface (mu CT analysis). In confirming the clinical evidence, this study reports for the first time that a blunt chest trauma considerably impaired bone healing, possibly via the interaction of the induced systemic inflammation with local inflammatory processes. (C) 2010 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 29:734-739, 2011