• Arch Orthop Trauma Surg · Dec 2019

    Development of a novel murine delayed secondary fracture healing in vivo model using periosteal cauterization.

    • Ina Gröngröft, Sandra Wissing, Dennis M Meesters, Martijn Poeze, Romano Matthys-Mark, Keita Ito, and Stephan Zeiter.
    • AO Research Institute Davos, Clavandelerstrasse 8, 7270, Davos Platz, Switzerland.
    • Arch Orthop Trauma Surg. 2019 Dec 1; 139 (12): 1743-1753.

    IntroductionDelayed union and nonunion development remain a major clinical problematic complication during fracture healing, with partially unclear pathophysiology. Incidences range from 5 to 40% in high-risk patients, such as patients with periosteal damage. The periosteum is essential in adequate fracture healing, especially during soft callus formation. In this study, we hypothesize that inducing periosteal damage in a murine bone healing model will result in a novel delayed union model.Materials And MethodsA mid-shaft femoral non-critically sized osteotomy was created in skeletally mature C57BL/6 mice and stabilized with a bridging plate. In half of the mice, a thin band of periosteum adjacent to the osteotomy was cauterized. Over 42 days of healing, radiographic, biomechanical, micro-computed tomography and histological analysis was performed to assess the degree of fracture healing.ResultsAnalysis showed complete secondary fracture healing in the control group without periosteal injury. Whereas the periosteal injury group demonstrated less than half as much maximum callus volume (p < 0.05) and bridging, recovery of stiffness and temporal expression of callus growth and remodelling was delayed by 7-15 days.ConclusionThis paper introduces a novel mouse model of delayed union without a critically sized defect and with standardized biomechanical conditions, which enables further investigation into the molecular biological, biomechanical, and biochemical processes involved in (delayed) fracture healing and nonunion development. This model provides a continuum between normal fracture healing and the development of nonunions.

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