Journal
BONE & JOINT RESEARCH
Volume 4, Issue 10, Pages 170-175Publisher
BRITISH EDITORIAL SOC BONE JOINT SURGERY
DOI: 10.1302/2046-3758.410.2000414
Keywords
Bone; healing; fracture
Categories
Funding
- Swedish Research Council [VR 2009-6725]
- Linkoping University
- Ostergotland County Council
- King Gustav V and Queen Victoria Mason Foundation
- European Community [279239]
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Objectives Healing in cancellous metaphyseal bone might be different from midshaft fracture healing due to different access to mesenchymal stem cells, and because metaphyseal bone often heals without a cartilaginous phase. Inflammation plays an important role in the healing of a shaft fracture, but if metaphyseal injury is different, it is important to clarify if the role of inflammation is also different. The biology of fracture healing is also influenced by the degree of mechanical stability. It is unclear if inflammation interacts with stability-related factors. Methods We investigated the role of inflammation in three different models: a metaphyseal screw pull-out, a shaft fracture with unstable nailing (IM-nail) and a stable external fixation (ExFix) model. For each, half of the animals received dexamethasone to reduce inflammation, and half received control injections. Mechanical and morphometric evaluation was used. Results As expected, dexamethasone had a strong inhibitory effect on the healing of unstable, but also stable, shaft fractures. In contrast, dexamethasone tended to increase the mechanical strength of metaphyseal bone regenerated under stable conditions. Conclusions It seems that dexamethasone has different effects on metaphyseal and diaphyseal bone healing. This could be explained by the different role of inflammation at different sites of injury.
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