Author |
양승오(Seoung Oh Yang),강흥식(Hung Sik Kang),장기현(Kee Hyun Chang),이명철(Myung Chul Lee),구경회(Kyung Hoi Koo),성상철(Sang Chul Seung),박인애(In Ae Park), |
Abstract |
It has been reported that hematoma is one of the most
crucial factors in fracture healing since callus
formation is disturbed by washing out the hematoma near
a fracture site. However, it is not clear why the
hamatoma is important and how it plays a role during
the fracture healing. In order to investigate the role
of hematoma in the process of fracture healing, the
osteogenic potential by subperiosteal transplantation
have been studied. Experimental fractures by operation
were made at the mid-shaft of the tibia in New Zealand
white rabbits. Removal of hematoma at the fracture site
was done after 2 and 3 days from experimental fracture,
and the removed hematoma was transplanted into the
subperiosteal area at the mid-shaft of the ulna of each
rabbit. As control gorups, we have performed 3
different procedures 1) the hematoma was transplanted
into the muscular layers at the thigh and forearm; 2)
autologous blood clots were transplanted into the
subperiosteal area of the ulna; and 3) sham operation
without a transplantation into the subperiosteal area.
After transplantation, seria bone scintigraphy and
simple radiography were performed at 4 days, 1 week,
and 2 weeks to detect an abnormality. The results of
bone scintigraphy were positive in 5 of 6 experimental
group. However, a11 in three control groups were
negative. Histological observation of the positive bone
revealed new bone formation with trabeculation. These
results suggest the hematoma in fracture site has
osteogenic potential in the subperiosteal area which
can be demonstrable by bone scintigraphy and histologic
findings. Therefore, it is considered that hematoma of
the fracture site plays an important role in the
process of fracture healing. Further biochemical
investigation using various experimentaI models is
mandatory to apply this preliminary result to the
treatment of clinical delayed union or nonunion. |