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A novel rat model of tibial fracture for trauma researches: a combination of different types of fractures and soft tissue injuries.

ABSTRACT: BACKGROUND:The outcomes for open tibial fractures with severe soft tissue injury are still a great challenge for all the trauma surgeons in the treatment. However, most of the existing open tibial fracture models can only provide minimal soft tissue injury which cannot meet the requirement of severe trauma research. Our goal is to investigate a novel tibial fracture model providing different fractures combined with soft tissue injury for better application in trauma research. METHODS:A total of 144 Sprague-Dawley rats were randomly divided into 4 groups. With group 1 as control, the other groups sustained different right tibial fractures by the apparatus with buffer disc settings either 3?mm, 10?mm, or 15?mm. X-ray and computed tomography angiography (CTA) were performed at 6?h to evaluate the fracture patterns and vascular injuries. Peripheral blood and tibialis anterior muscle were harvested at 6?h, 1?day, 3?days, 7?days, 14?days, and 28?days for ELISA and histological analysis. RESULTS:X-ray and ?CT results indicated that different fractures combined with soft tissue injuries could be successfully provided in this model. According to OTA and Gustilo classification, the fractures and soft tissue injuries were evaluated and defined: 36 type I in group 2, 34 type II in group 3, and 36 type III in group 4. The CTA confirmed no arterial injuries in groups 1 and 2, 2 arterial injuries in group 3, and 35 in group 4. ELISA indicated that the levels of pro-inflammatory cytokines TNF-? and IL-1? were significantly higher in group 4 than in other groups, and the levels of anti-inflammatory cytokines TGF-? and IL-10 were significantly higher in surgery groups than in group 1 in later stage or throughout the entire process. HE, Masson, and caspase-3 stains confirmed the most severe inflammatory cell infiltration and apoptosis in group 4 which lasted longer than that in groups 2 and 3. CONCLUSIONS:The novel apparatus was valuable in performing different fractures combined with soft tissue injuries in a rat tibial fracture model with high reproducibility and providing a new selection for trauma research in the future.

SUBMITTER: Shi E

PROVIDER: S-EPMC6813134 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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A novel rat model of tibial fracture for trauma researches: a combination of different types of fractures and soft tissue injuries.

Shi Enxian E Chen Gang G Qin Bengang B Yang Yi Y Fang Jintao J Li Liang L Wang Yuanyuan Y Zhu Menghai M Yang Jiantao J Gu Liqiang L

Journal of orthopaedic surgery and research 20191024 1

<h4>Background</h4>The outcomes for open tibial fractures with severe soft tissue injury are still a great challenge for all the trauma surgeons in the treatment. However, most of the existing open tibial fracture models can only provide minimal soft tissue injury which cannot meet the requirement of severe trauma research. Our goal is to investigate a novel tibial fracture model providing different fractures combined with soft tissue injury for better application in trauma research.<h4>Methods< ...[more]

PMID: 31651336

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Project description:Tibial plateau fractures account for a small portion of all fractures; however, these fractures can pose a surgical challenge when occurring concomitantly with ligament injuries.The purpose of this study was to compare 2-year outcomes of soft tissue reconstruction with or without a concomitant tibial plateau fracture and open reduction internal fixation. We hypothesized that patients with a concomitant tibial plateau fracture at the time of soft tissue surgery would have inferior outcomes compared with patients without an associated tibial plateau fracture.Cohort study; Level of evidence, 3.Forty patients were included in this study: 8 in the fracture group and 32 in the matched control group. Inclusion criteria for the fracture group included patients who were at least 18 years old at the time of surgery and sustained a tibial plateau fracture and a concomitant injury of the anterior cruciate ligament, posterior cruciate ligament, medial collateral ligament, or fibular collateral ligament in isolation or any combination of cruciate or collateral ligaments and who subsequently underwent isolated or combined ligament reconstruction. Patients were excluded if they underwent prior ipsilateral knee surgery, sustained additional bony injuries, or sustained an isolated extra-articular ligament injury at the time of injury. Each patient with a fracture was matched with 4 patients from a control group who had no evidence of a tibial plateau fracture but underwent the same soft tissue reconstruction procedure.Patients in the fracture group improved significantly from preoperatively to postoperatively with respect to Short Form-12 (P < .05) and Western Ontario and McMaster Universities Osteoarthritis Index total scores (P < .05). The Lysholm (P = .075) and Tegner scores (P = .086) also improved, although this was not statistically significant. Patients in the control group improved significantly from preoperatively to postoperatively across all measured scores. A comparison of the postoperative results between the 2 groups showed no statistically significant difference.The presence of a tibial plateau fracture in conjunction with a ligamentous knee injury did not have a negative effect on postoperative patient-reported outcomes. Patient-reported outcome scores after surgery in both the fracture and control groups improved beyond the minimally clinically important difference, indicating that the presence of a fracture did not detract from the outcomes observed in patients without fractures undergoing concomitant ligament reconstruction.

Project description:BackgroundAt present, bone union delay or failure remains challenging for clinicians. It has been reported that adipose-derived mesenchymal stem cells (ADMSCs) offer a promising way to promote bone fracture healing. In recent years, nanomaterials have been applied in regenerative medicine. This study aimed to investigate whether ADMSCs combined with platinum nanoparticles (PtNPs) could further improve fracture healing on the basis of ADMSCs.MethodsADMSCs were co-cultured with PtNPs in vitro to investigate the effect of PtNPs on the differentiation of ADMSCs. Twenty Sprague-Dawley (SD) rats were randomly divided into four groups (with five rats in each group). The left tibias of all rats were fractured. Phosphate-buffered saline (PBS), PtNPs, ADMSC, and ADMSC mixed with PtNPs were then injected into the fracture sites based on the group classifications. The fracture was monitored by X-ray immediately after the fracture and on days 14 and 28 post-fracture. The tibias of the rats were subsequently harvested after the last X-ray and evaluated by micro computed tomography (micro-CT), histological analysis, and immunohistochemical detection.ResultsPtNPs significantly enhanced the osteogenic differentiation of ADMSCs in vitro. On days 14 and 28 post-fracture, the radiographic score of the ADMSC + PtNPs group was higher than that of the ADMSC group, the score of the ADMSC group was higher than that of the PtNPs and control groups, and there was no significant difference between the PtNPs and control groups. Micro-CT confirmed that combined ADMSCs with PtNPs were more effective than using ADMSCs alone in promoting fracture healing. The histological and immunohistochemical results further supported this conclusion.ConclusionsOur findings demonstrated that PtNPs could promote osteogenic differentiation of ADMSC in vitro. ADMSCs combined with PtNPs could accelerate fracture healing further in vivo and are a promising a potential method for the treatment of fracture healing.

Project description:Recognition of injuries in racing animals is essential to identify potential risk factors so actions can be taken to reduce or mitigate the cause of the injury to safeguard the animal. Racing greyhounds are subject to musculoskeletal injuries associated with athletic pursuit, in particular soft-tissue injuries, lacerations, and fractures. The objective of this study was therefore to determine risk factors for soft-tissue injuries, lacerations and fractures occurring during racing, using a cohort of greyhounds racing in New Zealand between 10th September 2014 and 31st July 2020. Dog-level, race-level and track-level risk factors for each outcome were assessed using mixed-effects multivariable logistic regression including trainer as a random effect. Throughout the study period there were 218,700 race starts by 4,914 greyhounds, with a total of 4,385 injuries. Of these, 3,067 (69.94%) were classed as soft-tissue injuries, 641 (14.62%) were reported as lacerations, and 458 (10.44%) were fractures. Greyhounds with a low racing frequency (racing more than 7 days apart) had 1.33 [95% confidence interval (CI): 1.06-1.67] times the odds of fracture compared to those racing more frequently. Older greyhounds had a greater odds of fracture compared with younger greyhounds. Racing every 7 days had a lower odds of soft-tissue injury compared with racing more than once a week. Dogs over 39 months had 1.53 (95% CI: 1.35-1.73) times the odds of sustaining a soft-tissue injury compared to the younger dogs. Greyhounds originating from Australia had a higher odds of fracture and laceration compared with New Zealand dogs. Better performing dogs (higher class) had a greater odds of fracture and laceration whilst maiden dogs had a higher odds of soft-tissue injury. Greyhounds starting from the outside box had a higher odds of fracture. There was considerable variation in the odds of soft-tissue injury at different racetracks. In conclusion, although the incidence of soft-tissue injuries was higher than other injury types, the repercussion of such injuries was less than those for fractures. The results from this study will help to inform intervention strategies aimed at reducing the rate of injuries in racing greyhounds, enhancing racing safety and greyhound welfare.

Project description:Introduction and importance: Unicondylar tibial plateau fractures with tibial shaft fractures are extremely rare among the elderly group of people. The traditional treatment method is to apply double plates to fix unicondylar tibial plateau fractures combined with tibial shaft fractures respectively, but this fixation method can disrupt the blood supply around the soft tissues and increase the rate of postoperative infection and fracture non-union. In this paper, we would analyse an old unicondylar tibial plateau fracture (Schatzker type III) with tibial shaft fracture which admitted to our department and discussed the efficacy of using intramedullary nails and plates in the treatment of these fractures. Case presentation A 78-year-old woman with an old unicondylar tibial plateau fracture combined with tibial shaft fracture was presented in this case. Using an intramedullary nail combined with a plate to achieve good results. Clinical discussion This case represents a rare case of an unicondylar tibial plateau fracture with a tibial shaft fracture. In this case, the tibial plateau fracture was first incised and internally fixed with a 9-hole plate across the fracture line of the tibial shaft, followed by fixing the tibial shaft fracture with an intramedullary nail. This treatment helped us successfully reset the unicondylar tibial plateau fracture with tibial shaft fracture and provided a satisfactory outcome for the patient. Conclusion Using intramedullary nails combined with plates to treat unicondylar tibial plateau fractures with tibial shaft fractures allowed for a predictable healing result. Highlights • Unicondylar tibial plateau fractures with tibial shaft fractures are extremely rare in the elderly.• Traditional double plate internal fixation seriously affected soft tissue and bone healing.• The use of plates in combination with intramedullary nails can reduce the destruction of soft tissue and fix both the tibial plateau and the tibial shaft.

Project description:PurposeTo examine the condition and triggers of stress fractures of the lateral tibial plateau (LTP) similar to type III lateral hinge fractures (LHFs) after open wedge high tibial osteotomy (OWHTO).MethodsOWHTO was performed in 118 knees. They were examined for LHFs by computed tomography (CT). Patients were divided into the stress fracture group (Group SF) if they showed fracture lines on CT performed after starting weight-bearing walking and the normal group (Group N) for others.ResultsThe mean age was significantly older in Group SF (P?=?0.022). Preoperatively, Group SF showed a significantly higher tibio-femoral angle (TFA, P?=?0.014). No significant differences were observed in TFA and weight-bearing line ratio after surgery. Correction angle was significantly higher in the SF group. And all of the SF were more than 13 degrees. There was no significant difference in LHF incidence between groups, whereas stress fracture incidence differed significantly for each type of LHF (chi-squared test, P?=?0.0001): 14.6% of type I cases, 100% of type II cases, 0% of type III cases, and 6.1% of those without LHF.DiscussionThe load on the LTP is assumed to act as a shearing force in type II fractures, which may contribute greatly to stress fractures. In type III, stress fractures may not occur because of the load dispersed at the fracture part. The stress fracture site is similar to type III LHF, and this kind of fracture is thought to be a delayed type III because it occurs after patients start weight-bearing walking. Moreover, they are observed in type I cases with a stable hinge and in 6% of cases without LHF. This study showed that high varus knees corrected with a large correction angle may develop stress fractures. OWHTO requires attention to stress fractures of the LTP, which can be regarded as delayed type III, in those developing LHFs postoperatively or having a high varus knee preoperatively.ConclusionThese results indicated the possibility of stress fracture in LTP during weight-bearing exercise after OWHTO, which was regarded as a delayed type III fracture. The results showed that Correction angle was more than 13 degrees, and lateral hinge fracture type II of the Takeuchi classification was an inducement of this stress fracture.Level of evidenceLevel IV.

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A novel rat model of tibial fracture for trauma researches: a combination of different types of fractures and soft tissue injuries.

Publications

A novel rat model of tibial fracture for trauma researches: a combination of different types of fractures and soft tissue injuries.

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