Effect of extracorporeal shock wave therapy on fracture healing in rat femural fractures with intact and excised periosteum
Birhan Oktaş1, Zafer Orhan2, Barış Erbil2, Erdem Değirmenci2, Nil Üstündağ2
1Department of Orthopedics and Traumatology, Medical Faculty of Kırıkkale University, Kırıkkale, Turkey
2Department of Orthopedics and Traumatology, Medical Faculty of Düzce University, Düzce, Turkey
Keywords: Extracorporeal shock wave treatment; fracture healing; lithotripsy; nonunion; open fracture; periosteum.
Objectives: The aim of this study is to compare the effect of extracorporeal shock wave therapy (ESWT) on fractures with intact periosteum and excised periosteum. Materials and methods: Thirty-seven Wistar albino rats were randomized into four groups. Osteotomy and intramedullary Kirschner wire fixation were performed on all right femurs under ketamin anesthesia. The first group (n=10) was identified as control group. In the second group (n=10), periosteum located at the osteotomy site was excised circumferentially during surgery. In the third group (n=9), periosteum was left intact and ESWT was applied. In the forth group (n=8), periosteums of all rats were excised and ESWT was applied. All fracture lines were evaluated radiographically each two weeks and histologically at the sixth week. Results were evaluated statistically.
Results: In periosteum excised group which represents a model of open fractures with soft tissue defect, ESWT application had a significantly positive histologic effect on bone healing. However, radiological evaluation did not reveal any statistically significant difference between groups with intact and excised periosteums.
Conclusion: According to our findings, ESWT can be used to improve fracture healing and prevent pseudoarthrosis in the treatment of open fractures with accompanying soft tissue and periosteum damage. However, further clinical studies are required to include ESWT in routine practice.