EFFECTIVENESS OF FRACTURE-END REGENERATION OR EXTRACORPOREAL SHOCK WAVE THERAPY IN DELAY OF TIBIAL UNION: EXPERIMENTAL STUDY

Year 2023, Volume: 24 Issue: 2, 228 - 233, 05.04.2023

Murat Kaya , Mert Ciftdemir , Cem Copuroglu , Mert Özcan

https://doi.org/10.18229/kocatepetip.1094515

Abstract

OBJECTIVE: The purpose of this present study was to compare the results of fracture regeneration or Extracorporeal Shock Wave Therapy (ESWT) added to the fracture dynamization procedure in the rat tibia delayed union model.
MATERIAL AND METHODS: A total of 30 female Sprague-Dawley Rats were divided into three groups. Right tibia transverse diaphyseal fractures were made in all rats. After the intramedullary fixation for delayed fracture union model, the fracture line was distracted with a propylene spacer, which was removed in all groups at the end of the 6th week, and the fracture line was dynamized. Only dynamization was applied to the Control Group (Group 1). The fracture ends were regenerated during dynamization in the fracture-end regeneration group (Group 2). In the ESWT group (Group 3), 15 kV 500 shock waves were applied at the 24th hour of dynamization. After the sacrification at the end of the 12th week, all right tibiae were taken for radiological and histopathological examinations.
RESULTS: Radiological and histopathological union scores were found to be significantly higher in Group 2 and Group 3 than in the Control Group (P=0.001). No significant differences were detected between Group 2 and Group 3 in terms of radiological union scores (P=0.254). Histopathological scoring was significantly higher in Group 3 than in Group 2 (P=0.001).
CONCLUSIONS: The addition of fracture-end regeneration or ESWT to dynamization in the rat tibia delayed union model allowed us to obtain better radiological and histopathological results when compared to the dynamization group alone. A clinical comparative study will contribute to the literature.

Keywords

Fracture healing, Tibial fractures, Intramedullary, Fracture fixation

KIRIK UÇ TAZELEME VEYA EKSTRAKORPOREAL ŞOK DALGA TEDAVİSİNİN TİBİA KAYNAMA GECİKMESİNDE ETKİNLİĞİ; DENEYSEL ÇALIŞMA

Abstract

AMAÇ: Bu çalışmanın amacı rat tibia kaynama gecikmesi modelinde, kırık dinamizasyon işlemine eklenen kırık uç tazeleme veya Ekstrakorporeal Şok Dalga Tedavisinin (ESWT) sonuçlarını karşılaştırmaktır.
GEREÇ VE YÖNTEM: 30 dişi Sprague-Dawley cinsi rat üç gruba ayrıldı. Tüm ratlarda sağ tibia transvers diyafizyal kırık oluşturuldu. Gecikmiş kırık kaynaması modeli amaçlı intramedüller tespit sonrası kırık hat propylene spacer ile distrakte edildi. 6. Haftada tüm gruplardaki propylene spacerlar çıkartılarak distraksiyon alanı dinamize edildi. Kontrol grubunda (Grup 1) sadece dinamizasyon uygulandı. Kırık uç tazeleme grubunda (Grup 2) dinamizasyon sırasında kırık uçları tazelendirildi. ESWT grubunda (Grup 3) dinamizasyonun 24. Saatinde 15 kV 500 şok dalgası uygulandı. 12. haftanın sonunda sakrifikasyonun ardından tüm sağ tibialar radyolojik ve histopatolojik incelemeye alındı.
BULGULAR: Radyolojik ve histopatolojik kaynama skorları Grup 2 ve Grup 3’te kontrol grubuna göre anlamlı derecede yüksekti (P=0.001). Grup 2 ve Grup 3 arasında radyolojik kaynama skoru açısından anlamlı farklılık yoktu (P=0.254). Grup 3’te histopatolojik skorlama Grup 2’ye göre anlamlı derecede yüksekti (P=0.001).
SONUÇ: Rat tibia gecikmiş kaynama modelinde dinamizasyona, kırık uç tazeleme veya ESWT eklenmesi sadece dinamizasyon uygulanan gruba göre daha iyi radyolojik ve histopatolojik sonuçlar elde etmemizi sağlamıştır. Klinik karşılaştırmalı bir çalışma literatür açısından katkı sağlayacaktır.

Keywords

Kırık iyileşmesi, Tibia kırıkları, İntramedüller, Kırık sabitlenmesi

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