Publication: Low-intensity pulsed ultrasound increased blood vessel size during fracture healing in patients with a delayed-union of the osteotomized fibula
Authors
Korstjens, Clara M. ; Rutten, Sjoerd ; Nolte, Peter A. ; van Duin, Marion A. ; Klein Nulend, Jenneke
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Publisher
Universidad de Murcia. Departamento de BiologĂa Celular e HistologĂa
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DOI
DOI: 10.14670/HH-11-972
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info:eu-repo/semantics/article
Description
Abstract
Disturbed vascularity leads to impaired
fracture healing. Since low-intensity pulsed ultrasound
(LIPUS) increases new bone formation in delayedunions, we investigated whether LIPUS increases blood
supply in delayed-unions of the osteotomized fibula, and
if LIPUS-increased bone formation is correlated to
increased blood supply. Blood vessel parameters were
analysed using histology, immunohistochemistry, and
histomorphometric analysis as well as their correlation
with bone formation and resorption parameters. Fibular
biopsies of thirteen patients with a delayed-union of the
osteotomized fibula treated for 2-4 months with or
without LIPUS originating from a randomized
prospective double-blind placebo-controlled clinical trial
were studied. In histological sections of the fibular
biopsies parameters of blood vessel formation were
measured and were related to histomorphometric bone
characteristics of newly formed bone of the same
samples analysed in our previously published study on
the effects of LIPUS on bone healing at the tissue level
in delayed-unions. LIPUS-treated delayed-unions and
sham-treated delayed-unions as well as healed delayedunions and failed-to-heal delayed-unions were
compared. The volume density of blood vessels was
increased in LIPUS-treated delayed-unions compared to
sham-treated controls. LIPUS did not change blood
vessel number, but significantly increased blood vessel
size. Healed delayed-unions as well as LIPUS-treated
and sham-treated delayed-unions showed significant
correlations between blood vessel size and osteoid
volume. LIPUS increases blood vessel size, essential for
fracture healing, in bone from patients with a delayedunion of the osteotomized fibula. The increased osteoid
volume in delayed-unions can largely be explained by
increased blood supply and perfusion.
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Citation
Histology and Histopathology, Vol.33, nÂş7, (2018)
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