Poor muscle coverage delays fracture healing in rats.

We undertook this study in rats to ascertain the influence of muscle coverage on tibial fracture healing. 30 rats were randomly assigned to three intervention groups. Following a mid-diaphyseal osteotomy in the left tibia, reamed nailing was performed in all animals. In one group (A), the antero-lateral muscles were detached from the fractured bone, while the anterolateral compartment was excised in another group (B). In the third group (C), the muscle compartment was resected, and the superficial gluteal muscle was mobilized and transposed over the fractured area. Muscle intervention, like that in group A and C, had no effect on the blood flow. The fibular nerve was resected in all the rats. At 4 weeks, we studied the healing bones in each group clinically, radiologically and mechanically. At 4 weeks, radiographs in two planes revealed a clearly visible fracture line in the three experimental groups. Mechanical testing of the healing fractures showed significantly lower bending moment and bending rigidity in group B than in groups A and C. No difference in mechanical characteristics was detected between the healing bones in groups A and C. This animal study indicates that in tibial fractures, an extensive muscle tissue defect may have negative effects on early bone healing.