Internal remodeling of periosteal new bone during fracture healing.

A closed fracture model of the rat tibia was employed to study internal remodeling of periosteal new bone during fracture repair. Static histomorphometric parameters of osteoid surface (or perimeter) and eroded surface (resorption surface) were used as indicators of appositional bone formation and resorption of bone trabeculae, respectively. Intracortical remodeling at the fracture site was evaluated using quantitative tetracycline histology and microradiography. The extents of osteoid and eroded bone surfaces did not differ significantly in the periosteal woven new bone in the early phases of fracture healing. Later on, the periosteal new bone had significantly more osteoid surface than eroded surface (p less than 0.001). The number of osteoclasts also decreased significantly over time during fracture healing (p = 0.028). Cortical bone showed a continuous increase of porosity (p less than 0.01) between 1 and 6 weeks after fracture. These results suggest that there is a time-related change in the balance of periosteal bone formation and resorption during the progress of fracture repair. We hypothesize that this change was related to the restoration of bony continuity. Further studies are, however, needed to indicate the histomorphometric features of periosteal new bone in fracture nonunions.