Chalikias Stavros, Papaioannou Nikolaos, Koundis George, Pappa Eleni, Galanos Antonios, Anastassopoulos George, Sarris Ioannis N, Panteliou Sofia, Chronopoulos Efstathios, Dontas Ismene A
Department of Orthopedics, Golden Jubilee National Hospital, Glasgow, GBR.
Laboratory for Research of the Musculoskeletal System, KAT General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, GRC.
Cureus. 2021 Feb 15;13(2):e13342. doi: 10.7759/cureus.13342.
Introduction Monitoring the progress of fracture healing is essential in order to establish the appropriate timing that ensures adequate bone strength for weight-bearing. In the present experimental study on a rat model of femoral fracture healing, the measurement of bone density and strength by peripheral quantitative computerized tomography (pQCT) was correlated with the modal damping factor (MDF) method. Methods Four groups of 12 male six-month-old Wistar rats each were anesthetized and submitted to baseline femoral pQCT and MDF scanning, followed by aseptic midshaft osteotomy of the right femur which was fixed by a locking intramedullary nail technique. The animals were left to recover and re-scanned following euthanasia of each group after six, eight, 10, and 12 weeks, respectively. The parameters measured by the pQCT method were total bone mineral density (BMD) and polar strength strain index (SSIp). Results Fracture healing progressed over time and at 12 weeks post-osteotomy there was no statistically significant difference between the osteotomized right and the control left femurs regarding MDF, BMD, and SSIp measurements. The highest correlations for the osteotomized femurs were observed between MDF and BMD (r = -0.647, P = 0.043), and between MDF and SSIp (r = -0.350, P = 0.321), at 10 weeks postoperatively. The high to moderate correlations between MDF and BMD, and between MDF and SSIp respectively, support the validity of MDF in assessing fracture healing. Conclusions Based on our findings in this fracture healing animal model, the results from the MDF method are reliable and correlate highly with the total BMD and moderately with the SSI polar values obtained by the pQCT method of bone quality measurement. Further studies are needed which may additionally support that the MDF method can be an attractive portable alternative to monitor fracture healing in the community.
引言 监测骨折愈合进程对于确定确保承重时有足够骨强度的合适时机至关重要。在当前这项关于大鼠股骨骨折愈合模型的实验研究中，通过外周定量计算机断层扫描（pQCT）测量骨密度和强度，并与模态阻尼因子（MDF）方法进行关联。方法 将四组，每组12只六个月大的雄性Wistar大鼠麻醉后进行基线股骨pQCT和MDF扫描，随后对右股骨进行无菌中段截骨术，并用锁定髓内钉技术固定。让动物恢复，每组分别在术后6周、8周、10周和12周安乐死后再次扫描。通过pQCT方法测量的参数为总骨矿物质密度（BMD）和极向强度应变指数（SSIp）。结果 骨折愈合随时间推移而进展，截骨术后12周，在MDF、BMD和SSIp测量方面，截骨的右侧股骨与对照的左侧股骨之间无统计学显著差异。术后10周，截骨股骨的MDF与BMD之间（r = -0.647，P = 0.043）以及MDF与SSIp之间（r = -0.350，P = 0.321）观察到最高相关性。MDF与BMD之间以及MDF与SSIp之间分别存在高到中度相关性，支持了MDF在评估骨折愈合方面的有效性。结论 根据我们在这个骨折愈合动物模型中的发现，MDF方法的结果可靠，与通过pQCT骨质量测量方法获得的总BMD高度相关，与SSI极向值中度相关。还需要进一步的研究，这可能会额外支持MDF方法可以成为在社区监测骨折愈合的一种有吸引力的便携式替代方法。
