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

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.