Nonunion using a canine model.

Abstract

The investigation involved a search for a model of atrophic nonunion. Fifty-two mature, adult, mongrel dogs were used to study the repair after creating a 0.5-cm bone defect in the mid-diaphysis of the radius. In addition, a 2-cm wide strip of periosteum was circumferentially resected from each osteotomy extremity. No immobilization was used thereafter. The reparative process was assessed by X-rays, histology, vascular injection, and scintigraphy. The dogs we distributed into three groups according to the time of follow-up (1, 3, and 6 months). Two kinds of repair were recognized after 3 months and were well-established after 6 months: disturbed healing with much callus (54%) and disturbed healing with absent or scanty callus (46%). In the first instance, the periosteum had regenerated and produced the external callus. The bone ends were capped with fibrocartilage; the vascularization around the defect was increased and displayed a well-defined vascular picture. In the healing pattern with absent external callus (atrophic nonunion), the bone defect was enlarged and filled with fibrous tissue, but there was no deficient vascularization in and around the osteotomy. Radioactivity counting showed an increased uptake around the osteotomy site in both types of repair, which persisted over time but was higher in the 1-month group. It was concluded that the present model yields a consistent pattern of a disturbed reparative process that mimics human cases of atrophic or hypertrophic nonunion. The differences between the two kinds of repair seemed to be related to the periosteal capacity of regeneration.