Abstract
Objective To investigate the space-time characteristics of angiogenesis and of the vascular endothelial growth factor (VEGF) expression in the treatment of fracture nonunion by reamed and unreamed intramedullary nailings. Methods Models of fracture nonunion were set up using 200 3-month-old male SD rats which were randomized into 2 groups. In the experiment group (80 rats) reamed intramedullary nailing was applied and in the control group (80 rats) unreamed intramedullary nailing was used. Samples were obtained at the site of fracture at 1st, 3rd, 5th, 7th, 14th, 21st, 28th and 42nd days after operation. The remaining 40 rats were used for appraisal of the models of fracture nonunion. We counted vessels through Von Willebrand Factor (VWF) expression. VWF and VEGF were detected with immunohistochemistry. Results In the treatment of fracture nonunion, the curative rate was higher for the experiment group than for the control group. In the experiment group: from 1st to 7th day, vessels were detected in periosteum and bony callus; from 7th to 14th day, vessels grew into bone fracture gap along with granulation tissue; from 14th to 42nd day, vessels were detected in endosteum. In the control group: from 1st to 7th day,vessels were detected in endosteum; from 7th to 14th day, vessels appeared in granulation tissue but did not grow into bone fracture gap; from 14th to 42nd day, vessels still remained in endosteum and granulation tissue. Vessel counts and VEGF expression in the experiment group were higher than in the control group.Conclusions Since VEGF seems to determine the space-time characteristics of angiogenesis and the amount of vessels, it plays an important role in treatment of nonunion. It maybe an important mechanism by which reamed intramedullary nailing can facilitate healing of fracture nonunion. Key words: Fracture, nonunion; Angiogenesis; Vascular endothelial growth factor (VEGF)
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