The comparison of ESWT effect on the fracture healing process in normal and deperiosted rat femora

ObjectiveESWT is believed to improve bone healing after fracture. But no any strict knowledge exists about cellular and biological mechanism of ESWT on bone healing. And also no any study has focused on periosteal existence yet. The purpose of this study was to evaluate the effect of periosteal stripping on ESW therapy and to explain the relationship between periosteum and ESWT in fracture healing.BackgroundRetardation in fracture healing is still a big problem for physicians especially for orthopaedic surgeons. Many improving factors have been investigated in recent years with new technological development. ESWT is used now widely for the treatment of nonunions. Many theories exist for its mechanism of action. But no any research can be found about its relationship with and effect on periosteal tissue in the literature. We assumed that periosteal stripping will decrease its effect on fracture healing.Material and Method40 female adult Wistard Albino rats divided into 4 groups randomly were used in our study. Their right femora are broken and stabilized with a pin intramedullarly. In 2nd and 4th groups all femora are deperiosted. Rats in 3th and 4th groups are treated with ESWT focused on fracture line directly. All rats are sacrificed at 6th week and examined histologically and radiologically. Than results are evaluated statistically.ResultsThe rate of fracture healing was statistically different between periosteal stripped and nonstripped group. There was also statistically meaningful difference between ESWT applied and nonapplied groups. In groups which periosteum is maintained ESWT had an improving effect on fracture healing. But in deperiosted groups ESWT application created a major difference radiologically and histologically.ConclusionESWT applied on deperiosted tissue creates a positive effect on fracture healing. But further studies are needed for more information about the usage of ESWT on fractures with periosteal damage especially in the open fractures.