The effects of human amniotic fluid injection and combined application with human amniotic membrane on fracture healing in rats(an experimental study)

2.ABSTRACTThe Effects of Human Amniotic Fluid njection and Combined Application withHuman Amniotic Membrane on Fracture Healing in Rats(An Experimental Study)Alper Gultekin,MDDokuz Eylul University,School of MedicineDepartment of Orthopaedics and TraumatologyIzmir,TurkeyFractures are among common injuries in orthopedics and traumatology practice.10% ofthese require surgical intervention due to healing problems. Besides the classical treatmentmethods (cast application, traction etc.), alternative treatment modalities are considered byunderstanding the biology of fracture healing and the availability of biological factors andmatrix components to shorten the time required for healing and to maximize the union rates.Its shown that human amniotic fluid and human amniotic membrane contain factors thatenhancing fracture healing. The purpose of this study was to determine the effects of humanamniotic fluid and human amniotic membrane on fracture healing model in rats.72 tibiae of 36 Wistar rats with normal activity weighing between 250-300 grs wereincluded in the study following approval of both Animal Eperimental and ClinicalExperimental Ethics Committee.Transverse fracture lines are created surgically in both tibiaeof rats, then stabilized intramedullary. The samples were divided into three groups. The firstgroup was left untreated following intramedullary fixation (control/group 1), human amnioticfluid was injected to the second group (group 2), human amniotic membrane wrapping andhuman amniotic fluid injection was both applied to the last group (group 3). X-Rays of allsamples were taken after they were sacrified. Some of the tibiae were scoredhistopathologically using modified Lane-Sandhu Grading Scale at 3rd week (n=34) and therest (n=32) at 6th week. The results were statistically analysed by Mann Whitney U andWilcoxon tests.There were no significant differences in the quality of healing between the control andtreatment groups at 3rd week,but second group (amniotic fluid injection) has statisticallybetter scores than combined therapy group (group 3) at 3rd week (p=0,021). The results ofsecond group (amniotic fluid injection) were statistically better than control (group1) andcombined therapy (group 3) groups at 6th week (respectively p=0.036, p=0.019). Nostatistically significant differences were detected between combined therapy group (group 3)and the control (group 1) at 6th week. The mean results of all groups at 6th week were betterthan 3rd week however this was statistically significant for two groups except the control (resp. p=0.037, p=0.041)We conclude that local injection of human amniotic fluid is effective but humanamniotic membrane wrapping has very limited effect on fracture healing in rats.We suggestthat, the results of this study are promising for further studies with larger sample groups.Key words: Fracture healing, human amniotic fluid, human amniotic membrane