The effects of cerebrospi̇nal flui̇d after head trauma on fracture uni̇on on rats

ABSTRACT The Effect of Cerebrospinal Fluid, Collected After Head Trauma, on Fracture Union on Rats Objectives: Accelerated fracture healing after head trauma is reported in the literature, although the mechanism of this event is not clear yet. In this study, our hypothesis was that cerebrospinal fluid mixes into the blood circulation after the traumatic brain injury and accelerates the fracture union. To prove this hypothesis we aimed to show the effect of cerebrospinal fluid, collected after head trauma on fracture union on rat model. Material and Methods: 42 Wistar albino male rats were divided into three groups as control group, study group and head trauma group. Head trauma group consisted of 12 rats, for each rat we performed head trauma. Two of them died after the trauma so we collected cerebrospinal fluid of remaining 10 rats. Study group and control group consisted of 15 rats. For each group we performed femur fracture and intramedullar fixation and we injected the cerebrospinal fluid that is taken from head trauma group, to the interfragmanter area of the study group. Because of a rat's death on fifth day, the study group assessed on 14 rats. On 30'th day of our study we disarticulated the operated femur from the acetabulum of both study and control groups. The callus tissue of femur fracture was observed radiologically according to the width and length of callus tissue, defined by Lane and Sanhu's radiographical scale. The callus tissue was observed histologically according to the scale of Huo et al. 0,05 was considered as statistically significance level. Results: In our radiological measurements, the study group's callus tissue length found to be significantly higher than the control group (p=0,0001). On the other hand, study group's callus tissue mean width was found as higher than the control group but there was no significant difference (p=0,158). There was no significant difference between the Lane and Sandhu's radiographical scale of each group (p=0,700). In our histological measurements, the study group's callus tissue grade found to be significantly higher than the control group (p=0,014). Conclusion: The underlying mechanism of accelerated fracture union after head trauma is still unknown. On rat model, the cerebrospinal fluid collected after head trauma, accelerated the fracture union histologically and affected the length of callus tissue histologically. It is possible that after head trauma some agents may increase in the cerebrospinal fluid and affects the fracture union. More studies are needed to understand the mechanism of cerebrospinal fluid's effects on fracture union after head trauma. Key Words: Head trauma, fracture union, cerebrospinal fluid.