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Abstract
Background and purpose — Metaphyseal fractures heal in a rapid fashion that is different from the bone shaft healing process. Animal studies have focused on diaphyseal fractures. We investigated the metaphyseal fracture-healing process in rabbits.
Animals and methods — 60 rabbits (divided into 12 groups) underwent proximal tibial osteotomy, anatomical reduction, and fixation with screws. After surgery, the proximal tibiae were harvested at different time points for histology.
Results — No obvious osteonecrosis or bone resorption were found 2 weeks after surgery. From day 5 to week 5, woven bone or new trabeculae formed. From week 2, remodeling into lamellar bone started and reached a peak at week 6. These 3 stages overlapped. Histomorphometry showed that the structure changed as a unimodal curve.
Interpretation — The healing process of metaphyseal fractures appears to differ from the commonly studied healing process in diaphyseal fractures. It is rapid, and can be divided into 4 histological stages: cellular activation and differentiation, formation of woven bone, transformation of woven bone into lamellar bone, and further remodeling.
WC, DH, PZ, and BJ conceived and designed the experiments. WC, DH, NH, and YK performed them. WC, DH, PZ, and XY analyzed the data. WC, PZ, and BJ wrote the manuscript.
This study was funded by Chinese National Ministry of Science and Technology, 973 Project Planning (No. 2014CB542200), the National Natural Science Fund (Nos. 31271284, 31171150, 81171146, 30971526, 31100860, 31040043, 31371210, 81372044), the Educational Ministry New Century Excellent Talents Support Project (No. BMU 20110270), and the Ministry of Education Innovation Team (IRT1201).
No competing interests declared.