The significance of first rib fractures.
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A histomorphometric study was carried out in the region of healing defects in the ribs of Beagles. A transverse fracture was made in the left 9th and 10th ribs. Eleven Beagles received either ethanol vehicle (n = 6) or PGE2 orally (n = 5) for the 30 day period from surgery to time of necropsy. Double-pulsed labels were given with each of two fluochrome markers, calcein prior to surgical treatment and oxytetracycline hydrochloride prior to euthanasia. The objectives were to determine the effects of fracture on regional remodeling in the haversian envelope; to determine the effects of PGE2 on the regional remodeling changes in the haversian envelope; and to determine the systemic effects of PGE2 on remodeling changes of the contralateral matching sites. The remodeling changes after surgically induced fracture were relatively insignificant between the injured and uninjured sides in the non-treated dogs as well as in the PGE2 treated group. This may be attributable to the global effect of a fracture. However, there were significantly slower rates of mineral apposition (P less than 0.05) and a longer period for osteon formation time (P less than 0.05) on the injured side compared to the uninjured side of the PGE2 treated dogs. The remodeling activities were increased on both sides in the PGE2 treated dogs when compared to the non-treated ones with more remodeling sites per unit cortical area (P less than 0.01), and a higher turnover rate (shorter total remodeling period in days) with a faster resorption rate and a net increase in mineral apposition rates at the end of the experiment (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
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A histomorphometric study was carried out on healing defects in the ribs of beagles. A transverse fracture was made surgically in the midshaft of the left 9th and 10th ribs. Ten beagles received injections of either a buffer vehicle (n = 4) or prostaglandin E1 (PGE1) at a dose of 0.4 mg/day locally (n = 6) into the fracture sites for a 10-day period and were killed 30 days after the surgery. Double-pulsed fluorescent labels were given with each of two fluochrome markers, calcein before surgical treatment and oxytetracycline hydrochloride before killing. The objectives were to determine manifestations of the regional acceleratory phenomenon (RAP) as changes in regional remodeling in the haversian envelope induced by fracture, effects of PGE1 on modification of the RAP in the haversian envelope, and systemic effects of PGE1 on remodeling changes of the contralateral matching sites. The differences in haversian remodeling between the injured and uninjured ribs of the experimental dogs indicated an increase in activation frequency, that is, regional acceleratory phenomenon. The significant effect of PGE1 on enhancing fracture-induced acceleration of haversian remodeling was doubtful, because of the preexistent biologic differences found in the two experimental groups. Nevertheless, the two groups shared a similar pattern of remodeling activity. The posttraumatic mineralization that declined at the sampled sites need further investigation.
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Sixteen dogs were placed under general anesthesia and flail segments of the left chest were created by transecting ribs 7,8,9, and 10 anteriorly and posteriorly. Fractures were 10 cm apart so that a 10-cm flail segment encompassing four ribs was created. In Group I, the control (N = 5), the chest wall muscles were closed without any stabilization of the fractures. Group II (N = 5) had stabilization of both anterior and posterior fracture sites by polypropylene sutures. Group III (N = 6) had stabilization of the fractures in ribs 7 and 8 with 2.5-cm bone grafts taken from the left fourth rib. Ribs 9 and 10 were stabilized by polypropylene sutures. The study established a canine model for flail chest. It also showed that strut stabilization of rib fractures with bone grafts promotes better healing than suture stabilization. It suggests that using bone grafts taken from another rib to stabilize flail segments may be unsatisfactory since the rib used as a donor showed no signs of regeneration at 30 days.
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Twenty sheep were placed under general anesthesia and five ribs (6-10) were transected at their lateral angle using a pair of rib shears. The fractures were stabilized by titanium wire mesh plates. After 4, 6, 8, 10 and 12 weeks groups of 4 animals were sacrificed and rib samples were prepared for histological examinations. The study showed that the osteosynthesis stabilized the fractures and that the healing is similar to untreated rib fractures. This osteosynthesis method is a good contribution to severe injured chest treatment.
A histomorphometric study was done on healing defects in the ribs of Beagles. A transverse fracture was made in the left 9th and 10th ribs. Beagles were given either ethanol vehicle (n = 6) or prostaglandin (PG) E2 orally (n = 5) for the 30-day period after surgical manipulation to time of necropsy. Double fluorescent labels to measure bone matrix mineralization were given with each of 2 fluorochrome markers--calcein before dogs were surgically manipulated and oxytetracycline hydrochloride before they were euthanatized. The objectives were to determine the effects of fracture on regional remodeling in the periosteum, the effects of PGE2 on the regional remodeling changes in the periosteum induced by the fracture, and the systemic effect of PGE2 on remodeling changes of the contralateral matching sites. The fracture in the nontreated dogs (ethanol only) stimulated remodeling activity in the periosteum with increased resorption (P less than 0.01). However, after surgical manipulation (necropsy) was done, the extent of mineralization on the bone surface was decreased and was decreased more on the nonfractured ribs (right side) than on the fractured (healing) ribs (left side) (P less than 0.05). In the treated dogs, the administration of PGE2 increased the extent of mineralization on the bone surface on the healing ribs. However, as in the nontreated dogs, the administration of PGE2 did not alter the decreasing pattern of mineralization when comparing the bone surfaces at necropsy with the bone surfaces before surgical manipulation was done.(ABSTRACT TRUNCATED AT 250 WORDS)
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