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The objective of this study was to compare the effects of soft tissue coverage by either muscle or fasciocutaneous tissue on the healing of open tibial fractures in a murine model. An open tibial fracture, stripped of periosteum with intramedullary fixation, was created in mice. Experimental groups were devised to allow exclusive comparison of either muscle alone or skin plus fascia in direct contact with healing bone. To exclusively assess the relative efficacy of muscle and fasciocutaneous tissue to promote healing of a fracture stripped of periosteum, a piece of sterile inert material (polytetrafluoroethylene) was positioned anteriorly, excluding skin and fascia (muscle group) or posteriorly, excluding muscle (fasciocutaneous group). Skeletal repair was assessed histologically and quantified by histomorphometry; quantitative peripheral computed tomography (pQCT) and mechanical testing using a four-point bending technique. This standardized, reproducible model allowed characterization of the morphology of open fracture healing. At 28 days postfracture, there was faster healing in the experimental muscle coverage group compared to skin and fascia alone. Furthermore, there was almost 50% more cortical bone content and a threefold stronger union beneath muscle compared to fasciocutaneous tissue (p < 0.05 by one-way ANOVA). Exclusive comparison of muscle and fasciocutaneous tissue in our novel murine model demonstrates that muscle is superior for the coverage of open tibial fractures for both the rate and quality of fracture healing.

Original publication

DOI

10.1002/jor.20649

Type

Journal article

Journal

Journal of orthopaedic research : official publication of the Orthopaedic Research Society

Publication Date

09/2008

Volume

26

Pages

1238 - 1244

Addresses

Kennedy Institute of Rheumatology Division, Faculty of Medicine, Imperial College, London, United Kingdom. l.harry@imperial.ac.uk

Keywords

Fascia, Muscle, Skeletal, Periosteum, Surgical Flaps, Skin, Animals, Mice, Fractures, Open, Tibial Fractures, Fracture Fixation, Intramedullary, Models, Animal, Fracture Healing, Female, Dermatologic Surgical Procedures, Fasciotomy