Modelle der metaphysären Frakturheilung

Zusammenfassung

Obwohl klinisch viele Frakturen im gelenknahen metaphysären Knochenbereich auftreten, basiert unser Grundlagenwissen über die Knochenheilung überwiegend auf experimentellen Studien an diaphysären Modellen. Tierexperimentelle Studien zur metaphysären Frakturheilung wurden an Schafen, Hunden, Kaninchen und Ratten vor allem an der Femur-kondyle, aber auch an der proximalen und distalen Tibia durchgeführt. Die Studien beschränken sich jedoch auf röntgenologische und histologische Auswertungen ohne Charakterisierung der biomechanischen Bedingungen im Frakturheilungsgebiet. Ein erstes, biomechanisch charakterisiertes Modell am Schafsfemurkondylus zeigte, dass es wie bei der diaphysären Knochenheilung eine enge Korrelation der Knochenheilung mit den biomechanischen Bedingungen gibt. Im Unterschied zur diaphysären Heilung verläuft die metaphysäre Heilung jedoch ohne Kallus-bildung durch direkte trabekuläre Heilung. Die Möglichkeiten und Grenzen der bestehenden Modelle werden diskutiert.

Summary

Our knowledge of fracture healing is mainly based on experimental studies of diaphyseal fracture healing models, even though many fractures clinically occur in metaphyseal areas. Experimental studies on metaphyseal models were performed on sheep, dogs, rabbits and rats mainly in the femoral condyle but also in the proximal and distal tibia. Published studies on metaphyseal models were limited to radiological and histological analysis without a characterisation of the biomechanical condition in the healing zone. Recently a first sheep model with characterized biomechanical conditions could demonstrate a correlation between interfragmentary strain and bone healing similar to diaphyseal fractures. In contrast to diaphyseal bone healing however the metaphyseal fracture healing takes place by trabecular bone healing without external callus formation. The possibilities and limitations of the existing metaphyseal fracture healing models are discussed.

Schlüsselwörter

Frakturheilung - Modelle - Biomechanik - Histologie

Keywords

Fracture healing - models - biomechanics - histology

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