Effect Of Shock Wave On Bone Callus Formation And Expression Of Vegf And Bfgf During Fracture Healing

Objective This experiment was performed to investigate the effect of extracorporeal shockwave[ES W] on bone callus formation and the expression of VEGF and bFGF during bone fracture healing. The aim was to discuss the probably mechanisms of the shockwaves promoting bone healing arid to provide the experiment evidence for shockwaves application in orthopedics territory.Methods 60 New Zealand rabbits were divided into six time groups randomly(3d, 1w, 2w,3w,4w,6w), then a fracture modle was created in both radii. Each of the right limbs received 2000 impulses of shock wave at 14Kv, whereas the left limbs were used controls. The evaluations included the callus formation based on serial radiographic at 1,2,4 and 6 week. Besides, the histologic examinations was made at 3d,1,2,3,4 and 6 week, the bone callus formation was studied with sorft ware, and microscopical examinations with immunohistochemical stains for detecting VEGF and bFGF expression was made at 3d,1,2,3,4 and 6 week, the protein expression index was studied with sorft ware too.All examination results was analyzed with SAS8.1 Results 1.Based on radiographic examinations, it was found that the amount of callus formation of the control laterals and the treated laterals was improved with times went on. However,there was statistically significant difference in the amount of callus formation between the treated and the control limbs at 1,2,4 and 6 weeks.(P=0.0004, P=0.0022, P<0.0001, P<0.0001)2.In histologic examination, at 4 weeks there was significantly less fibrous tissue, fibrocartilage callus and cartilage callus formation in the treated limbs (1=18.13, P<0.0001; t=11.10, P<0.0001; t=20.68,P<0.0001), however, there was significantly more cortical bone formation in the treated limbs than the control limbs (t=-12.53, P<0.0001); At 6 weeks, there was significantly less fibrocartilage callus, cartilage callus and woven bone formation in the treated limbs than the control limbs (t=11.16, P<0.0001; t=11.90, P<0.0001; t=7.82, P<0.0001), however, there was significantly more cortical bone formation in the treated limbs than the control limbs(t=-3.51,P=0.0066)。3. In immunohistochemical examination at 1,2 and 3 week, the VEGF positive index of the treated limbs were higher than that of the control limbs and statistical difference existed between two lateral limbs(P=0.0005, P=0.0004,P=0.0049)4. at 3 d,1,2 and 3 week, the bFGF positive index of the treated limbs were higher than that of the control limbs and there was statistical difference between two lateral limbs (P=0.0001, P<0.0001,P=0.0001, P=0.0130)Conclusion:(1)Shock wave could up-regulate the expression of VEGF. (2) Shock wave could up-regulate the expression of bFGF. (3) Shock wave could increase the bone callus formation,and was beneficial to bone fracture healing。...