Christian Deininger (Salzburg / AT), Maximilian Wenzel (Salzburg / AT), Andrea Wagner (Salzburg / AT), Andreas Traweger (Salzburg / AT), Herbert Tempfer (Salzburg / AT), Amelie Deluca (Salzburg / AT), Valeska Hofmann (Tübingen / DE), Thomas Freude (Salzburg / AT), Florian Wichlas (Salzburg / AT)
Abstract text (incl. references and figure legends)
Objective: Is there a significant increase in osseous regeneration and/or bone tissue volume by a pedicled/unpedicled periosteal flap compared to the empty defect and a crossover group in a criditcal-sized defect model in the rat femoral diaphysis? An analysis.
Methods: For experimental setup, see Fig.1. A prospective randomized plate osteosynthesis (1.5mm angular stable 5-hole plate) of a 5 mm csd in the right femur was performed. The periosteal flap was dissected along with the supplying vessel from the medial femoral condyle and fixed to the plate and to the defect with a suture. In the PF_lig group, it was ligated. The CO group received a vascular periosteal flap to the empty defect by a second operation after 6 weeks. After the endpoint (12 weeks after initial therapy), evaluation was performed by µ-CT examination and descriptive histological examination including MOVAT stain.
Results: There was a significant increase in bone volume in the PF group compared to the other 3 groups (Fig. 2). In the specimens with PF, primary fibrotic tissue is seen in the defect, which occurs to be partially calcified - immature woven bone. There is no capping of the defect ends in these section. Capping of the defect ends is seen in all other groups. The medullary cavity has closed with compact bone.
Conclusions: The results of this study indicate that a vascular periosteal flap promotes significantly increased new bone formation compared to all other groups. The surgical technique of a vascularized periosteal flap in combination with an autologous bone graft could promote the healing of a pseudarthrosis in a clinical setting.
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