Table Ia.
List of articles included in our systematic review on fracture healing without drug therapies and its effect on callus formation.
| Author (last name, year) | Study design | Sample size | Intervention type | Conclusions | Callus formation (+/-) |
|---|---|---|---|---|---|
| Hao Y. et al., 2007 | Animal study | Sprague-Dawley rats (n=96, female). OPF group (OVX) n=48 NF group (Control) n=48 | A mid-shaft femur fracture model was established 12 weeks after OVX. Femurs were harvested at 4, 8 and 12 weeks for peripheral quantitative computed tomography (pQCT), micro-computed tomography (MicroCT), histology and biomechanical test. | MicroCT data (12 wks) showed the total callus, bony callus, and newly formed bone was approximately 20% lower in the OPF group than that in the NP group, and the total connectivity was 56% lower in the OPF group as compared to the NF group. Biomechanical test data, at 12 weeks, showed that the failure load of the left femur of OPF group was 17% less compared to that of the NF group (Pb0.01), and 15% lower bending stiffness (Pb0.05), 20% lower bending stress (Pb0.01), and 28% lower energy at failure (Pb0.0 were observed in the OPF | Decreased |
| Lill C.A., et al 2003 | Animal study | Swiss Mountain sheep (14 female) Group 1: 7 osteoporotic sheep. Group 2: 7 healthy animals (controls). | A mid-shaft osteotomy of the right tibia fracture (gap of 3 mm). To avoid an effect of bone healing due to the corticosteroid, the medication was stopped 90 days before osteotomy. Bending stiffness and torsional stiffness of the callus zone were also determined. | Callus area, callus density, and osteoporosis status were determined at 0, 4, and 8 weeks using peripheral quantitative computed tomography. The increase of in vivo bending stiffness of the callus was delayed approximately 2 weeks in osteoporotic animals. A significant difference (33%) in torsional stiffness was found between the osteotomized and contralateral intact tibia in osteoporotic animals, but no significant difference occurred in normal sheep (2%). In osteoporotic animals, ex vivo bending stiffness was reduced (21%). Bending stiffness was correlated with callus density; torsional stiffness was correlated with callus area and to a lesser extent with callus density. This study demonstrated a delay of fracture healing in osteoporotic sheep tibiae with respect to callus formation, mineralization, and mechanical properties. | Delayed |
| H. Namkung- Matthai, et al. 2001 | Animal study | 34 female Sprague-Dawley rats, aged 2 months, ovariectomized or sham operation (sx). Ovx rats were fed LCD to induce rapid osteoporosis, whereas sx rats were fed conventional food | An open right femoral midshaft fracture was created and stabilized by intramedullary pins in rats from both ovx and sx groups (517/gp) | Biomechanical data from the healing femur of the ovx rats revealed a fivefold decrease in the energy required to break the fracture callus, a threefold decrease in peak failure load, a twofold decrease in stiffness and a threefold decrease in stress as compared with the sx group. Histomorphological analysis: revealed a delay in fracture callus healing with poor development of mature bone in the ovx rats. | Decreased |
| Kubo T., et al. 1999 | Animal study | Wister rats (n=90 female) ovariectomized (n=15) sham-operation (n=10) 30 rats each from the OVX+F group and the control-F group were used for examinations and the remaining 10 rats were used for examination | A transverse fracture on the diaphysis produced by a lateral longitudinal incision on the unilateral femur Maintained a low calcium diet | Femur fracture was produced 12 weeks after ovariectomy, and the healing process was monitored for the subsequent 12 weeks. As a result, the healing rate was 100% in all animals. Bone fracture itself can be healed even under such conditions as low bone mineral density, low estrogen and low calcium | Increased |