• Lutz Claes, Anita Ignatius, Raimund Lechner, Florian Gebhard, Michael Kraus, Stefan Baumgärtel, Stefan Recknagel, and Gert D Krischak.
• Institute of Orthopaedic Research and Biomechanics, Center for Musculoskeletal Research, University of Ulm, Ulm, Germany. lutz.claes@uni-ulm.de
• Acta Orthop. 2011 Apr 1; 82 (2): 223-7.

Background And PurposeThere is some clinical evidence that fracture healing is impaired in multiply injured patients. Nothing is known, however, about the effects of various types of injuries and their contribution to a possible disturbance of the fracture-healing process. We investigated the effect of a thoracic trauma and an additional soft-tissue trauma on fracture healing in a rat tibia model.Methods3 groups of rats were operated: group A with a simple fracture of the tibia and fibula, group B with a fracture and an additional thoracic trauma, and group C with a fracture, thoracic trauma, and an additional soft-tissue trauma. The fracture and the soft-tissue injury were produced by a special guillotine-like device and the thoracic trauma by a blast wave generator. After one day, the serum level of IL-6 was quantified, and at the end of the study (28 days) the mechanical properties and the callus volume of the healed tibia were determined.ResultsIncreasing the severity of the injury caused IL-6 levels to more than double 1 day after injury. It halved the load to failure in mechanical tests and led to reduced callus volume after 28 days of healing.InterpretationFracture healing is impaired when additional thoracic trauma and soft tissue trauma occurs.

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