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Deferoxamine restores callus size, mineralization, and mechanical strength in fracture healing after radiotherapy.
- Source :
-
Plastic and reconstructive surgery [Plast Reconstr Surg] 2013 May; Vol. 131 (5), pp. 711e-719e. - Publication Year :
- 2013
-
Abstract
- Background: Therapeutic augmentation of fracture-site angiogenesis with deferoxamine has proven to increase vascularity, callus size, and mineralization in long-bone fracture models. The authors posit that the addition of deferoxamine would enhance pathologic fracture healing in the setting of radiotherapy in a model where nonunions are the most common outcome.<br />Methods: Thirty-five Sprague-Dawley rats were divided into three groups. Fracture, irradiated fracture, and irradiated fracture plus deferoxamine. The irradiated fracture and irradiated fracture plus deferoxamine groups received a human equivalent dose of radiotherapy [7 Gy/day for 5 days, (35 Gy)] 2 weeks before mandibular osteotomy and external fixation. The irradiated fracture plus deferoxamine group received injections of deferoxamine into the fracture callus after surgery. After a 40-day healing period, mandibles were dissected, clinically assessed for bony union, imaged with micro-computed tomography, and tension tested to failure.<br />Results: Compared with irradiated fractures, metrics of callus size, mineralization, and strength in deferoxamine-treated mandibles were significantly increased. These metrics were restored to a level demonstrating no statistical difference from control fractures. In addition, the authors observed an increased rate of achieving bony unions in the irradiated fracture plus deferoxamine-treated group when compared with irradiated fracture (67 percent and 20 percent, respectively).<br />Conclusions: The authors' data demonstrate nearly total restoration of callus size, mineralization, and biomechanical strength, and a threefold increase in the rate of union with the use of deferoxamine. The authors' results suggest that the administration of deferoxamine may have the potential for clinical translation as a new treatment paradigm for radiation-induced pathologic fractures.
- Subjects :
- Animals
Biomechanical Phenomena drug effects
Biomechanical Phenomena physiology
Biomechanical Phenomena radiation effects
Bony Callus physiology
Bony Callus radiation effects
Calcification, Physiologic physiology
Calcification, Physiologic radiation effects
Disease Models, Animal
Fracture Healing radiation effects
Male
Mandible drug effects
Mandible physiology
Mandible surgery
Osteotomy
Radiation Injuries, Experimental physiopathology
Random Allocation
Rats
Rats, Sprague-Dawley
Siderophores pharmacology
Tensile Strength drug effects
Tensile Strength physiology
Tensile Strength radiation effects
Bony Callus drug effects
Calcification, Physiologic drug effects
Deferoxamine pharmacology
Fracture Healing drug effects
Radiation Injuries, Experimental drug therapy
Radiotherapy adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1529-4242
- Volume :
- 131
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Plastic and reconstructive surgery
- Publication Type :
- Academic Journal
- Accession number :
- 23629110
- Full Text :
- https://doi.org/10.1097/PRS.0b013e3182865c57