The primary goal of scientific investigations into fracture healing is to achieve a complete structural and functional restoration with research into control mechanisms and early biomechanical influences on the orientation of precursor cell immigration pathways. Primary fibrin networks can exhibit isotropy or anisotropy as a result of retraction triggered by messenger substances and energy carriers. This suggests the existence of a primary biomechanical component that is used in the immigration of precursor cells. The morphometry of fibrin structures gives a mean value of 1.12 ± 0.007 (mean ± SEM), which differs markedly from the hypothetical value of zero, thus demonstrating anisotropy or alignment of the fibrin structures. The morphometric test of precursor cell counts to analyze the dynamics of precursor cell immigration, carried out in the bone marrow between the 10th and 25th days, reveals significant differences between the cell count in the marrow and the osteotomy gap. The greatest movement of mononuclear cells in the marrow takes place on the 15th day, with 4.9 ± 0.2 cells per counting field. In the osteotomy gap, the levels found on the 15 th day were 3.1 ± 0.1, and remained the same until the 25 th day, whereupon a figure of 2.9 ± 0.1 was returned. We interpret the alignment of the fibrin network as an early morphological correlate of a biomechanical component. The administration of platelet-rich plasma (PRP) in human patients seems sensible, and the industry already offers PRP methods for use on human patients (Curasan AG, Kleinostheim, Germany). Thrombocytic factors can be obtained which boost the retraction process and pre-form network structures for precursor cell immigration. Nondifferentiated mononuclear cells migrate along both fine and thick fibrin structures. Growth factors, gene therapy and cell therapy may in future have a positive influence on the complex process of bone healing. Tissue engineering also offers other ways of restoring the original structure of bones in a short space of time.
|Number of pages||12|
|Journal||Applied Cardiopulmonary Pathophysiology|
|Publication status||Published - dec. 1 2007|
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
- Cardiology and Cardiovascular Medicine
- Physiology (medical)