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The impact of hyperbaric hyperoxia on fracture repair



DOI:10.1038/bonekey.2013.199

Hyperbaric hyperoxia (HBO) was studied in vivo in mice to determine its impact on bone development and fracture healing.

Eight male mice, subjected to 90% oxygen at 2 atmospheres absolute (ATA) for 90 min per day for 5 days, showed increased rates of mineral apposition and bone formation in the femur and lumbar vertebrae compared to non-exposed controls. Expression of alkaline phosphatase and type 1 collagen alpha 1 were shown to be enhanced in the lumbar vertebrae of HBO-exposed mice.

A group of 24 mice was exposed to HBO conditions after an open femur fracture had been surgically induced. Control groups of equal numbers of mice included sham-operated HBO-treated, non-HBO-treated with a fracture and sham-operated and untreated groups. The HBO groups were subjected to 90% oxygen at 2 ATA for 90 min per day, five times per week for 6 weeks following surgery. HBO-exposed mice showed a significantly larger fracture callus at 2 weeks after surgery, and by 6 weeks treated mice showed significantly higher femur stiffness, and their healing femur was able to take a significantly higher mechanical load (P=0.07 in both cases).

Editor’s comment: While this study is one of the first to demonstrate convincingly that hyperbaric oxygen is beneficial in fracture healing, there are several caveats. Perfusion of oxygen may be much more efficient in mice than larger animals, and the effects on early fracture healing and endochondral ossification were not investigated.


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