Publication

Is human fracture hematoma inherently angiogenic?

Street, J
; 
Winter, D
; 
Wang, J H
; 
Wakai, A
; 
McGuinness, A
; 
Redmond, H P
Author
Street, J
 Winter, D
 Wang, J H
 Wakai, A
 McGuinness, A
 Redmond, H P
Advisors
Editors
Other Contributors
Departments
Department of Academic Surgery, Cork University Hospital, Ireland.
Date
2012-02-03T15:12:33Z
Date Submitted
Keywords
Other Subjects
Subject Mesh
Adult
Animals
Bony Callus/*pathology
Cell Division
Cells, Cultured
Endothelial Growth Factors/blood
Endothelium, Vascular/cytology
Female
Fractures, Bone/complications
Hematoma/etiology/*pathology
Humans
Lymphokines/blood
Male
Mice
Mice, Inbred C57BL
Middle Aged
*Neovascularization, Pathologic
Protein Isoforms
Vascular Endothelial Growth Factor A
Vascular Endothelial Growth Factors
Planned Date
Start Date
Collaborators
Principal Investigators
Alternative Titles
Publisher
URI
https://hdl.handle.net/10147/209111
Abstract
This study attempts to explain the cellular events characterizing the changes seen in the medullary callus adjacent to the interfragmentary hematoma during the early stages of fracture healing. It also shows that human fracture hematoma contains the angiogenic cytokine vascular endothelial growth factor and has the inherent capability to induce angiogenesis and thus promote revascularization during bone repair. Patients undergoing emergency surgery for isolated bony injury were studied. Raised circulating levels of vascular endothelial growth factor were seen in all injured patients, whereas the fracture hematoma contained significantly higher levels of vascular endothelial growth factor than did plasma from these injured patients. However, incubation of endothelial cells in fracture hematoma supernatant significantly inhibited the in vitro angiogenic parameters of endothelial cell proliferation and microtubule formation. These phenomena are dependent on a local biochemical milieu that does not support cytokinesis. The hematoma potassium concentration is cytotoxic to endothelial cells and osteoblasts. Subcutaneous transplantation of the fracture hematoma into a murine wound model resulted in new blood vessel formation after hematoma resorption. This angiogenic effect is mediated by the significant concentrations of vascular endothelial growth factor found in the hematoma. This study identifies an angiogenic cytokine involved in human fracture healing and shows that fracture hematoma is inherently angiogenic. The differences between the in vitro and in vivo findings may explain the phenomenon of interfragmentary hematoma organization and resorption that precedes fracture revascularization.
Language
eng
Citation
Clin Orthop Relat Res. 2000 Sep;(378):224-37.
ISSN
0009-921X (Print)
0009-921X (Linking)
eISSN
ISBN
DOI
PMID
10986998
PMCID
Sponsorships
Funding Sources
Funding Amounts
Grant Identifiers
Methodology
Duration
Ethical Approval