The Effect of Low-Intensity Pulsed Ultrasound on Expression of Growth Factors and Bone Regeneration in Rib Fracture.

Abstract
SESSION TITLE:
Postoperative ICU Issues PostersSESSION TYPE: Original Investigation PosterPRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PMPURPOSE: In this study we investigated the effect of low-intensity pulsed ultrasound (LIPUS) on expression of growth factors and fracture healing in rat ribs.METHODS: 72 male Wistar-Albino rats were randomly distributed in 3 equal groups, each including 24 subjects. To simulate a fracture; left thoracotomy was performed under general anaesthesia and a 0.5 cm segment was removed from the ribs. After 24 hours of surgery LIPUS began to be implemented according to the groups. Group 1 served as control for the observation of normal bone healing. LIPUS was applied at a doses of %20 (2 msn pulse-8 msn pause) 100 mW/cm2 and %50 (5 msn pulse - 5 msn pause) 200 mW/cm2 for 6 minutes per day respectively in group 2 and 3. Eight animals from each group were sacrificed at 2, 4 and 6 weeks for further assessment. We analysed histologic changes in the bone.RESULTS: Although no statistical difference was noted for osteoblasts, osteoclasts, new bone formation, lymphocytes and Fibroblast Growth Factor (FGF) among all groups; there were significant differences in all growth factors including Epidermal Growth Factor Receptor (EGFR), Vascular Endothelial Growth Factor (VEGF), Insulin-Like Growth Factors (IGF-I and II), Transforming Growth Factor-β1 (TGF-β1) and Platelet Derived Growth Factor (PDGF). Histologic consolidation was significantly increased by LIPUS. In our study while LIPUS stimulates all growth factors outside the FGF.CONCLUSIONS: In accordance with the literature, LIPUS either used in lower or higher doses stimulates the growth factors and consolidation of rib fractures. The most prominent improvement was observed in 200 mW/cm2 group after long term follow-up.CLINICAL IMPLICATIONS: Accelerating the natural healing process in patients with rib fractures will be able to treat more effective, short and low cost treatment.DISCLOSURE: The following authors have nothing to disclose: Mustafa Calik, Gulten Karaca, Halim Yilmaz, Saniye Calik, Hasan Esen, Mustafa Avunduk, Hidir EsmeNo Product/Research Disclosure Information.
PMID: 25334912