Background: Biological osteosynthesis preserves blood supply and promotes rapid healing by aligning fracture fragments without direct surgical exposure. Pedicle screws are primarily designed for internal fixation in spinal procedures. A key objective of many orthopedic studies is to assess the biocompatibility of implants with bone and adjacent soft tissue. This study aims to evaluate the biocompatibility and effects of the Pedicle screw-Rod configuration as a novel external fixation method in canine tibial osteotomy.
Methods: With ethics approval, eight healthy, intact male dogs, aged 10–12 months and weighing between 20 and 22 kg, underwent a minimally invasive medial tibial approach for surgical fixation of tibial osteotomy using a Pedicle screw-Rod configuration. Postoperative evaluations included ultrasound assessments at the osteotomy site and histological evaluations at the bone-screw interface.
Results: B-mode ultrasound evaluation indicated healing progress at all osteotomy sites. The color Doppler examination revealed an initial increase in signals in the surrounding soft tissue during the first 4 weeks post-operation, followed by a decrease in signals within the adjacent soft tissue between the 5th and 8th weeks. During this latter period, the signals were primarily concentrated on the bone surface and the callus. The bone-screw interface at various screw sites exhibited similar histological changes, indicating effective integration of the newly formed woven bone into the screw threads.
Conclusions: Fixation of non-articular tibial osteotomy with Pedicle screw-Rod configuration resulted in secondary bone healing, characterized by abundant callus formation and neovascularization. This implant demonstrated favorable biocompatibility with bone and surrounding soft tissue, without significant complications.
| [1] |
DeCamp CE. Fractures of the tibia and fibula. Brinker, Piermattei and Flo's Handbook of Small Animal Orthopedics and Fracture Repair. 5th ed. Elsevier Health Sciences; 2015: 670-707.
|
| [2] |
Palmer RH. Biological osteosynthesis. Vet Clin North Am Small Anim Pract. 1999; 29(5): 1171-1185.
|
| [3] |
Perren SM. Evolution of the internal fixation of long bone fractures: the scientific basis of biological internal fixation: choosing a new balance between stability and biology. J Bone Joint Surg Br. 2002; 84(8): 1093-1110.
|
| [4] |
Field J, Törnkvist H. Biological fracture fixation: a perspective. VCOT. 2001; 14(4): 169-178.
|
| [5] |
Zheng K, Li X, Fu J, et al. Effects of Ti2448 half-pin with low elastic modulus on pin loosening in unilateral external fixation. J Mater Sci Mater Med. 2011; 22: 1579-1588.
|
| [6] |
Egger EL. Complications of external fixation: a problem-oriented approach. Vet Clin North Am Small Anim Pract. 1991; 21(4): 705-733.
|
| [7] |
Green SA. Complications of external skeletal fixation. Clin Orthop Relat Res. 1983; 180: 109-116.
|
| [8] |
Boos N, Webb J. Pedicle screw fixation in spinal disorders: a European view. Eur Spine J. 1997; 6: 2-18.
|
| [9] |
Magerl F. External skeletal fixation of the lower thoracic and the lumbar spine. Current Concepts of External Fixation of Fractures. Springer-Verlag; 1982: 353-366.
|
| [10] |
Mathews H, Long B. Endoscopy-assisted percutaneous suprafascial internal fixation: evolution of technique and surgical considerations. Orthop Int Ed. 1995; 3: 496-500.
|
| [11] |
Ishii K, Funao H, Isogai N, et al. The history and development of the percutaneous pedicle screw (PPS) system. Medicina. 2022; 58(8): 1064.
|
| [12] |
Anand N, Baron EM, Thaiyananthan G, Khalsa K, Goldstein TB. Minimally invasive multilevel percutaneous correction and fusion for adult lumbar degenerative scoliosis: a technique and feasibility study. Clin Spine Surg. 2008; 21(7): 459-467.
|
| [13] |
Deininger MH, Unfried MI, Vougioukas VI, Hubbe U. Minimally invasive dorsal percutaneous spondylodesis for the treatment of adult pyogenic spondylodiscitis. Acta Neurochir. 2009; 151: 1451-1457.
|
| [14] |
Eck JC. Minimally invasive corpectomy and posterior stabilization for lumbar burst fracture. TSJ. 2011; 11(9): 904-908.
|
| [15] |
Hikata T, Isogai N, Shiono Y, et al. A retrospective cohort study comparing the safety and efficacy of minimally invasive versus open surgical techniques in the treatment of spinal metastases. Clin Spine Surg. 2017; 30(8): E1082-E1087.
|
| [16] |
Ishii K. Surgical technique of minimally invasive transforaminal interbody fusion (MIS-TLIF). Bone Joint J. 2012; 2: 361-364.
|
| [17] |
Tomycz L, Parker SL, McGirt MJ. Minimally invasive transpsoas L2 corpectomy and percutaneous pedicle screw fixation for osteoporotic burst fracture in the elderly: a technical report. Clin Spine Surg. 2015; 28(2): 53-60.
|
| [18] |
Kim YY, Choi WS, Rhyu KW. Assessment of pedicle screw pullout strength based on various screw designs and bone densities—an ex vivo biomechanical study. TSJ. 2012; 12(2): 164-168.
|
| [19] |
Braunstein EM, Goldstein SA, Ku J, Smith P, Matthews LS. Computed tomography and plain radiography in experimental fracture healing. Skeletal Radiol. 1986; 15: 27-31.
|
| [20] |
Grigoryan M, Lynch JA, Fierlinger AL, et al. Quantitative and qualitative assessment of closed fracture healing using computed tomography and conventional radiography1. Acad Radiol. 2003; 10(11): 1267-1273.
|
| [21] |
Dominguez S, Liu P, Roberts C, Mandell M, Richman PB. Prevalence of traumatic hip and pelvic fractures in patients with suspected hip fracture and negative initial standard radiographs—a study of emergency department patients. Acad Emerg Med. 2005; 12(4): 366-369.
|
| [22] |
Phillips TG, Reibach AM, Slomiany WP. Diagnosis and management of scaphoid fractures. Am Fam Physician. 2004; 70(5): 879-884.
|
| [23] |
Tervonen O, Junila J, Ojala R. MR imaging in tibial shaft fractures: a potential method for early visualization of delayed union. Acta Radiol. 1999; 40(4): 410-414.
|
| [24] |
Averill S, Johnson AL, Chambers M, et al. Qualitative and quantitative scintigraphic imaging to predict fracture healing. VCOT. 1999; 12(3): 142-150.
|
| [25] |
Pozzi A, Risselada M, Winter MD. Assessment of fracture healing after minimally invasive plate osteosynthesis or open reduction and internal fixation of coexisting radius and ulna fractures in dogs via ultrasonography and radiography. JAVMA. 2012; 241(6): 744-753.
|
| [26] |
Risselada M, Kramer M, De Rooster H, Taeymans O, Verleyen P, Van Bree H. Ultrasonographic and radiographic assessment of uncomplicated secondary fracture healing of long bones in dogs and cats. Vet Surg. 2005; 34(2): 99-107.
|
| [27] |
Risselada M, van Bree H, Kramer M, Duchateau L, Verleyen P, Saunders J. Ultrasonographic assessment of fracture healing after plate osteosynthesis. Vet Radiol Ultrasound. 2007; 48(4): 368-372.
|
| [28] |
Risselada M, Kramer M, Saunders JH, Verleyen P, Van Bree H. Power Doppler assessment of the neovascularization during uncomplicated fracture healing of long bones in dogs and cats. Vet Radiol Ultrasound. 2006; 47(3): 301-306.
|
| [29] |
Barros J, Barbieri C, Fernandes C. Scintigraphic evaluation of tibial shaft fracture healing. Injury. 2000; 31(1): 51-54.
|
| [30] |
Baltaxe HA, Shaw DD, Connolly JF. Assessment of healing of long-bone fractures by intraosseous venography. Radiology. 1980; 137(1): 53-56.
|
| [31] |
Jackson N, Assad M, Vollmer D, Stanley J, Chagnon M. Histopathological evaluation of orthopedic medical devices: the state-of-the-art in animal models, imaging, and histomorphometry techniques. Toxicol Pathol. 2019; 47(3): 280-296.
|
| [32] |
Inoue N, Ohnishi I, Chen D, Deitz LW, Schwardt JD, Chao EY. Effect of pulsed electromagnetic fields (PEMF) on late-phase osteotomy gap healing in a canine tibial model. J Orthop Res. 2002; 20(5): 1106-1114.
|
| [33] |
Bleedorn JA, Sullivan R, Lu Y, Nemke B, Kalscheur V, Markel MD. Percutaneous lovastatin accelerates bone healing but is associated with periosseous soft tissue inflammation in a canine tibial osteotomy model. J Orthop Res. 2014; 32(2): 210-216.
|
| [34] |
Gooran MM, Mazaheri-Khameneh R, Hashemi-Asl SM, Hobbenaghi R. Assessment of pedicle screw-rod implantation as an external fixation method for tibial osteotomy in a canine model. VAS. 2024; 26:100403.
|
| [35] |
Risselada M, van Bree H, Kramer M, et al. Evaluation of nonunion fractures in dogs by use of B-mode ultrasonography, power Doppler ultrasonography, radiography, and histologic examination. Am J Vet Res. 2006; 67(8): 1354-1361.
|
| [36] |
Bottinelli O, Calliada F, Campani R. Bone callus: possible assessment with color Doppler ultrasonography. Normal bone healing process. Radiol Med. 1996; 91(5): 537-541.
|
| [37] |
Abdul N, Dixon D, Walker A, et al. Fibrosis is a common outcome following total knee arthroplasty. Sci Rep. 2015; 5(1): 16469.
|
| [38] |
Schell H, Reuther T, Duda GN, Lienau J. The pin–bone Interface in external fixator: a standardized analysis in a sheep osteotomy model. J Orthop Trauma. 2011; 25(7): 438-445.
|
| [39] |
Moroni A, Caja V, Maltarello M, et al. Biomechanical, scanning electron microscopy, and microhardness analyses of the bone-pin interface in hydroxyapatite coated versus uncoated pins. J Orthop Trauma. 1997; 11(3): 154-161.
|
| [40] |
Kohli N, Stoddart JC, van Arkel RJ. The limit of tolerable micromotion for implant osseointegration: a systematic review. Sci Rep. 2021; 11(1): 10797.
|
| [41] |
Huang K, Wu T, Lou J, et al. Impact of bone-implant gap size on the interfacial osseointegration: an in vivo study. BMC Musculoskelet Disord. 2023; 24(1): 115.
|
| [42] |
Pommer A, Muhr G, Dávid A. Hydroxyapatite-coated Schanz pins in external fixators used for distraction osteogenesis: a randomized, controlled trial. JBJS. 2002; 84(7): 1162-1166.
|
| [43] |
Sellei RM, Kobbe P, Dienstknecht T, et al. Biomechanical properties of different external fixator frame configurations. Eur J Trauma Emerg Surg. 2015; 41(3): 313-318.
|
| [44] |
Baran O, Havitcioglu H, Tatari H, Cecen B. The stiffness characteristics of hybrid Ilizarov fixators. J Biomech. 2008; 41(14): 2960-2963.
|
RIGHTS & PERMISSIONS
2025 The Author(s). Animal Models and Experimental Medicine published by John Wiley & Sons Australia, Ltd on behalf of The Chinese Association for Laboratory Animal Sciences.