Initial vascularization and tissue differentiation are influenced by fixation stability

Larger interfragmentary shear movements in the semirigid fixator group were associated with a reduced initial blood supply. At 6 weeks the semirigid fixator group showed a significantly lower percentage of mineralized bone and a higher amount of fibrous tissue leading to a significantly lower stiffness of the callus than the rigid fixator group. This initial delay in healing was compensated for in the later stages with the production of greater volumes of callus tissue so that both groups showed the same callus stiffness at 9 weeks. However, the rigid fixator group showed signs of the beginning of callus remodeling at the latest time points suggesting a faster bone healing. The results indicate the important role of the initial mechanical stability specifically in the vascularization of an osteosynthesis. Further studies should illustrate the precise role of mechanical conditions on the regulation of angiogenesis during early bone healing.