Impaired bone healing following treatment of established nonunion correlates with serum cytokine expression.
Model: Critically sized 8 mm segmental defect created in the mid-diaphysis of the femur with an oscillating saw and stabilised with a radiolucent polysulfone fixation plate; for delayed groups the defect was left empty for 8 weeks to establish nonunion, then reopened with removal of mineralised end capping and soft tissue ingrowth
All acutely treated defects bridged compared with 50 percent of delayed 2 microgram and 75 percent of delayed 5 microgram defects, and the delayed deficit in bone formation and mechanical strength was not rescued by a 2.5 fold dose increase, with non-responders showing higher serum tumour necrosis…
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