2022, Vol. 26 ›› Issue (26): 4136-4140

Hyperbaric oxygen improves fracture healing by promoting osteoblast proliferation

Yu Xue1, Li Xiaofeng2, Shu Kegang3, Wu Liwei3, Wang Yonglin3, Lyu Dingkang3, Zhou Anyuan3, Liang Chaoxin4, Yang Yuan5   

Abstract: BACKGROUND: Most fractures can be healed, 5%-10% of which will develop into nonunion. Clinical trials have confirmed that hyperbaric oxygen can accelerate fracture healing by significantly increasing the partial pressure of arterial oxygen via the blood circulation and promoting metabolism.
OBJECTIVE: To explore the effect and mechanism of hyperbaric oxygen intervention for different time on the healing of femoral fractures in rabbits.
METHODS: Twelve New Zealand white rabbits were selected to make femoral fracture models and randomly divided into a hyperbaric oxygen treatment group for 1 month, a hyperbaric oxygen treatment group for 2 months, a normoxia treatment group for 1 month, and a normoxia treatment group for 2 months (3 rabbits per group). In the hyperbaric oxygen treatment groups, all animals were placed in a hyperbaric animal cabin for hyperbaric oxygen treatment on the 1st day after modeling. After 1 and 2 months of treatment, enzyme-linked immunosorbent assay was used to detect the levels of serum osteocalcin and type I collagen C-terminal peptide and hematoxylin-eosin staining was used to observe fracture healing.
RESULTS AND CONCLUSION: After 1 month of treatment, expression levels of osteocalcin and type I collagen C-terminal peptide in serum showed no significant difference between the hyperbaric oxygen treatment groups and normoxia treatment groups (P > 0.05). After 2 months of treatment, the serum level of type I collagen C-terminal peptide was significantly decreased (P < 0.001) and the serum level of osteocalcin was significantly increased (P < 0.01) in the hyperbaric oxygen treatment group than the normoxia treatment group. After 1 month of treatment, there was no difference in the severity of pathological injury between the hyperbaric oxygen treatment group and normoxia treatment group. Whereas, after 2 months of treatment, pathological injuries were significantly reduced in the hyperbaric oxygen treatment group compared with the normoxia treatment group. To conclude, hyperbaric oxygen treatment for 2 months can effectively increase the expression of osteocalcin, suggesting that it may promote the formation of osteoblasts and accelerate fracture healing.
Key words: hyperbaric oxygen, bone healing, osteocalcin, type I collagen C-terminal peptide, femoral fracture