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. 2021 Nov 23;14(1):30044.
doi: 10.52965/001c.30044. eCollection 2022.

Traumatized periosteum: Its histology, viability, and clinical significance

Bishnu Prasad Patro  1 , Mahesh Rath  1 , Debahuti Mohapatra  1 , Saroj Kumar Patra  1 , Mahesh Chandra Sahu  1 , Gurudip Das  1 , Jagannath Sahoo  1
Affiliations

Traumatized periosteum: Its histology, viability, and clinical significance

Bishnu Prasad Patro et al. Orthop Rev (Pavia). .

Abstract

The periosteum covers the surface of long bone except at the joints. During fracture fixation, we found the periosteum is ragged and damaged. Our objective is to determine the microscopic picture of traumatized periosteum in terms of the degree of damage, cell type, stromal tissue, and vascularity. Periosteum of 1cm*1cm is harvested at 1cm, 3cm, and 5cm proximal and distal to fracture site following fracture of a long bone in 20 humans. Ragged and damaged periosteum mainly consists of an outer fibrous layer with many hemorrhagic tissue and neovascularization. Osteoprogenitor cells were seen only in 12 out of 97 samples, mostly harvested 5 cm from the fracture site. The innermost layer of the periosteum remains attached to the bone surface after separating the fibrous layer following a fracture. The use of a periosteal elevator on the bone surface further damages the inner layer of the periosteum. Using a scalpel to separate the periosteum or merely pulling it away from the bone surface will decrease damage to the inner cambium layer. Fracture reduction can be achieved by indirect means at least 5 cm away from the fracture site.

Keywords: fracture; histology; periosteum; trauma.

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Figures

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Figure 1. Slide with thick cambium layer (Blue arrows).
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Figure 2. Triangular-shaped Osteoprogenitor cells (Blue arrows).
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Figure 3. Fibrous layer with long elongated fibroblasts (Blue arrows).
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Figure 4. Haemorrhage within periosteum (Blue arrows and Blood vessel (Green arrows).
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Chart 1. Presence of Haemorrhage in periosteum Samples.
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Chart 2. Presence of Fibrous Layer in Periosteal Samples.
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Chart 3. Presence of Cambium Layer in Periosteal Samples.
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Chart 4. Presence of Osteoprogenitor Cells in Periosteal Samples.
See this image and copyright information in PMC

References

    1. 1. Holtrop ME. The ultrastructure of bone. Annals of Clinical and Laboratory Science. 1975;5:264-271. - PubMed
    1. 2. Tenenbaum HC, Palangio KG, Holmyard DP, Pritzker KPH. An ultrastructural study of osteogenesis in chick periosteum in vitro. Bone. 1986;7(4):295-302. doi:10.1016/8756-3282(86)90211-5 - PubMed
    1. 3. Bilkay U, Tokat C, Helvaci E, et al. Osteogenic capacities of tibial and cranial periosteum: A biochemical and histologic study. J Craniofac Surg. 2008;19(2):453-458. doi:10.1097/scs.0b013e318052fe3d - PubMed
    1. 4. Ito Y, Fitzsimmons JS, Sanyal A, Mello MA, Mukherjee N, O’Driscoll SW. Localization of chondrocyte precursors in periosteum. Osteoarthritis Cartilage. 2001;9(3):215-223. doi:10.1053/joca.2000.0378 - PubMed
    1. 5. Diaz-Flores L, Gutierrez R, Lopez-Alonso A, Gonzalez R, Varela H. Pericytes as a supplementary source of osteoblasts in periosteal Osteogenesis. Clin Orthop Relat Res. 1992;NA;(275):280-286. doi:10.1097/00003086-199202000-00042 - PubMed

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