Adjunctive hyperbaric oxygen therapy in the treatment of atrophic tibial nonunion with Ilizarov external fixator: a radiographic and scintigraphic study in rabbits

Acta Orthop Traumatol Turc. 2012;46(2):126-31. doi: 10.3944/AOTT.2012.2586.


Objective: The aim of this experimental study was to determine the effects of adjunctive hyperbaric oxygen therapy (HBO) on atrophic tibial nonunion treatment using Ilizarov external fixator.

Methods: Twenty New Zealand white rabbits were randomly divided into two equal groups. A circular external fixator was applied to the right tibia of all the rabbits. A 5-mm bone block was resected and a tibial pseudarthrosis was obtained after a 6-month waiting period. The experimental group rabbits (n=10) underwent daily 2.5 ATA HBO therapy for 2 hours for 20 days and the control group rabbits (n=10) did not receive any corresponding treatment. Osteoblastic activity was evaluated with bone scintigraphy on days 30 and 90. Fracture healing was evaluated by plain radiographs on days 30 and 90.

Results: On Day 30, radiological scores were statistically similar in both groups (p=0.167). However, on Day 90, the experimental group displayed significantly higher radiological scores (p<0.001). Osteoblastic activity was also higher in the experimental group on both scintigraphic assessments (p=0.005 and p=0.001).

Conclusion: The results of this study suggest that HBO can be used as a supplementary therapy in the management of atrophic tibial nonunion.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Combined Modality Therapy
  • Disease Models, Animal
  • External Fixators*
  • Fracture Healing
  • Hyperbaric Oxygenation / methods*
  • Ilizarov Technique / instrumentation*
  • Osteoblasts / metabolism
  • Pseudarthrosis* / metabolism
  • Pseudarthrosis* / physiopathology
  • Rabbits
  • Tibial Fractures* / metabolism
  • Tibial Fractures* / physiopathology
  • Time Factors
  • Treatment Outcome