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In This Article

  • Summary
  • Abstract
  • Introduction
  • Protocol
  • Representative Results
  • Discussion
  • Acknowledgements
  • Materials
  • References
  • Reprints and Permissions

Summary

This protocol describes a method to perform fractures on adult mice and monitor the healing process.

Abstract

Fracture repair is an essential function of the skeleton that cannot be reliably modeled in vitro. A mouse injury model is an efficient approach to test whether a gene, gene product or drug influences bone repair because murine bones recapitulate the stages observed during human fracture healing. When a mouse or human breaks a bone, an inflammatory response is initiated, and the periosteum, a stem cell niche surrounding the bone itself, is activated and expands. Cells residing in the periosteum then differentiate to form a vascularized soft callus. The transition from the soft callus to a hard callus occurs as the recruited skeletal progenitor cells differentiate into mineralizing cells, and the bridging of the fractured ends results in the bone union. The mineralized callus then undergoes remodeling to restore the original shape and structure of the healed bone. Fracture healing has been studied in mice using various injury models. Still, the best way to recapitulate this entire biological process is to break through the cross-section of a long bone that encompasses both cortices. This protocol describes how a stabilized, transverse femur fracture can be safely performed to assess healing in adult mice. A surgical protocol including detailed harvesting and imaging techniques to characterize the different stages of fracture healing is also provided.

Introduction

Fractures, breaks in the continuity of the bone surface, occur in all segments of the population. They become severe in people who have fragile bones due to aging or disease, and the health care costs of fragility fractures are expected to exceed $25 billion in 5 years1,2,3,4,5. Understanding the biological mechanisms involved in fracture repair would be a starting point in developing new therapies aimed at enhancing the healing process. Previous research has shown that, upon fracture, four significant step....

Protocol

All animal experiments described were approved by the Institutional Animal Care and Use Committee of the Harvard Medical Area. 12-week-old C57BL/6J mice (males and females) were used in this protocol. C57BL/6J male and female mice achieve peak bone mass around 12 weeks of age with femurs wide enough to fit a stabilizing pin, making them an appropriate strain to use for this protocol15.

1. Preparation for the surgery

  1. Autoclave the surgical eq.......

Representative Results

In C57BL/6J mice, a successful surgery completes the healing steps mentioned earlier with little to no local inflammatory response or periosteal involvement in the sham-operated contralateral femur. A hematoma is formed a few hours after surgery, and the periosteum is activated to recruit skeletal progenitors for chondrogenesis. Various cell populations, such as Prx1+ mesenchymal progenitors, can be traced during the repair process using commercially available fluorescent reporter mouse models (

Discussion

The injury model detailed in this protocol encompasses all four significant steps observed during the healing of spontaneous fractures, including (1) pro-inflammatory response with the formation of the hematoma, (2) recruitment of skeletal progenitors from the periosteum to form the soft callus, (3) mineralization of the callus by osteoblasts and (4) remodeling of the bone by osteoclasts.

The surgical procedure described in this manuscript is optimized for adult mice at least 12 weeks old. A 2.......

Acknowledgements

We thank Dr. Vicki Rosen for financial support and guidance with the project. We would also like to thank the veterinary and IACUC staff at the Harvard School of Medicine for consultation regarding sterile technique, animal well-being, and the materials used to develop this protocol.

....

Materials

NameCompanyCatalog NumberComments
23 G x 1 TW IM (0.6 mm x 2 5mm) needleBD precision305193Use as guide needle
27 G x 1 ¼ (0.4 mm x 30 mm)BD precision305136Use as stabilizing pin
9 mm wound autoclip applier/remover/clips kitBraintree Scientific, INCACS-KIT
Alcian Blue 8 GXElectron Microscopy Sciences10350
Ammonium hydroxideMillipore SigmaAX1303
Circular blade X926.7 THIN-FLEXAbrasive technologiesCELBTFSG633
DREMEL 7700-1/15, 7.2 V Rotary Tool KitDremel7700 1/15
Eosin YThermoScientific7111
Fine curved dissecting forcepsVWR82027-406
Hematoxulin Gill 2Sigma-AldrichGHS216
Hydrochloric acidMillipore SigmaHX0603-4
IsofluranePatterson Veterinary07-893-1389
Microsurgical kitVWR95042-540
Orange GSigma-Aldrich1625
Phloxine BSigma-AldrichP4030
Povidone-Iodine SwabsPDIS23125
SCANCO Medical µCT35Scanco
Slow-release buprenorphineZoopharm

References

  1. Black, D. M., Rosen, C. J. Postmenopausal osteoporosis. The New England Journal of Medicine. 374, 2096-2097 (2016).
  2. Curtis, E. M., Moon, R. J., Harvey, N. C., Cooper, C. The impact of fragility fracture and approaches to osteoporosis r....

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