ArticleFrontiers in physiology2025
Characterization of human skeletal stem cells in closed and open tibia fractures: a single center pilot study.
Article in Frontiers in physiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Tibial shaft fractures are the most common long bone fractures and carry a significant risk of nonunion, particularly in open injuries. This increased risk has been attributed to heightened activation of damage-associated molecular pathways, cellular senescence, and alterations in the fracture milieu. However, most supporting evidence arises from animal studies under controlled conditions, and the cellular and biochemical environment of human traumatic fractures remains poorly understood. While mechanical and patient-related factors have been associated with impaired healing, the biological mechanisms are not well defined. Human skeletal stem cells (hSSCs) play a critical role in bone regeneration and may provide insight into differential healing responses. This study aimed to characterize hSSC recruitment and functional capacity in open versus closed tibial fractures. Methods: A prospective pilot study of patients undergoing acute tibial shaft fixation at a Level 1 trauma center was conducted. During intramedullary nailing, reamings were collected for analysis. hSSCs were isolated via flow cytometry. Functional assays included colony-forming unit (CFU) counts and Results: 19 patients with isolated tibial shaft fractures (8 closed, 11 open) treated with intramedullary nailing were included. hSSC frequency was significantly lower in open fractures compared to closed fractures after outlier exclusion (2.75% ± 1.67% vs. 5.64% ± 5.80, p = 0.032), suggesting reduced early recruitment. However, no significant differences were observed in CFU capacity (0.0078 ± 0.0071 vs. 0.0156 ± 0.0117, p = 0.221) or osteogenic differentiation (1.24 ± 0.22 vs. 1.52 ± 0.85, p = 0.419). CD146 Conclusion: Open tibial fractures demonstrate reduced early hSSC recruitment compared to closed fractures in the acute period of fracture healing, while
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