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A two-way ANOVA indicates statistically significant differences in fracture healing outcomes considering the main interaction of group crossed with days post-injury for total fracture callus volume (F = 0.024, power = 0.83). Interestingly, bone composition was not affected by polytrauma overall (F = 0.242, power = 0.79) (Supplemental Fig. Tukey-Kramer HSD post-hoc testing on the main interaction of group shows that at the earliest time point, 5 days post-injury, there was increased bone formation with polytrauma when the bone injury occurred contralateral to brain injury (Fig. Contralateral polytrauma also had significantly more bone than the ipsilateral polytrauma (p Stereological evaluation of fracture healing.Total callus volume was impacted by both polytrauma and sidedness of the injuries (Fig. (A) Total volume of the fracture callus, (B) bone composition in the fracture callus, (C) cartilage composition in the fracture callus, (D) bone marrow and blood vessel space composition in the fracture callus.Polytraumatic injuries, specifically long bone fracture and traumatic brain injury (TBI), frequently occur together.Clinical observation has long held that TBI can accelerate fracture healing, yet the complexity and heterogeneity of these injuries has produced conflicting data with limited information on underlying mechanisms.(A) The TBI only group included TBI without tibia fracture, the ipsilateral polytrauma group included TBI with ipsilateral tibia fracture, the contralateral polytrauma group included TBI with contralateral tibia fracture, and the fracture only group included tibia fracture without TBI.

When considered alone, mechanical damage from a TBI causes an immediate and direct loss of neural tissue.To assess both the humoral and neuronal impacts of TBI on fracture healing, we created a novel rodent model which combined a TBI with a concomitant long bone fracture either ipsilateral (same side) or contralateral (opposite side) to the brain lesion (Fig. Polytrauma injuries were compared to both TBI and fracture only. Blood and spleen were collected to evaluate systemic inflammation.TBI were produced in the right hemisphere following a craniotomy using an electromagnetic-controlled cortical contusion impactor (CCI) (Fig. Fracture callus and brain tissue were collected for histological processing and quantification.Experimental design overview of traumatic brain injury (TBI) with concomitant tibia fracture.Schematic of experimental design and protocol is described in Materials and Methods.

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