Evidence for overgrowth after midfemoral fracture via increased RNA for mitosis.

Middiaphyseal femoral fractures in children and young rats stimulate linear femoral growth, a phenomenon commonly attributed to increased vascularity. To test for changes in mRNA expression of genes related to blood vessels, nerve fibers, cartilage, bone, and cell metabolism, we measured mRNA gene expression for all known rat genes in the physis at various times after diaphyseal fracture. Female Sprague-Dawley rats, 4 weeks of age at surgery, were subjected to a unilateral, simple, transverse, middiaphyseal femoral fracture stabilized with an intramedullary rod. At 0 (intact), 0.1, 0.4, 1, 2, 3, 4, and 6 weeks after fracture, the femoral head with the proximal physis was collected from fractured and intact femora. The RNA was extracted, processed to biotinlabeled cRNA, and hybridized to Affymetrix Rat 230 2.0 GeneChip microarrays. Transcripts from fracture-induced lengthening of the injured femora were compared to those of the intact contralateral femur. In the proximal physis, transcripts related to blood vessels and cartilage formation were down-regulated by fracture. Transcripts related to bone remodeling, nerve axon elongation, cell division, and protein synthesis were up-regulated by fracture. The data support increased mitotic activity in the physis after a midshaft fracture and not increased vascularity.