High-energy orthopedic injuries cause severe damage to soft tissues and are prone to infection and healing complications, making them a challenge to manage. Further research is facilitated by a clinically relevant animal model with commensurate fracture severity and soft-tissue damage, allowing evaluation of novel treatment options and techniques. Here we report a reproducible, robust, and clinically relevant animal model of high-energy trauma with extensive soft-tissue damage, based on compressed air-driven membrane rupture as the blast wave source. As proof-of-principle showing the reproducibility of the injury, we evaluate changes in tissue and bone perfusion for a range of different tibia fracture severities, using dynamic contrast-enhanced fluorescence imaging and microcomputed tomography. We demonstrate that fluorescence tracer temporal profiles for skin, femoral vein, fractured bone, and paw reflect the increasing impact of more powerful blasts causing a range of Gustilo grade I–III injuries. The maximum fluorescence intensity of distal tibial bone following 0.1 mg/kg intravenous indocyanine green injection decreased by 35% (p < 0.01), 75% (p < 0.001), and 87% (p < 0.001), following grade I, II, and III injuries, respectively, compared to uninjured bone. Other kinetic parameters of bone and soft tissue perfusion extracted from series of fluorescence images for each animal also showed an association with severity of trauma. In addition, the time-intensity profile of fluorescence showed marked differences in wash-in and wash-out patterns for different injury severities and anatomical locations. This reliable and realistic high-energy trauma model opens new research avenues to better understand infection and treatment strategies. Level of evidence: Level III; Case–control.

中文翻译：

---

具有荧光引导骨灌注评估初步经验的高能开放性骨折模型

高能量骨科损伤会对软组织造成严重损伤，并且容易发生感染和愈合并发症，这使它们难以管理。具有相应骨折严重程度和软组织损伤的临床相关动物模型促进了进一步研究，从而可以评估新的治疗方案和技术。在这里，我们基于压缩空气驱动的膜破裂作为爆炸波源，报告了一种具有广泛软组织损伤的高能量创伤的可重复、稳健且临床相关的动物模型。作为显示损伤可重复性的原理验证，我们使用动态对比增强荧光成像和显微计算机断层扫描评估了一系列不同胫骨骨折严重程度的组织和骨灌注变化。我们证明了皮肤、股静脉、骨折和爪子的荧光示踪剂时间分布反映了更强大的冲击波的影响越来越大，导致一系列 Gustilo I-III 级损伤。静脉注射吲哚菁绿0.1 mg/kg后胫骨远端最大荧光强度降低35%（ 与未受伤的骨骼相比，I、II 和 III 级损伤后的发生率分别为 p < 0.01 )  、75% ( p  < 0.001) 和 87% ( p < 0.001)。从每只动物的一系列荧光图像中提取的骨骼和软组织灌注的其他动力学参数也显示出与创伤严重程度的关联。此外，荧光的时间强度曲线显示不同损伤严重程度和解剖位置的洗入和洗出模式存在显着差异。这种可靠且逼真的高能量创伤模型开辟了新的研究途径，以更好地了解感染和治疗策略。证据等级：Ⅲ级；病例对照。