Abstract: OBJECTIVE: To investigate the efficacy on the combination of oral strontium ranelate(Sr R) with a topical Chinese herbal paste on facilitation of fracture healing.METHODS: An open fracture was created at the mid-shaft of the right tibia of rat. A herbal pastecalled CDR containing Honghua(Flos Carthami), Chuanxuduan(Radix Dipsaci Asperoidis) and Dahuang(Radix Et Rhizoma Rhei Palmati) was prepared. The rats were treated with either CDR topically on the fracture site, or Sr R orally, or their combinations.Bone turnover biochemical markers in serum were measured. Microarchitecture of the fracture was analyzed using micro-CT after 14 and 28 d, followed by histomorphometrical analysis.RESULTS: Micro-computed tomography analysis revealed that the combined treatment of CDR with600 mg/g Sr R significantly increased the total callus density, mineralized callus volume fraction, mineralized callus mineral content and mineralized callus density of the callus after 28 d of treatment. This result was consistent with the histomorphometrical analysis on the osteoid volume. Analysis of biochemical markers showed that the combined treatments reduced the bone resorption that occurs temporarily after fracture.CONCLUSION: This study demonstrated that the combined treatment of oral Sr R and topical CDR is effective to promote fracture healing by their additive effect on promoting bone formation and retarding bone resorption.

Key words: Fracture healing, Osteogenesis, Bone resorption, Medicine,Chinese Traditional, Integrative medicine, Strontium ranelate