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Sample records for fracture healing relationships

  1. Relationship between microstructure, material distribution, and mechanical properties of sheep tibia during fracture healing process.

    Science.gov (United States)

    Gao, Jiazi; Gong, He; Huang, Xing; Fang, Juan; Zhu, Dong; Fan, Yubo

    2013-01-01

    The aim of this study was to investigate the relationship between microstructural parameters, material distribution, and mechanical properties of sheep tibia at the apparent and tissue levels during the fracture healing process. Eighteen sheep underwent tibial osteotomy and were sacrificed at 4, 8, and 12 weeks. Radiographs and micro-computed tomography (micro-CT) scanning were taken for microstructural assessment, material distribution evaluation, and micro-finite element analysis. A displacement of 5% compressive strain on the longitudinal direction was applied to the micro-finite element model, and apparent and tissue-level mechanical properties were calculated. Principle component analysis and linear regression were used to establish the relationship between principle components (PCs) and mechanical parameters. Visible bony callus formation was observed throughout the healing process from radiographic assessment. Apparent mechanical property increased at 8 weeks, but tissue-level mechanical property did not increase significantly until 12 weeks. Three PCs were extracted from microstructural parameters and material distribution, which accounted for 87.592% of the total variation. The regression results showed a significant relationship between PCs and mechanical parameters (R>0.8, PCT imaging could efficiently predict bone strength and reflect the bone remodeling process during fracture healing, which provides a basis for exploring the fracture healing mechanism and may be used as an approach for fractured bone strength assessment.

  2. The relationship between interfragmentary movement and cell differentiation in early fracture healing under locking plate fixation.

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    Miramini, Saeed; Zhang, Lihai; Richardson, Martin; Mendis, Priyan; Oloyede, Adekunle; Ebeling, Peter

    2016-03-01

    Interfragmentary movement (IFM) at the fracture site plays an important role in fracture healing, particularly during its early stage, via influencing the mechanical microenvironment of mesenchymal stem cells within the fracture callus. However, the effect of changes in IFM resulting from the changes in the configuration of locking plate fixation on cell differentiation has not yet been fully understood. In this study, mechanical experiments on surrogate tibia specimens, manufactured from specially formulated polyurethane, were conducted to investigate changes in IFM of fractures under various locking plate fixation configurations and loading magnitudes. The effect of the observed IFM on callus cell differentiation was then further studied using computational simulation. We found that during the early stage, cell differentiation in the fracture callus is highly influenced by fracture gap size and IFM, which in turn, is highly sensitive to locking plate fixation configuration. The computational model predicted that a small gap size (e.g. 1 mm) under a relatively flexible configuration of locking plate fixation (larger bone-plate distances and working lengths) could experience excessive strain and fluid flow within the fracture site, resulting in excessive fibrous tissue differentiation and delayed healing. By contrast, a relatively flexible configuration of locking plate fixation was predicted to improve cartilaginous callus formation and bone healing for a relatively larger gap size (e.g. 3 mm). If further confirmed by animal and human studies, the research outcome of this paper may have implications for orthopaedic surgeons in optimising the application of locking plate fixations for fractures in clinical practice.

  3. Relationship among bone mineral density, collagen composition, and biomechanical properties of callus in the healing of osteoporotic fracture

    Institute of Scientific and Technical Information of China (English)

    SHEN Bin; MU Jian-xiong; PEI Fu-xing

    2007-01-01

    Objective: To study the change and relationship among bone mineral density (BMD), collagen composition and biomechanical properties of the callus in the healing process of osteoporotic fracture.Methods: The osteoporotic rat model and fracture model were established through bilateral ovariectomy(OVX) and osteotomy of the middle shaft of the right hind tibiae, respectively. Ninety female SD rats were randomly divided into OVX group and sham group. With the samples of blood and callus, roentgenoraphic and histological observation were performed for the assessment of the healing progress of the fracture, and the serum concentration of TRAP-5b, proportion of type Ⅰ collagen,BMD and biomechanical properties of the callus were measured.Results: The OVX group experienced a significant delay of fracture healing. The mean serum concentration of TRAP-5b of rats in the OVX group was much higher than that in the sham group after the operation (P < 0.05), but the difference at the same time point after fracture was smaller than that before fracture (P < 0.05 ). The BMD of the callus in both groups reached the peak value at the 6 th week after fracture while the proportion of the type Ⅰ collagen and the biomechanical strength reached the peak at the 8th week.Conclusions: The deficiency of estrogen after the ovariectomy could induce the up-regulation of the osteoclasts activities, whereas the potency of further activation after fracture was depressed. Although the synthesis of collagen together with its mineralization determines the biomechanical properties of new bone, the accumulation of collagen could be assessed as an index in the prediction of biomechanical strength of bones independent of the bone mineral deposition.

  4. CT examinations of healing fractures

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    Nutz, V.; Uexkuell-Gueldenband, V. v.

    1988-10-01

    The CT appearances of healing fractures were studied following tibial osteotomy in a dog. Traditional radiological investigations and CT were carried out until healing was complete; CT showed callus on the ninth day, whereas radiographs only showed it after 19 days. After 32 days, callus filled nearly the entire medullary cavity. Similar observations were made in several human situations. CT demonstrates interposed material in the fracture very clearly, even if there is marked callus formation within the fracture.

  5. The healing of fractured bones

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    Bacon, G.E. [Central Electricity Generating Board, Cheltenham (United Kingdom)

    1997-04-01

    A method utilising neutron beams of width 1 mm, used on D1B (2.4 A) and D20 (1.3 A) to study the healing of fractured bones is presented. It is found that the callus bone uniting the fractured tibia of a sheep, whose healing had been encouraged by daily mechanical vibration over a period of three months, showed no trace of the large preferential vertical orientation of the apatite crystals which is characteristic of the normal bone. Nevertheless the bone had regained about 60% of its mechanical strength and the callus bone, although not oriented, was well crystallized. It is considered that the new monochromator for D20, expected to give increased intensity at 2.5 A, will be of considerable advantage. (author). 2 refs.

  6. Impaired Fracture Healing after Hemorrhagic Shock

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    Philipp Lichte

    2015-01-01

    Full Text Available Impaired fracture healing can occur in severely injured patients with hemorrhagic shock due to decreased soft tissue perfusion after trauma. We investigated the effects of fracture healing in a standardized pressure controlled hemorrhagic shock model in mice, to test the hypothesis that bleeding is relevant in the bone healing response. Male C57/BL6 mice were subjected to a closed femoral shaft fracture stabilized by intramedullary nailing. One group was additionally subjected to pressure controlled hemorrhagic shock (HS, mean arterial pressure (MAP of 35 mmHg for 90 minutes. Serum cytokines (IL-6, KC, MCP-1, and TNF-α were analyzed 6 hours after shock. Fracture healing was assessed 21 days after fracture. Hemorrhagic shock is associated with a significant increase in serum inflammatory cytokines in the early phase. Histologic analysis demonstrated a significantly decreased number of osteoclasts, a decrease in bone quality, and more cartilage islands after hemorrhagic shock. μCT analysis showed a trend towards decreased bone tissue mineral density in the HS group. Mechanical testing revealed no difference in tensile failure. Our results suggest a delay in fracture healing after hemorrhagic shock. This may be due to significantly diminished osteoclast recruitment. The exact mechanisms should be studied further, particularly during earlier stages of fracture healing.

  7. Management of impaired fracture healing: Historical aspects

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    Gajdobranski Đorđe

    2005-01-01

    Full Text Available Introduction Establishing continuity of long bones in cases of impaired bone healing and pseudo-arthrosis is one of the most complex problems in orthopedics. Impaired bone healing The problem of impaired fracture healing is not new. As in other areas of human life, the roots of modern treatment of impaired bone healing lie in ancient medicine. A relatively high percentage of impaired bone healing, as well as unsatisfactory results of standard therapies of impaired bone healing and pseudoarthrosis demonstrate the actuality of this problem. This paper represents an attempt to pay respect to some of those who have dedicated their work to this problem in orthopedic surgery, and it is a historical review on impaired bone fracture healing. At the same time it should be an additional stimulus and challenge for orthopedic surgeons to further study impaired bone fracture healing, improve the existing and find new methods for their adequate treatment. Conclusion The authors are certain that the number of researchers throughout the world who have contributed to treatment modalities of impaired bone healing, is much higher, but not all are mentioned in this paper. However, it does not lessen their contributions to orthopedics.

  8. A first order system model of fracture healing

    Institute of Scientific and Technical Information of China (English)

    WANG Xiao-ping; ZHANG Xian-long; LI Zhu-guo; YU Xin-gang

    2005-01-01

    A first order system model is proposed for simulating the influence of stress stimulation on fracture strength during fracture healing. To validate the model, the diaphyses of bilateral tibiae in 70 New Zealand rabbits were osteotomized and fixed with rigid plates and stress-relaxation plates, respectively. Stress shielding rate and ultimate bending strength of the healing bone were measured at 2 to 48 weeks postoperatively. Ratios of stress stimulation and fracture strength of the healing bone to those of intact bone were taken as the system input and output. The assumed first order system model can approximate the experimental data on fracture strength from the input of stress stimulation over time, both for the rigid plate group and the stress-relaxation plate group, with different system parameters of time constant and gain. The fitting curve indicates that the effect of mechanical stimulus occurs mainly in late stages of healing. First order system can model the stress adaptation process of fracture healing. This approach presents a simple bio-mathematical model of the relationship between stress stimulation and fracture strength, and has the potential to optimize planning of functional exercises and conduct parametric studies.

  9. Inhibition of Midkine Augments Osteoporotic Fracture Healing.

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    Melanie Haffner-Luntzer

    Full Text Available The heparin-binding growth and differentiation factor midkine (Mdk is proposed to negatively regulate osteoblast activity and bone formation in the adult skeleton. As Mdk-deficient mice were protected from ovariectomy (OVX-induced bone loss, this factor may also play a role in the pathogenesis of postmenopausal osteoporosis. We have previously demonstrated that Mdk negatively influences bone regeneration during fracture healing. Here, we investigated whether the inhibition of Mdk using an Mdk-antibody (Mdk-Ab improves compromised bone healing in osteoporotic OVX-mice. Using a standardized femur osteotomy model, we demonstrated that Mdk serum levels were significantly enhanced after fracture in both non-OVX and OVX-mice, however, the increase was considerably greater in osteoporotic mice. Systemic treatment with the Mdk-Ab significantly improved bone healing in osteoporotic mice by increasing bone formation in the fracture callus. On the molecular level, we demonstrated that the OVX-induced reduction of the osteoanabolic beta-catenin signaling in the bony callus was abolished by Mdk-Ab treatment. Furthermore, the injection of the Mdk-Ab increased trabecular bone mass in the skeleton of the osteoporotic mice. These results implicate that antagonizing Mdk may be useful for the therapy of osteoporosis and osteoporotic fracture-healing complications.

  10. Flexible fixation and fracture healing

    DEFF Research Database (Denmark)

    Schmal, Hagen; Strohm, Peter C; Jaeger, Martin

    2011-01-01

    to the bone surface than external fixator bars. External fixators have the advantage of being less expensive, highly flexible, and technically less demanding. They remain an integral part of orthopaedic surgery for emergent stabilization, for pediatric fractures, for definitive osteosynthesis in certain...

  11. Computational simulation of bone fracture healing under inverse dynamisation.

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    Wilson, Cameron J; Schütz, Michael A; Epari, Devakara R

    2017-02-01

    Adaptive finite element models have allowed researchers to test hypothetical relationships between the local mechanical environment and the healing of bone fractures. However, their predictive power has not yet been demonstrated by testing hypotheses ahead of experimental testing. In this study, an established mechano-biological scheme was used in an iterative finite element simulation of sheep tibial osteotomy healing under a hypothetical fixation regime, "inverse dynamisation". Tissue distributions, interfragmentary movement and stiffness across the fracture site were compared between stiff and flexible fixation conditions and scenarios in which fixation stiffness was increased at a discrete time-point. The modelling work was conducted blind to the experimental study to be published subsequently. The simulations predicted the fastest and most direct healing under constant stiff fixation, and the slowest healing under flexible fixation. Although low fixation stiffness promoted more callus formation prior to bridging, this conferred little additional stiffness to the fracture in the first 5 weeks. Thus, while switching to stiffer fixation facilitated rapid subsequent bridging of the fracture, no advantage of inverse dynamisation could be demonstrated. In vivo data remains necessary to conclusively test this treatment protocol and this will, in turn, provide an evaluation of the model's performance. The publication of both hypotheses and their computational simulation, prior to experimental testing, offers an appealing means to test the predictive power of mechano-biological models.

  12. Early period of fracture healing in ovariectomized rats

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    徐少文; 喻任; 赵光锋; 王建卫

    2003-01-01

    Objective: To evaluate the effect of osteoporosis on fracture healing through observing the histomorphological changes, bone mineral density of callus and expression and distribution of transforming growth factor beta 1 (TGF-β1),basic fibroblast growth factor (bFGF) and bone morphogenetic protein-2 (BMP-2) in ovariectomized rats.Methods: Sixty female Sprague-Dawley rats (aged 12 weeks and weighing 235 g on average) were randomly divided into an ovariectomized (OVX) group (n=30) and a sham-operated (SO) group (n=30). Ovariectomy was performed in the OVX rats and same incision was made in the SO rats. Three months later, fracture of femoral shaft was made on all the rats. Then they were killed at different time points. Callus formation was observed with histological and immunohistochemical methods.Results: A reduction in callus and bone mineral density in the healing femur and a decrease of osteoblasts expressing TGF-β1 near the bone trabecula were observed in the OVX rats 3-4 weeks after fracture. Histomorphological analysis revealed a higher content of soft callus in the OVX rats than that in the SO rats. Immunohistochemistry results showed that no remarkable difference in expression and distribution of BMP-2 and bFGF between the OVX and SO groups was found.Conclusions: Osteoporosis influences the quantity and quality of callus during the early period of fracture healing. The effect of osteoporosis on fracture healing has no relationship with the expression of BMP-2 or bFGF. The decreased expression of TGF-β1 in osteoblasts may cause a decrease in quality of facture healing after osteoporosis.

  13. The science of ultrasound therapy for fracture healing.

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    Della Rocca, Gregory J

    2009-01-01

    Fracture healing involves a complex interplay of cellular processes, culminating in bridging of a fracture gap with bone. Fracture healing can be compromised by numerous exogenous and endogenous patient factors, and intense research is currently going on to identify modalities that can increase the likelihood of successful healing. Low-intensity pulsed ultrasound (LIPUS) has been proposed as a modality that may have a benefit for increasing reliable fracture healing as well as perhaps increasing the rate of fracture healing. We conducted a review to establish basic scince evidence of therapeutic role of lipus in fracture healing. An electronic search without language restrictions was accomplished of three databases (PubMed, Embase, Cinahl) for ultrasound-related research in osteocyte and chondrocyte cell culture and in animal fracture models, published from inception of the databases through December, 2008. Studies deemed to be most relevant were included in this review. Multiple in vitro and animal in vivo studies were identified. An extensive body of literature exists which delineates the mechanism of action for ultrasound on cellular and tissue signaling systems that may be related to fracture healing. Research on LIPUS in animal fracture models has demonstrated promising results for acceleration of fracture healing and for promotion of fracture healing in compromised tissue beds. A large body of cellular and animal research exists which reveals that LIPUS may be beneficial for accelerating normal fracture healing or for promoting fracture healing in compromised tissue beds. Further investigation of the effects of LIPUS in human fracture healing is warranted for this promising new therapy.

  14. The science of ultrasound therapy for fracture healing

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    Della Rocca Gregory

    2009-01-01

    Full Text Available Fracture healing involves a complex interplay of cellular processes, culminating in bridging of a fracture gap with bone. Fracture healing can be compromised by numerous exogenous and endogenous patient factors, and intense research is currently going on to identify modalities that can increase the likelihood of successful healing. Low-intensity pulsed ultrasound (LIPUS has been proposed as a modality that may have a benefit for increasing reliable fracture healing as well as perhaps increasing the rate of fracture healing. We conducted a review to establish basic scince evidence of therapeutic role of lipus in fracture healing. An electronic search without language restrictions was accomplished of three databases (PubMed, Embase, Cinahl for ultrasound-related research in osteocyte and chondrocyte cell culture and in animal fracture models, published from inception of the databases through December, 2008. Studies deemed to be most relevant were included in this review. Multiple in vitro and animal in vivo studies were identified. An extensive body of literature exists which delineates the mechanism of action for ultrasound on cellular and tissue signaling systems that may be related to fracture healing. Research on LIPUS in animal fracture models has demonstrated promising results for acceleration of fracture healing and for promotion of fracture healing in compromised tissue beds. A large body of cellular and animal research exists which reveals that LIPUS may be beneficial for accelerating normal fracture healing or for promoting fracture healing in compromised tissue beds. Further investigation of the effects of LIPUS in human fracture healing is warranted for this promising new therapy.

  15. Indium-111 leukocyte scanning and fracture healing

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    Mead, L.P.; Scott, A.C.; Bondurant, F.J.; Browner, B.D. (Univ. of Texas Medical School, Houston (USA))

    1990-01-01

    This study was undertaken to determine the specificity of indium-111 leukocyte scans for osteomyelitis when fractures are present. Midshaft tibial osteotomies were performed in 14 New Zealand white rabbits, seven of which were infected postoperatively with Staphylococcus aureus per Norden's protocol. All 14 rabbits were scanned following injection with 75 microCi of indium 111 at 72 h after osteotomy and at weekly intervals for 4 weeks. Before the rabbits were killed, the fracture sites were cultured to document the presence or absence of infection. The results of all infected osteotomy sites were positive, whereas no positive scans were found in the noninfected osteotomies. We concluded from this study that uncomplicated fracture healing does not result in a positive indium-111 leukocyte scan.

  16. Fracture healing: direct magnification versus conventional radiography

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    Link, T.M. [Dept. of Clinical Radiology, Westfaelische Wilhelms-Univ., Muenster (Germany); Kessler, T. [Dept. of Traumatic and Hand Surgery, Westfaelische Wilhelms-Univ., Muenster (Germany); Lange, T. [Dept. of Clinical Radiology, Westfaelische Wilhelms-Univ., Muenster (Germany); Overbeck, J. [Dept. of Traumatic and Hand Surgery, Westfaelische Wilhelms-Univ., Muenster (Germany); Fiebich, M. [Dept. of Clinical Radiology, Westfaelische Wilhelms-Univ., Muenster (Germany); Peters, P.E. [Dept. of Clinical Radiology, Westfaelische Wilhelms-Univ., Muenster (Germany)

    1994-08-01

    The aim of the study was to evaluate the potential of magnification radiography in diagnosing fracture healing and assessing its complications. Seventy-three patients with fractures or who had undergone osteotomy were radiographed with both conventional (non-magnified) and magnification (5-fold) techniques. Since 10 patients were radiographed twice and 1 three times, 83 radiographs using each technique were obtained. All radiographs were analysed and the findings correlated with the patients` follow-up studies. The microfocal X-ray unit used for magnification radiography had a focal spot size of 20-130 {mu}m. As an imaging system, digital luminescence radiography was employed with magnification, while normal film-screen systems were used with conventional radiography. Magnification radiography proved superior to conventional radiography in 47% of cases: endosteal and periosteal callus formations were seen earlier and better in 26 cases, and osseous union could be evaluated with greater certainty in 33 cases. In 49% of cases magnification radiography was equal and in 4% inferior to conventional radiography. Additionally an ``inter-observer analysis`` was carried out. Anatomical and pathological structures were classified into one of four grades. Results were significantly (P < 0.01) better using magnification radiography. We conclude that the magnification technique is a good method for monitoring fracture healing in its early stages. (orig.)

  17. Simulation of the nutrient supply in fracture healing.

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    Chen, G; Niemeyer, F; Wehner, T; Simon, U; Schuetz, M A; Pearcy, M J; Claes, L E

    2009-11-13

    The healing process for bone fractures is sensitive to mechanical stability and blood supply at the fracture site. Most currently available mechanobiological algorithms of bone healing are based solely on mechanical stimuli, while the explicit analysis of revascularization and its influences on the healing process have not been thoroughly investigated in the literature. In this paper, revascularization was described by two separate processes: angiogenesis and nutrition supply. The mathematical models for angiogenesis and nutrition supply have been proposed and integrated into an existing fuzzy algorithm of fracture healing. The computational algorithm of fracture healing, consisting of stress analysis, analyses of angiogenesis and nutrient supply, and tissue differentiation, has been tested on and compared with animal experimental results published previously. The simulation results showed that, for a small and medium-sized fracture gap, the nutrient supply is sufficient for bone healing, for a large fracture gap, non-union may be induced either by deficient nutrient supply or inadequate mechanical conditions. The comparisons with experimental results demonstrated that the improved computational algorithm is able to simulate a broad spectrum of fracture healing cases and to predict and explain delayed unions and non-union induced by large gap sizes and different mechanical conditions. The new algorithm will allow the simulation of more realistic clinical fracture healing cases with various fracture gaps and geometries and may be helpful to optimise implants and methods for fracture fixation.

  18. Transcriptional analysis of fracture healing and the induction of embryonic stem cell-related genes.

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    Manish Bais

    Full Text Available Fractures are among the most common human traumas. Fracture healing represents a unique temporarily definable post-natal process in which to study the complex interactions of multiple molecular events that regulate endochondral skeletal tissue formation. Because of the regenerative nature of fracture healing, it is hypothesized that large numbers of post-natal stem cells are recruited and contribute to formation of the multiple cell lineages that contribute to this process. Bayesian modeling was used to generate the temporal profiles of the transcriptome during fracture healing. The temporal relationships between ontologies that are associated with various biologic, metabolic, and regulatory pathways were identified and related to developmental processes associated with skeletogenesis, vasculogenesis, and neurogenesis. The complement of all the expressed BMPs, Wnts, FGFs, and their receptors were related to the subsets of transcription factors that were concurrently expressed during fracture healing. We further defined during fracture healing the temporal patterns of expression for 174 of the 193 genes known to be associated with human genetic skeletal disorders. In order to identify the common regulatory features that might be present in stem cells that are recruited during fracture healing to other types of stem cells, we queried the transcriptome of fracture healing against that seen in embryonic stem cells (ESCs and mesenchymal stem cells (MSCs. Approximately 300 known genes that are preferentially expressed in ESCs and approximately 350 of the known genes that are preferentially expressed in MSCs showed induction during fracture healing. Nanog, one of the central epigenetic regulators associated with ESC stem cell maintenance, was shown to be associated in multiple forms or bone repair as well as MSC differentiation. In summary, these data present the first temporal analysis of the transcriptome of an endochondral bone formation process

  19. Ultrasound attenuation as a quantitative measure of fracture healing

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    Gheduzzi, Sabina; Humphrey, Victor F.; Dodd, Simon P.; Cunningham, James L.; Miles, Anthony W.

    2004-10-01

    The monitoring of fracture healing still relies upon the judgment of callus formation and on the manual assessment of the stiffness of the fracture. A diagnostic tool capable of quantitatively measuring healing progression of a fracture would allow the fine-tuning of the treatment regime. Ultrasound attenuation measurements were adopted as a possible method of assessing the healing process in human long bones. The method involves exciting ultrasonic waves at 200 kHz in the bone and measuring the reradiation along the bone and across the fracture zone. Seven cadaveric femora were tested in vitro in intact form and after creating a transverse fracture by sawing through the cortex. The effects of five different fracture types were investigated. A partial fracture, corresponding to a 50% cut through the cortex, a closed fracture, and fractures of widths varying between 1, 2, and 4 mm were investigated. The introduction of a fracture was found to produce a dramatic effect on the amplitude of the signal. Ultrasound attenuation was found to be sensitive to the presence of a fracture, even when the fracture was well reduced. It would therefore appear feasible to adopt attenuation across a fracture as a quantitative measurement of fracture healing.

  20. Effects of anti-osteoporosis medications on fracture healing

    DEFF Research Database (Denmark)

    Jørgensen, Niklas R; Schwarz, Peter

    2011-01-01

    A number of fractures are complicated by impaired healing. This is prevalent in certain risk groups such as elderly, osteoporotics, postmenopausal women, and in people with malnutrition. At present, no pharmacologic treatments are available. Thus, there is an unmet need for medications that can...... stimulate bone healing. Parathyroid hormone (PTH) is the first bone anabolic drug approved for the treatment of osteoporosis and, intriguingly, a number of animal studies prove the ability of PTH to induce fracture healing. PTH may therefore be a potential novel treatment option in humans with impaired...

  1. Considerations on evolution and healing of vertebral fractures.

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    Klumpp, Raymond; Trevisan, Carlo; Nava, Veronica; Riccardi, Domenico; Recalcati, Wilmer

    2013-10-01

    Only little is known when talking about the evolution of a vertebral fracture. From the few studies available in the literature, we can deduce that the risk a vertebral compression fracture has to worsen its deformity is consistent. It is important to try to make a prognosis on how the fracture is going to heal based on the type of fracture encountered. A chapter of its own is the occurrence of a vertebral fracture non-union that is difficult to diagnose and treat, but comes along with a poor prognosis.

  2. Radiographic features of teriparatide-induced healing of femoral fractures

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    Youngwoo Kim

    2015-12-01

    Full Text Available Teriparatide is a drug that is used to increase bone remodeling, formation, and density for the treatment of osteoporosis. We present three cases of patients with a femoral insufficiency fracture. The patients were administered teripatatide in an attempt to treat severe osteoporosis and to enhance fracture healing. We found several radiographic features around the femoral fractures during the healing period. 1 Callus formation was found at a very early stage in the treatment. Teriparatide substantially increased the unusually abundant callus formation around the fracture site at 2 weeks. Moreover, this callus formation continued for 8 weeks and led to healing of the fracture. 2 Abundant callus formation was found circumferentially around the cortex with a ‘cloud-like’ appearance. 3 Remodeling of the teriparatide-induced callus formation was found to be part of the normal fracture healing process. After 1 year, normal remodeling was observed on plain radiographs. These findings indicate that teriparatide can be used as an adjuvant therapy in the management of femoral insufficiency fractures.

  3. Systemic treatment with telmisartan improves femur fracture healing in mice.

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    Xiong Zhao

    Full Text Available Recent clinical studies indicated that angiotensin receptor blockers (ARBs would decrease the risk of bone fractures in the elderly populations. There is little known about the role of the ARBs in the process of fracture healing. The purpose of the present study was to verify the hypothesis that systemic treatment with telmisartan has the ability to promote fracture healing. In this study, femur fractures were produced in 96 mature male BALB/c mice. Animals were treated with the ARBs telmisartan or vehicle. Fracture healing was analysed after 2, 5 and 10 weeks postoperatively using X-ray, biomechanical testing, histomorphometry, immunohistochemistry and micro-computed tomography (micro-CT. Radiological analysis showed the diameter of the callus in the telmisartan treated animals was significantly increased when compared with that of vehicle treated controls after two weeks of fracture healing. The radiologically observed promotion of callus formation was confirmed by histomorphometric analyses, which revealed a significantly increased amount of bone formation when compared with vehicle-treated controls. Biomechanical testing further showed a significantly greater peak torque at failure, and a higher torsional stiffness in telmisartan-treated animals compared with controls. There was an increased fraction of PCNA-positive cells and VEGF-positive cells in telmisartan-treated group compared with vehicle-treated controls. From the three-dimensional reconstruction of the bony callus, telmisartan-treated group significantly increased the values of BV/TV by 21.7% and CsAr by 26.0% compared to the vehicle-treated controls at 5 weeks post-fracture. In summary, we demonstrate in the current study that telmisartan could promote fracture healing in a mice model via increasing mechanical strength and improving microstructure. The most mechanism is probably by an increase of cell proliferation and neovascularization associated with a decreased VEGF expression

  4. Low-intensity pulsed ultrasound affects RUNX2 immunopositive osteogenic cells in delayed clinical fracture healing

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    Rutten, S.; Nolte, P.A.; Korstjens, C.M.; Klein-Nulend, J.

    2009-01-01

    Introduction: Osteogenic cell proliferation and differentiation play an important role in adequate fracture healing, and is target for osteoinductive therapies in delayed fracture healing. The aim of this study was to investigate whether low-intensity pulsed ultrasound enhances fracture healing at t

  5. The effect of immunonutrition (glutamine, alanine on fracture healing

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    Abdullah Küçükalp

    2014-11-01

    Full Text Available Background: There have been various studies related to fracture healing. Glutamine is an amino acid with an important role in many cell and organ functions. This study aimed to make a clinical, radiological, and histopathological evaluation of the effects of glutamine on fracture healing. Methods: Twenty rabbits were randomly allocated into two groups of control and immunonutrition. A fracture of the fibula was made to the right hind leg. All rabbits received standard food and water. From post-operative first day for 30 days, the study group received an additional 2 ml/kg/day 20% L-alanine L-glutamine solution via a gastric catheter, and the control group received 2 ml/kg/day isotonic via gastric catheter. At the end of 30 days, the rabbits were sacrificed and the fractures were examined clinically, radiologically, and histopathologically in respect to the degree of union. Results: Radiological evaluation of the control group determined a mean score of 2.5 according to the orthopaedists and 2.65 according to the radiologists. In the clinical evaluation, the mean score was 1.875 for the control group and 2.0 for the study group. Histopathological evaluation determined a mean score of 8.5 for the control group and 9.0 for the study group. Conclusion: One month after orally administered glutamine–alanine, positive effects were observed on fracture healing radiologically, clinically, and histopathologically, although no statistically significant difference was determined.

  6. Fracture and Healing of Rock Salt Related to Salt Caverns

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    Chan, K.S.; Fossum, A.F.; Munson, D.E.

    1999-03-01

    In recent years, serious investigations of potential extension of the useful life of older caverns or of the use of abandoned caverns for waste disposal have been of interest to the technical community. All of the potential applications depend upon understanding the reamer in which older caverns and sealing systems can fail. Such an understanding will require a more detailed knowledge of the fracture of salt than has been necessary to date. Fortunately, the knowledge of the fracture and healing of salt has made significant advances in the last decade, and is in a position to yield meaningful insights to older cavern behavior. In particular, micromechanical mechanisms of fracture and the concept of a fracture mechanism map have been essential guides, as has the utilization of continuum damage mechanics. The Multimechanism Deformation Coupled Fracture (MDCF) model, which is summarized extensively in this work was developed specifically to treat both the creep and fracture of salt, and was later extended to incorporate the fracture healing process known to occur in rock salt. Fracture in salt is based on the formation and evolution of microfractures, which may take the form of wing tip cracks, either in the body or the boundary of the grain. This type of crack deforms under shear to produce a strain, and furthermore, the opening of the wing cracks produce volume strain or dilatancy. In the presence of a confining pressure, microcrack formation may be suppressed, as is often the case for triaxial compression tests or natural underground stress situations. However, if the confining pressure is insufficient to suppress fracture, then the fractures will evolve with time to give the characteristic tertiary creep response. Two first order kinetics processes, closure of cracks and healing of cracks, control the healing process. Significantly, volume strain produced by microfractures may lead to changes in the permeability of the salt, which can become a major concern in

  7. Muscle-bone Interactions During Fracture Healing

    Science.gov (United States)

    2015-03-01

    physical trauma31, orthopaedic surgery32, or due to disease like fibrodysplasia ossificans progressiva, which has been identified to be a result of a...responsible for bone healing may provide opportunities to develop therapies to augment normal physiologic mechanisms underlying bone regeneration. Current... osteoporosis in premenopausal and postmenopausal women. J Bone Miner Metab 2008; 26:159-64. 70. Hill M, Goldspink G. Expression and splicing of the in- sulin

  8. Leptin Influences Healing in the Sprague Dawley Rat Fracture Model

    Science.gov (United States)

    Liu, Pengcheng; Cai, Ming

    2017-01-01

    Background Leptin plays a crucial role in bone metabolism, and its level is related to bone callus formation in the fracture repair process. The objective of this study was to evaluate the effect of recombinant leptin on the healing process of femoral fractures in rats. Material/Methods Forty-eight male Sprague Dawley (SD) rats with an average body weight of 389 g (range: 376–398 g) and an average age of 10 weeks were included in this animal research, and all rats were randomly divided into two major groups. Then standardized femur fracture models were implemented in all SD rats. Rats in the control group were treated with only 0.5 mL of physiological saline, and rats in the experimental group were treated with recombinant leptin 5 μg/kg/d along with the same 0.5 mL of physiological saline for 42 days intraperitoneally. At the same time, each major group was evenly divided into three parallel subgroups for each parallel bone evaluation separately at the second, fourth, and sixth weeks. Each subgroup included eight rats. Results The total radiological evaluation results showed that the healing progress of femoral fracture in the experimental group was superior to that in the control group from the fourth week. At the sixth week, experimental group rats began to present significantly better femoral fracture healing progress than that of the control group rats. Results of biomechanics show the ultimate load (N) and deflection ultimate load (mm) of the experimental group rats was significantly increased compared with that of the control group rats from the fourth week. Conclusions Our results suggest that leptin may have a positive effect on SD rat femur fracture healing. PMID:28088810

  9. Excess dietary methionine does not affect fracture healing in mice

    Science.gov (United States)

    Holstein, Joerg H.; Schmalenbach, Julia; Herrmann, Markus; Ölkü, Ilona; Garcia, Patric; Histing, Tina; Herrmann, Wolfgang; Menger, Michael D.; Pohlemann, Tim; Claes, Lutz

    2012-01-01

    Summary Background An elevated serum concentration of homocysteine (hyperhomocysteinemia) has been shown to disturb fracture healing. As the essential amino acid, methionine, is a precursor of homocysteine, we aimed to investigate whether excess methionine intake affects bone repair. Material/Methods We analyzed bone repair in 2 groups of mice. One group was fed a methionine-rich diet (n=13), and the second group received an equicaloric control diet without methionine supplementation (n=12). Using a closed femoral fracture model, bone repair was analyzed by histomorphometry and biomechanical testing at 4 weeks after fracture. Blood was sampled to measure serum concentrations of homocysteine, the bone formation marker osteocalcin, and the bone resorption marker collagen I C-terminal crosslaps Results Serum concentrations of homocysteine were significantly higher in the methionine group than in the control group, while serum markers of bone turnover did not differ significantly between the 2 groups. Histomorphometry revealed no significant differences in size and tissue composition of the callus between animals fed the methionine-enriched diet and those receiving the control diet. Accordingly, animals of the 2 groups showed a comparable bending stiffness of the healing bones. Conclusions We conclude that excess methionine intake causes hyperhomocysteinemia, but does not affect fracture healing in mice. PMID:23197225

  10. Locally applied Simvastatin improves fracture healing in mice

    Directory of Open Access Journals (Sweden)

    Aspenberg Per

    2007-09-01

    Full Text Available Abstract Background HMG-CoA reductase inhibitors, statins, are widely prescribed to lower cholesterol. High doses of orally administered simvastatin has previously been shown to improve fracture healing in a mouse femur fracture model. In this study, simvastatin was administered either subcutaneously or directly to the fracture area, with the goal of stimulating fracture repair at acceptable doses. Methods Femur fractures were produced in 70 mature male Balb-C mice and stabilized with marrow-nailing. Three experiments were performed. Firstly, 20 mice received subcutaneous injections of either simvastatin (20 mg or vehicle. Secondly, 30 mice were divided into three groups of 10 mice receiving continuous subcutaneous delivery of the vehicle substance, the vehicle with 5 mg or with 10 mg of simvastatin per kg bodyweight per day. Finally, in 20 mice, a silicone tube was led from an osmotic mini-pump to the fracture area. In this way, 10 mice received an approximate local dose of simvastatin of 0.1 mg per kg per day for the duration of the experiment and 10 mice received the vehicle compound. All treatments lasted until the end of the experiment. Bilateral femurs were harvested 14 days post-operative. Biomechanical tests were performed by way of three-point bending. Data was analysed with ANOVA, Scheffé's post-hoc test and Student's unpaired t-test. Results With daily simvastatin injections, no effects could be demonstrated for any of the parameters examined. Continuous systemic delivery resulted in a 160% larger force at failure. Continuous local delivery of simvastatin resulted in a 170% larger force at failure as well as a twofold larger energy uptake. Conclusion This study found a dramatic positive effect on biomechanical parameters of fracture healing by simvastatin treatment directly applied to the fracture area.

  11. Association between timing of zoledronic acid infusion and hip fracture healing

    DEFF Research Database (Denmark)

    Colón-Emeric, C; Nordsletten, L; Olson, S

    2010-01-01

    Patients in the Health Outcomes and Reduced Incidence with Zoledronic Acid Once Yearly (HORIZON) Recurrent Fracture Trial were assessed for evidence of delayed hip fracture healing. No association was observed between zoledronic acid (ZOL) and delayed healing. We conclude that ZOL has no clinically...... evident effect on fracture healing, even when the drug is infused in the immediate postoperative period. INTRODUCTION: Intravenous zoledronic acid 5 mg (ZOL) given after a hip fracture reduces secondary fracture rates and mortality. It has been postulated that bisphosphonates may affect healing if given...... soon after a fracture. We sought to determine whether the timing of ZOL infusion affected the risk of delayed hip fracture healing. METHODS: In the HORIZON Recurrent Fracture Trial, patients were randomized within 90 days of a low-trauma hip fracture to receive either once-yearly ZOL (n¿=¿1...

  12. Do Capacity Coupled Electric Fields Accelerate Tibial Stress Fracture Healing

    Science.gov (United States)

    2006-12-01

    MJ, Goll SR, Nichols CE, 3rd, Pollack SR: Prevention and treatment of sciatic denervation disuse osteoporosis in the rat tibia with capacitively...the healing of fractures. J Bone Joint Surg Am 83-A:259-70, 2001 40. Rubin CT, McLeod KJ, Lanyon LE: Prevention of osteoporosis by pulsed...USA Corresponding author Belinda R. Beck, Ph.D. Griffith University School of Physiotherapy and Exercise Science, PMB 50 Gold Coast Mail Centre Q

  13. CaMKK2 Inhibition in Enhancing Bone Fracture Healing

    Science.gov (United States)

    2016-05-01

    mm) retrograde through the distal condyle of the femur. Radiographic analyses were performed to confirm the location and quality of the fractures...costs, loss of productivity and most importantly, loss of patient quality of life. Prolonged healing time and non-union occur in 5-10% of these...male C57BL6 (50) were purchased from Harlan Laboratories (Indianapolis) and housed under a 12-hr light and dark cycle, with food and water provided ad

  14. Effects of Boric Acid on Fracture Healing: An Experimental Study.

    Science.gov (United States)

    Gölge, Umut Hatay; Kaymaz, Burak; Arpaci, Rabia; Kömürcü, Erkam; Göksel, Ferdi; Güven, Mustafa; Güzel, Yunus; Cevizci, Sibel

    2015-10-01

    Boric acid (BA) has positive effects on bone tissue. In this study, the effects of BA on fracture healing were evaluated in an animal model. Standard closed femoral shaft fractures were created in 40 male Sprague-Dawley rats under general anesthesia. The rats were allocated into five groups (n = 8 each): group 1, control with no BA; groups 2 and 3, oral BA at doses of 4 and 8 mg/kg/day, respectively; group 4, local BA (8 mg/kg); and group 5, both oral and local BA (8 mg/kg/day orally and 8 mg/kg locally). After closed fracture creation, the fracture line was opened with a mini-incision, and BA was locally administered to the fracture area in groups 4 and 5. In groups 2, 3, and 5, BA was administered by gastric gavage daily until sacrifice. The rats were evaluated by clinical, radiological, and histological examinations. The control group (group 1) significantly differed from the local BA-exposed groups (groups 4 and 5) in the clinical evaluation. Front-rear and lateral radiographs revealed significant differences between the local BA-exposed groups and the control and other groups (p < 0.05). Clinical and radiological evaluations demonstrated adequate agreement between observers. The average histological scores significantly differed across groups (p = 0.007) and were significantly higher in groups 4 and 5 which were the local BA (8 mg/kg) and both oral and local BA (8 mg/kg/day orally and 8 mg/kg locally), respectively, compared to the controls. This study suggests that BA may be useful in fracture healing. Further research is required to demonstrate the most effective local dosage and possible use of BA-coated implants.

  15. Therapeutic ultrasound in fracture healing: The mechanism of osteoinduction

    Directory of Open Access Journals (Sweden)

    John P

    2008-01-01

    Full Text Available Background: Ultrasound has been used therapeutically for accelerating fracture healing since many years. However, the controversy on the exact mechanism of osteoinduction still continues. In this study, we try to bring out the exact biomolecular mechanism by which ultrasound induces fracture healing. Materials and Methods: The study was conducted in two phases: animal experiments and clinical study. In the first phase, we induced fractures on the left tibia of Wistar strain rats under anaesthesia. They were divided into two groups. One of the groups was given low-intensity, pulsed ultrasound (30 MW/cm 2 20 min a day for 10 days. Tissue samples and radiographs were taken weekly for 3 weeks from both the groups. In the second phase of our study, ten patients with fractures of the distal end of the radius (ten fractures were included. Five of these were treated as cases, and five were treated as controls. Ultrasound was given 30 MW/cm 2 for 20 min every day for 2 weeks. The patients were assessed radiologically and sonologically before and after ultrasound therapy. Tissue samples were studied with thymidine incorporation test with and without adding various neurotransmitter combinations. Results: Radiological findings revealed that there was an increased callus formation in the ultrasound group. At the cellular level, there was an increased thymidine incorporation in the ultrasound group. When various neurotransmitters were added to the cells, there was an increased thymidine incorporation in the ultrasound group. In the second phase of the study, radiological and sonological assessments showed that there was an increased callus formation in the ultrasound group. In cytological study, thymidine incorporation was found to be increased in the ultrasound group. Conclusions: The results of animal and clinical studies demonstrated an early and increased callus formation in the ultrasound group. Cytological studies revealed increased thymidine

  16. Study of stress adaptability of fracture healing%骨折愈合的应力适应性研究

    Institute of Scientific and Technical Information of China (English)

    董福慧; 关继超; 赵勇; 邹炳曾; 尚天裕

    2001-01-01

    目的 探讨骨折端受力、肌肉动力、骨痂密度与骨折愈合的关系。方法 通过传感器电测技术与X线灰度分析的方法,从三个方面对骨折愈合的应力适应性进行了研究:①分别对14只1岁龄山羊进行了断端受力与骨折愈合的关系的研究;②对10只健康成年家兔进行了肌肉动力与骨折愈合的关系的研究;③对56只健康成年家兔进行了骨痂密度与骨折愈合的关系的研究。结果与结论 ①理想的骨折愈合与最佳的应力状态相适应;②肌肉动力是应力适应的反馈调节因素;③骨痂密度是应力适应的反馈结果。%Objective To explore the relationship between local stress status,muscular motivation,callus density and fracture healing.Methods Stress adaptability of fracture healing was studied from three respects:1.the relationship between fracture local stress and fracture healing was studied in 14 one year old goats;2.the relationship between muscular motivation and fracture healing was studied in 10 health adult rabbits and 3.the relationship between callus density and fracture healing was studied in 56 healthy adult rabbits.Electric transducer technique and X-ray densitometry method were used in all the three groups of animals.Results and Conclusion 1.Ideal fracture healing should be adapted to the best stress status;2.Muscular motivation is the biofeedback regulation factor of stress adaptability of fracture healing;3.The density of callus is the result of biofeedback of stress adaptability of fracture healing.

  17. Experimental Timescales of Fracture-Healing Rheological Behavior of Thermoreversible Gels

    Science.gov (United States)

    Thornell, Travis L.; Subramaniam, Krithika; Erk, Kendra A.

    Acrylic thermoreversible physical gels were used as a model soft material system to investigate fracture-healing behavior by shear rheometry. By using shear start-up experiments, gels at various concentrations and temperatures were measured to determine shear stress responses, and fracture was indicated by a decrease in shear stress (confirmed with rheophysical flow visualization experiments). Fractured gels were allowed to recover in the rheometer for set periods of time and were tested again using the same shear start-up procedure to evaluate the recovery kinetics of network strength. Relationships between the network recovery and the normalized ratio of the resting times and characteristic relaxation times of the gels were determined. It was found that resting times for fully healed networks needed to be 2 or 3 orders of magnitude greater than the relaxation times. The extent of fracture was also investigated. Gels that were deformed to smaller total strain magnitudes were suspected to have incomplete (or partial) fracture as results showed various responses for given resting times.

  18. Effect of early or delayed treatment upon healing of mandibular fractures: a systematic literature review

    DEFF Research Database (Denmark)

    Hermund, Niels Ulrich; Hillerup, Søren; Kofod, Thomas

    2008-01-01

    The possible relation between treatment delay and healing complications in mandibular fracture treatment (excluding condylar fractures) was reviewed systematically. Twenty-two studies were identified. No randomized studies focused on the effect of immediate or delayed treatment. The main focus...

  19. Neutrophils contribute to fracture healing by synthesizing fibronectin+ extracellular matrix rapidly after injury

    NARCIS (Netherlands)

    Bastian, Okan W.; Koenderman, Leo; Alblas, Jacqueline; Leenen, Luke P H; Blokhuis, Taco J.

    2016-01-01

    The role of inflammatory cells in bone regeneration remains unclear. We hypothesize that leukocytes contribute to fracture healing by rapidly synthesizing an "emergency extracellular matrix (ECM)" before stromal cells infiltrate the fracture hematoma (FH) and synthesize the eventual collagenous bone

  20. Urine matrix metalloproteinases (MMPs) as biomarkers for the progression of fracture healing.

    Science.gov (United States)

    Wigner, Nathan A; Kulkarni, Nitin; Yakavonis, Mark; Young, Megan; Tinsley, Brian; Meeks, Brett; Einhorn, Thomas A; Gerstenfeld, Louis C

    2012-03-01

    Whilst the majority of fractures heal normally, it is estimated that ∼10% of fractures exhibit some level of delayed or impaired healing. Although radiography is the primary diagnostic tool to assess the progression of fracture healing, radiographic features only qualitatively correlate with tissue level increases in mineral content and do not quantitatively measure underlying biological processes that are associated with the progression of healing. Specific metaloproteinases have been shown to be essential to processes of both angiogenesis and mineralised cartilage resorption and bone remodelling at different phases of fracture healing. The aim of this study was to determine the potential of using a simple urine based assay of the activity of two MMPs as a means of assessing the biological progression of fracture healing through the endochondral phase of healing. Using a standard mid-diaphyseal murine model of femoral fracture, MMP9 and MMP13 proteins and enzymatic activity levels were quantified in the urine of mice across the time-course of fracture healing and compared to the mRNA and protein expression profiles in the calluses. Both urinary MMP9 and MMP13 protein and enzymatic activity levels, assessed by Western blot, zymogram and specific MMP fluorometric substrate assays, corresponded to mRNA expression and immunohistologic assays of the proteins within callus tissues. These studies suggest that urinary levels of MMP9 and MMP13 may have potential as metabolic markers to monitor the progression of fracture healing.

  1. Increase in bone protein components with healing rat fractures: enhancement by zinc treatment.

    Science.gov (United States)

    Igarashi, A; Yamaguchi, M

    1999-12-01

    The alteration in bone components in the femoral-diaphyseal tissues with fracture healing was investigated. Rats were sacrificed 7 and 14 days after the femoral fracture. Protein content in the femoral-diaphyseal tissues was markedly elevated by fracture healing. Analysis with sodium dodecyl sulfate-polyacrylamide gel electrophoresis showed that many protein molecules were induced in the diaphyseal tissues with fracture healing. Moreover, when the femoral-diaphyseal tissues with fracture healing were cultured for 24 and 48 h in a serum-free medium, many proteins in the bone tissues were released into the medium. Also, the culture of the diaphyseal tissues with fracture healing caused a significant increase in bone alkaline phosphatase activity and deoxyribonucleic acid (DNA) content. Meanwhile, the presence of zinc acexamate (10-5 and 10-4 M), a stimulator of bone formation, in a culture medium induced a significant elevation of protein content and alkaline phosphatase activity in the diaphyseal tissues with fracture healing. Such an effect was completely abolished by the presence of cycloheximide (10-6 M), an inhibitor of protein synthesis. The present study suggests that fracture healing induces a newly synthesized bone protein component including stimulatory factor(s) for bone formation. Zinc supplementation may stimulate the healing of femoral fracture.

  2. Association between timing of zoledronic acid infusion and hip fracture healing

    DEFF Research Database (Denmark)

    Colón-Emeric, C; Nordsletten, L; Olson, S

    2011-01-01

    Patients in the Health Outcomes and Reduced Incidence with Zoledronic Acid Once Yearly (HORIZON) Recurrent Fracture Trial were assessed for evidence of delayed hip fracture healing. No association was observed between zoledronic acid (ZOL) and delayed healing. We conclude that ZOL has no clinical...

  3. Effectiveness of Teriparatide on Fracture Healing: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Shi, Zhongju; Zhou, Hengxing; Pan, Bin; Lu, Lu; Liu, Jun; Kang, Yi; Yao, Xue; Feng, Shiqing

    2016-01-01

    Purpose Nowadays, the efficacy of teriparatide in treating osteoporosis was widely accepted, but the discussion about using teriparatide to enhance fracture healing hasn’t come to an agreement. This meta-analysis was conducted to evaluate the effectiveness of teriparatide for fracture healing. Methods We searched PubMed, the Cochrane Library, and Embase in August 2016 for randomized controlled trials (RCTs) which concerned the treatment of teriparatide for fracture healing. Results Finally, a total of 380 patients were randomly assigned in the 5 trials included in this meta-analysis. There was a significant effectiveness with regards to function improvement in patients following fracture, however, there was no significant effectiveness with regards to time of radiographic fracture healing, fracture healing rate and reduction in pain. Conclusions This analysis showed that administration of teriparatide following fracture lacked the effectiveness for fracture healing. Moreover, teriparatide administration had no apparent adverse effects. These results should be interpreted with caution because of some clear limitations. If we want to confirm whether teriparatide improves fracture healing, more high-quality randomized controlled trials are needed. PMID:27997614

  4. Mechanics and mechano-biology of fracture healing in normal and osteoporotic bone.

    Science.gov (United States)

    Augat, Peter; Simon, Ulrich; Liedert, Astrid; Claes, Lutz

    2005-03-01

    Fracture repair, which aims at regaining the functional competence of a bone, is a complex and multifactorial process. For the success of fracture repair biology and mechanics are of immense importance. The biological and mechanical environments must be compatible with the processes of cell and tissue proliferation and differentiation. The biological environment is characterized by the vascular supply and by many biochemical components, the biochemical milieu. A good vascular supply is a prerequisite for the initiation of the fracture repair process. The biochemical milieu involves complex interactions among local and systemic regulatory factors such as growth factors or cytokines. The mechanical environment is determined by the local stress and strain within the fracture. However, the local stress and strain is not accessible, and the mechanical environment, therefore, is described by global mechanical factors, e.g., gap size or interfragmentary movement. The relationship between local stress and strain and the global mechanical factors can be obtained by numerical models (Finite Element Model). Moreover, there is considerable interaction between biological factors and mechanical factors, creating a biomechanical environment for the fracture healing process. The biomechanical environment is characterized by osteoblasts and osteocytes that sense the mechanical signal and express biological markers, which effect the repair process. This review will focus on the effects of biomechanical factors on fracture repair as well as the effects of age and osteoporosis.

  5. Immunohistochemical localization of key arachidonic acid metabolism enzymes during fracture healing in mice.

    Directory of Open Access Journals (Sweden)

    Hsuan-Ni Lin

    Full Text Available This study investigated the localization of critical enzymes involved in arachidonic acid metabolism during the initial and regenerative phases of mouse femur fracture healing. Previous studies found that loss of cyclooxygenase-2 activity impairs fracture healing while loss of 5-lipoxygenase activity accelerates healing. These diametric results show that arachidonic acid metabolism has an essential function during fracture healing. To better understand the function of arachidonic acid metabolism during fracture healing, expression of cyclooxygenase-1 (COX-1, cyclooxygenase -2 (COX-2, 5-lipoxygenase (5-LO, and leukotriene A4 hydrolase (LTA4H was localized by immunohistochemistry in time-staged fracture callus specimens. All four enzymes were detected in leukocytes present in the bone marrow and attending inflammatory response that accompanied the fracture. In the tissues surrounding the fracture site, the proportion of leukocytes expressing COX-1, COX-2, or LTA4H decreased while those expressing 5-LO remained high at 4 and 7 days after fracture. This may indicate an inflammation resolution function for 5-LO during fracture healing. Only COX-1 was consistently detected in fracture callus osteoblasts during the later stages of healing (day 14 after fracture. In contrast, callus chondrocytes expressed all four enzymes, though 5-LO appeared to be preferentially expressed in newly differentiated chondrocytes. Most interestingly, osteoclasts consistently and strongly expressed COX-2. In addition to bone surfaces and the growth plate, COX-2 expressing osteoclasts were localized at the chondro-osseous junction of the fracture callus. These observations suggest that arachidonic acid mediated signaling from callus chondrocytes or from callus osteoclasts at the chondro-osseous junction regulate fracture healing.

  6. Three-dimensional evaluation of healing joint morphology after closed treatment of condylar fractures.

    Science.gov (United States)

    Yamashita, Y; Inoue, M; Aijima, R; Danjo, A; Goto, M

    2016-03-01

    Closed treatment for condylar fractures has long been widely accepted. With closed treatment, the deviated bone fragments heal in their new positions, and this may subsequently cause a range of functional impairments. The association between healing morphology and post-treatment functional impairment is unclear. In this study, computed tomography images of 26 patients (35 sides) who had undergone closed treatment for condylar fractures were used to perform a comparative investigation of three-dimensional (3D) bone morphology before and after treatment. As a result, the morphology of the condylar process after treatment was classified into four different patterns: unchanged, spherical, L-shaped, and detached. In terms of the association between fracture types and healing morphology, fractures of the condylar head healed in the spherical pattern, simple fractures of the condylar neck healed in the spherical or L-shaped pattern, and comminuted fractures of the condylar neck healed in the spherical, L-shaped, or detached pattern. The association between mandibular deviation and healing morphology was also investigated, and it was found that deviation was greater for the spherical and detached patterns than for the L-shaped pattern. The present findings indicate that 3D evaluation of the fractured condylar process is required to elucidate the association with functional impairment after healing.

  7. Transcriptional Analysis of Fracture Healing and the Induction of Embryonic Stem Cell–Related Genes

    OpenAIRE

    Bais, Manish; McLean, Jody; Sebastiani, Paola; Young, Megan; Wigner, Nathan; Smith, Temple; Kotton, Darrell N.; Einhorn, Thomas A; Gerstenfeld, Louis C.

    2009-01-01

    Fractures are among the most common human traumas. Fracture healing represents a unique temporarily definable post-natal process in which to study the complex interactions of multiple molecular events that regulate endochondral skeletal tissue formation. Because of the regenerative nature of fracture healing, it is hypothesized that large numbers of post-natal stem cells are recruited and contribute to formation of the multiple cell lineages that contribute to this process. Bayesian modeling ...

  8. A Feasibility study on Monitoring of Fracture Healing by Electric Stimulation-A study on 2 tibial fracture cases

    Directory of Open Access Journals (Sweden)

    S. Kumaravel

    2010-09-01

    Full Text Available Sufferings associated with broken limbs have been on an exponential increase in India, mainly due to road accidents. Conventional healing and uniting methods takes any where between 1 ½ to 6 months depending on the nature of the fracture and the speed of reporting for medical care .In an effort to speed up the healing process low voltage electric stimulation has been tried and has been found to cut down the healing time by nearly 30% depending on the fracture-history. Also the course of fracture healing has been traced and definite trends during the process identified.Two case studies of fractures of the leg bone through electric stimulation indicate identical trends in the healingprocess.

  9. Disadvantages of interfragmentary shear on fracture healing--mechanical insights through numerical simulation.

    Science.gov (United States)

    Steiner, Malte; Claes, Lutz; Ignatius, Anita; Simon, Ulrich; Wehner, Tim

    2014-07-01

    The outcome of secondary fracture healing processes is strongly influenced by interfragmentary motion. Shear movement is assumed to be more disadvantageous than axial movement, however, experimental results are contradictory. Numerical fracture healing models allow simulation of the fracture healing process with variation of single input parameters and under comparable, normalized mechanical conditions. Thus, a comparison of the influence of different loading directions on the healing process is possible. In this study we simulated fracture healing under several axial compressive, and translational and torsional shear movement scenarios, and compared their respective healing times. Therefore, we used a calibrated numerical model for fracture healing in sheep. Numerous variations of movement amplitudes and musculoskeletal loads were simulated for the three loading directions. Our results show that isolated axial compression was more beneficial for the fracture healing success than both isolated shearing conditions for load and displacement magnitudes which were identical as well as physiological different, and even for strain-based normalized comparable conditions. Additionally, torsional shear movements had less impeding effects than translational shear movements. Therefore, our findings suggest that osteosynthesis implants can be optimized, in particular, to limit translational interfragmentary shear under musculoskeletal loading. © 2014 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  10. Simulated microgravity alters the expression of key genes involved in fracture healing

    Science.gov (United States)

    McCabe, N. Patrick; Androjna, Caroline; Hill, Esther; Globus, Ruth K.; Midura, Ronald J.

    2013-11-01

    Fracture healing in animal models has been shown to be altered in both ground based analogs of spaceflight and in those exposed to actual spaceflight. The molecular mechanisms behind altered fracture healing as a result of chronic exposure to microgravity remain to be elucidated. This study investigates temporal gene expression of multiple factors involved in secondary fracture healing, specifically those integral to the development of a soft tissue callus and the transition to that of hard tissue. Skeletally mature female rats were subjected to a 4 week period of simulated microgravity and then underwent a closed femoral fracture procedure. Thereafter, they were reintroduced to the microgravity and allowed to heal for a 1 or 2 week period. A synchronous group of weight bearing rats was used as a normal fracture healing control. Utilizing Real-Time quantitative PCR on mRNA from fracture callus tissue, we found significant reductions in the levels of transcripts associated with angiogenesis, chondrogenesis, and osteogenesis. These data suggest an altered fracture healing process in a simulated microgravity environment, and these alterations begin early in the healing process. These findings may provide mechanistic insight towards developing countermeasure protocols to mitigate these adaptations.

  11. Teriparatide Improves Fracture Healing and Early Functional Recovery in Treatment of Osteoporotic Intertrochanteric Fractures.

    Science.gov (United States)

    Huang, Tsan-Wen; Chuang, Po-Yao; Lin, Shih-Jie; Lee, Chien-Yin; Huang, Kuo-Chin; Shih, Hsin-Nung; Lee, Mel S; Hsu, Robert Wen-Wei; Shen, Wun-Jer

    2016-05-01

    Osteoporotic intertrochanteric fractures result in serious health problems and decrease health-related quality of life (HRQoL). Faster time-to-union is important for early return to daily activities and reduction of complications. Teriparatide has been shown to accelerate fracture healing, but the literature is sparse on this topic. The aim of this study is to assess whether teriparatide accelerates fracture healing.Between 2008 and 2014, patients with osteoporotic intertrochanteric fractures who underwent surgical interventions were enrolled in this retrospective cohort study. Group 1 included patients who were not on any osteoporosis medication prior to fracture and who postoperatively received only calcium and vitamin D; patients in Group 2 were not on any osteoporosis medication prior to fracture, and received teriparatide and calcium and vitamin D postoperatively. Patients in Group 3 were those who were on alendronate prior to fracture and postfracture received teriparatide as well as calcium and vitamin D. Demographics, time-to-union, HRQoL (short-form health survey [SF]-12 physical component summary [PCS] and SF-12 mental component summary [MCS]), morbidities, mortalities, and radiographic and functional outcomes between groups were compared.A total of 189 patients were enrolled in this study. There were 83 patients in Group 1, 47 patients in Group 2, and 59 patients in Group 3. A significantly shorter time-to-union was found in the teriparatide-treated groups (mean, 13.6, 12.3, and 10.6 weeks, respectively [P = 0.002]). With regard to SF-12 PCS, the scores were significantly better in teriparatide-treated groups at 3 months (mean, 19, 28, and 29, respectively [P = 0.002]) and 6 months (mean, 28, 37, and 38, respectively [P = 0.008]). Similar inter-group differences were noted when comparing the pain scores, the ability to get around the house, the ability to get out of the house, and the ability to go shopping at 3 and 6 months. Complications

  12. Comparison in bone turnover markers during early healing of femoral neck fracture and trochanteric fracture in elderly patients

    Directory of Open Access Journals (Sweden)

    Shota Ikegami

    2009-10-01

    Full Text Available Healing of fractures is different for each bone and bone turnover markers may reflect the fracture healing process. The purpose of this study was to determine the characteristic changes in bone turnover markers during the fracture healing process. The subjects were consecutive patients with femoral neck or trochanteric fracture who underwent surgery and achieved bone union. There were a total of 39 patients, including 33 women and 6 men. There were 18 patients (16 women and 2 men with femoral neck fracture and 21 patients (17 women and 4 men with trochanteric fracture. Serum bone-specific alkaline phosphatase (BAP was measured as a bone formation marker. Urine and serum levels of N-terminal telopeptide of type I collagen (NTX, as well as urine levels of C-terminal telopeptide of type I collagen (CTX and deoxypyridinoline (DPD, were measured as markers of bone resorption. All bone turnover markers showed similar changes in patients with either type of fracture, but significantly higher levels of both bone formation and resorption markers were observed in trochanteric fracture patients than in neck fracture patients. BAP showed similar levels at one week after surgery and then increased. Bone resorption markers were increased after surgery in patients with either fracture. The markers reached their peak values at three weeks (BAP and urinary NTX, five weeks (serum NTX and DPD, and 2-3 weeks (CTX after surgery. The increase in bone turnover markers after hip fracture surgery and the subsequent decrease may reflect increased bone formation and remodeling during the healing process. Both fractures had a similar bone turnover marker profile, but the extent of the changes differed between femoral neck and trochanteric fractures.

  13. Fracture behaviour of a self-healing microcapsule-loaded epoxy system

    Directory of Open Access Journals (Sweden)

    2011-03-01

    Full Text Available The effect of temperature on the fracture behaviour of a microcapsule-loaded epoxy matrix was investigated. Microencapsulated epoxy and mercaptan-derivative healing agents were incorporated into an epoxy matrix to produce a polymer composite capable of self-healing. Maximum fracture loads were measured using the double-torsion method. Thermal aging at 55 and 110°C for 17 hours [hrs] was applied to heal the pre-cracked samples. The addition of microcapsules appeared to increase significantly the load carrying capacity of the epoxy after healing. Once healed, the composites achieved as much as 93–171% of its virgin maximum fracture load at 18, 55 and 110°C. The fracture behavior of the microcapsule- loaded epoxy matrix was influenced by the healing temperature. The high self-healing efficiency may be attributed to the result of the subsurface micro-crack pinning or deviation, and to a stronger microencapsulated epoxy and mercaptanderivative binder than that of the bulk epoxy. The results show that the healing temperature has a significant effect on recovery of load transferring capability after fracture.

  14. AN ULTRASTRUCTURE INVESTIGATION OF OSTEOPORO-SIS FRACTURE HEALING IN OVARIECTOMIZED RAT

    Institute of Scientific and Technical Information of China (English)

    楼国祥; 张先龙

    2003-01-01

    Objective To elucidate the influence of osteoporosis on the fracture healing in ovariectomized rat. Methods 24 females 8-month-old SD rats were divided randomly into two groups.12 were sham-operated(Sham)and 12 were bilaterally ovariectomized(OVX) 3 months later.The femoral fracture model were made in both groups,the healing process was observed by transmission electron microscopy(TEM) on d3,d7,d14,d21,d28,and d42 after making fracture in control groups(Sham) and the osteoporosis group(OVX).Results According to the TEM findings,the types of fracture healing cells,their ultrastructure changes and functional states were almost identical in both groups till d21 after making fracture.In OVX group,the calcified cartilage was not resorbed and replaced by new woven bone,a lot of necrosis chondrocytes were found being embedded in a calcified chondroid matrix on d28;after this period,osteoclastic bone resorption become severe gra-dually accompanied by osteocytic osteolysis during d28 to d42 of fracture healing. Conclusion Osteoporosis greatly affect the fracture healing in the later period of healing proess.It demonstrated as endochondral bone formation delayed and increased osteoclastic bone resorption which was made even more severed by osteocytic osteolysis during the period of bone callus remodelling.

  15. Increase in bone growth factors with healing rat fractures: the enhancing effect of zinc.

    Science.gov (United States)

    Igarashi, A; Yamaguchi, M

    2001-10-01

    The effect of zinc, a stimulator of bone formation, on bone protein components in the femoral-diaphyseal tissues with fracture healing was investigated. Rats were sacrificed between 1 and 7 days after the femoral fracture, and the diaphyseal tissues were cultured in a serum-free Dulbecco's modified Eagle's medium for 24 h. Protein content in the femoral-diaphyseal tissues was markedly elevated by fracture healing. The amount of protein in the medium cultured with the diaphyseal tissues obtained from fracture healing rats was markedly elevated as compared with that of normal rats, indicating that bone protein components were secreted into culture medium. Analysis with sodium dodecyl sulfate-polyacrylamide gel elecrophoresis (SDS-PAGE) showed that many protein molecules were secreted from the diaphyseal tissues with fracture healing. Especially, protein molecule of about 66 kDa was markedly secreted by fracture healing. The presence of zinc acexamate (10(-5) and 10(-4) M) in culture medium induced a significant elevation of medium protein content; the zinc effect was enhanced by culture with the diaphyseal tissues of fracture healing rats. Also, the culture of diaphyseal tissues with fracture healing caused a significant increase in insulin-like growth factor-I (IGF-I) and transforming growth factor-beta1 (TGF-beta1) in culture medium. The production of IGF-I and TGF-beta1 from bone tissues with fracture healing was significantly enhanced in the presence of zinc acexamate (10(-6)-10(-4) M). Moreover, the addition of IGF-I (10(-8) M) or TGF-beta1 (10(-10) M) in a culture medium caused a significant elevation of protein content in the medium cultured with the femoral-diaphyseal tissues from normal and fracture healing rats. The effect of IGF-I or TGF-beta1 was significantly enhanced in the presence of zinc acexamate (10(-4) M). Also, deoxyribonucleic acid (DNA) content in the diaphyseal tissues from normal and fracture healing rats was significantly raised by the

  16. Healing relationships and the existential philosophy of Martin Buber

    Directory of Open Access Journals (Sweden)

    Stange Kurt C

    2009-08-01

    Full Text Available Abstract The dominant unspoken philosophical basis of medical care in the United States is a form of Cartesian reductionism that views the body as a machine and medical professionals as technicians whose job is to repair that machine. The purpose of this paper is to advocate for an alternative philosophy of medicine based on the concept of healing relationships between clinicians and patients. This is accomplished first by exploring the ethical and philosophical work of Pellegrino and Thomasma and then by connecting Martin Buber's philosophical work on the nature of relationships to an empirically derived model of the medical healing relationship. The Healing Relationship Model was developed by the authors through qualitative analysis of interviews of physicians and patients. Clinician-patient healing relationships are a special form of what Buber calls I-Thou relationships, characterized by dialog and mutuality, but a mutuality limited by the inherent asymmetry of the clinician-patient relationship. The Healing Relationship Model identifies three processes necessary for such relationships to develop and be sustained: Valuing, Appreciating Power and Abiding. We explore in detail how these processes, as well as other components of the model resonate with Buber's concepts of I-Thou and I-It relationships. The resulting combined conceptual model illuminates the wholeness underlying the dual roles of clinicians as healers and providers of technical biomedicine. On the basis of our analysis, we argue that health care should be focused on healing, with I-Thou relationships at its core.

  17. Healing relationships and the existential philosophy of Martin Buber

    Science.gov (United States)

    Scott, John G; Scott, Rebecca G; Miller, William L; Stange, Kurt C; Crabtree, Benjamin F

    2009-01-01

    The dominant unspoken philosophical basis of medical care in the United States is a form of Cartesian reductionism that views the body as a machine and medical professionals as technicians whose job is to repair that machine. The purpose of this paper is to advocate for an alternative philosophy of medicine based on the concept of healing relationships between clinicians and patients. This is accomplished first by exploring the ethical and philosophical work of Pellegrino and Thomasma and then by connecting Martin Buber's philosophical work on the nature of relationships to an empirically derived model of the medical healing relationship. The Healing Relationship Model was developed by the authors through qualitative analysis of interviews of physicians and patients. Clinician-patient healing relationships are a special form of what Buber calls I-Thou relationships, characterized by dialog and mutuality, but a mutuality limited by the inherent asymmetry of the clinician-patient relationship. The Healing Relationship Model identifies three processes necessary for such relationships to develop and be sustained: Valuing, Appreciating Power and Abiding. We explore in detail how these processes, as well as other components of the model resonate with Buber's concepts of I-Thou and I-It relationships. The resulting combined conceptual model illuminates the wholeness underlying the dual roles of clinicians as healers and providers of technical biomedicine. On the basis of our analysis, we argue that health care should be focused on healing, with I-Thou relationships at its core. PMID:19678950

  18. Mice lacking pten in osteoblasts have improved intramembranous and late endochondral fracture healing.

    Directory of Open Access Journals (Sweden)

    Travis A Burgers

    Full Text Available The failure of an osseous fracture to heal (development of a non-union is a common and debilitating clinical problem. Mice lacking the tumor suppressor Pten in osteoblasts have dramatic and progressive increases in bone volume and density throughout life. Since fracture healing is a recapitulation of bone development, we investigated the process of fracture healing in mice lacking Pten in osteoblasts (Ocn-cre(tg/+;Pten(flox/flox . Mid-diaphyseal femoral fractures induced in wild-type and Ocn-cre(tg/+;Pten(flox/flox mice were studied via micro-computed tomography (µCT scans, biomechanical testing, histological and histomorphometric analysis, and protein expression analysis. Ocn-cre(tg/+;Pten(flox/flox mice had significantly stiffer and stronger intact bones relative to controls in all cohorts. They also had significantly stiffer healing bones at day 28 post-fracture (PF and significantly stronger healing bones at days 14, 21, and 28 PF. At day 7 PF, the proximal and distal ends of the Pten mutant calluses were more ossified. By day 28 PF, Pten mutants had larger and more mineralized calluses. Pten mutants had improved intramembranous bone formation during healing originating from the periosteum. They also had improved endochondral bone formation later in the healing process, after mature osteoblasts are present in the callus. Our results indicate that the inhibition of Pten can improve fracture healing and that the local or short-term use of commercially available Pten-inhibiting agents may have clinical application for enhancing fracture healing.

  19. Healing of multiple fractured thoracic dorsal spinous processes in a Quarter horse

    OpenAIRE

    Molnar, Rebeccah; Barber, Spencer M.; Pharr, John W.; Panizzi, Luca; Plaxton, Andrea

    2012-01-01

    A Quarter horse gelding sustained fracture and displacement of spinous processes T2–T10. Radiographic evidence of healing was seen 3 mo following injury, and at 2 years post-injury all spinous processes had healed and undergone partial re-alignment. This re-alignment has not been reported before.

  20. Healing of multiple fractured thoracic dorsal spinous processes in a Quarter horse.

    Science.gov (United States)

    Molnar, Rebeccah; Barber, Spencer M; Pharr, John W; Panizzi, Luca; Plaxton, Andrea

    2012-03-01

    A Quarter horse gelding sustained fracture and displacement of spinous processes T2-T10. Radiographic evidence of healing was seen 3 mo following injury, and at 2 years post-injury all spinous processes had healed and undergone partial re-alignment. This re-alignment has not been reported before.

  1. The Changed Route of Anterior Tibial Artery due to Healed Fracture

    Directory of Open Access Journals (Sweden)

    Kemal Gökkuş

    2016-01-01

    Full Text Available We would like to highlight unusual sequelae of healed distal third diaphyseal tibia fracture that was treated conservatively 36 years ago, in which we incidentally detected peripheral CT angiography. The anterior tibial artery was enveloped three-quarterly by the healing callus of the bone (distal tibia.

  2. Role of Medicinal Plants and Natural Products on Osteoporotic Fracture Healing

    Directory of Open Access Journals (Sweden)

    Mohd Azri Abd Jalil

    2012-01-01

    Full Text Available Popularly known as “the silent disease” since early symptoms are usually absent, osteoporosis causes progressive bone loss, which renders the bones susceptible to fractures. Bone fracture healing is a complex process consisting of four overlapping phases—hematoma formation, inflammation, repair, and remodeling. The traditional use of natural products in bone fractures means that phytochemicals can be developed as potential therapy for reducing fracture healing period. Located closely near the equator, Malaysia has one of the world’s largest rainforests, which are homes to exotic herbs and medicinal plants. Eurycoma longifolia (Tongkat Ali, Labisia pumila (Kacip Fatimah, and Piper sarmentosum (Kaduk are some examples of the popular ethnic herbs, which have been used in the Malay traditional medicine. This paper focuses on the use of natural products for treating fracture as a result of osteoporosis and expediting its healing.

  3. Radiological findings and healing patterns of incomplete stress fractures of the pars interarticularis

    Energy Technology Data Exchange (ETDEWEB)

    Dunn, Andrew J.; Campbell, Robert S.D. [Royal Liverpool and Broadgreen University Teaching Hospitals, Department of Medical Imaging, Liverpool (United Kingdom); Mayor, Peter E. [Leighton Hospital, Department of Medical Imaging, Crewe, Cheshire (United Kingdom); Rees, Dai [Robert Jones and Agnes-Hunt Orthopaedic Hospital, Department of Orthopaedic Surgery, Oswestry, Shropshire (United Kingdom)

    2008-05-15

    The objective was to retrospectively record the CT and MRI features and healing patterns of acute, incomplete stress fractures of the pars interarticularis. The CT scans of 156 adolescents referred with suspected pars interarticularis stress fractures were reviewed. Patients with incomplete (grade 2) pars fractures were included in the study. Fractures were assessed on CT according to vertebral level, location of cortical involvement and direction of fracture propagation. MRI was also performed in 72 of the 156 cases. MRI images of incomplete fractures were assessed for the presence of marrow oedema and cortical integrity. Fracture healing patterns were characterised on follow-up CT imaging. Twenty-five incomplete fractures were identified in 23 patients on CT. All fractures involved the inferior or infero-medial cortex of the pars and propagated superiorly or superolaterally. Ninety-two percent of incomplete fractures demonstrated either complete or partial healing on follow-up imaging. Two (8%) cases progressed to complete fractures. Thirteen incomplete fractures in 11 patients confirmed on CT also had MRI, and 92% demonstrated oedema in the pars. Ten out of thirteen fractures (77%) showed a break in the infero-medial cortex with intact supero-lateral cortex, which correlated with the CT findings. MRI incorrectly graded one case as a complete (grade 3) fracture, and 2 cases as (grade 1) stress reaction. Six fractures had follow-up MRI, 67% showed partial or complete cortical healing, and the same number showed persistent marrow oedema. Incomplete fracture of the pars interarticularis represents a stage of the evolution of a complete stress fracture. The direction of fracture propagation is consistent, and complete healing can be achieved in most cases with appropriate clinical management. CT best demonstrates fracture size and extent, and is the most appropriate modality for follow-up. MRI is limited in its ability to fully depict the cortical integrity of

  4. Midkine-deficiency delays chondrogenesis during the early phase of fracture healing in mice.

    Directory of Open Access Journals (Sweden)

    Melanie Haffner-Luntzer

    Full Text Available The growth and differentiation factor midkine (Mdk plays an important role in bone development and remodeling. Mdk-deficient mice display a high bone mass phenotype when aged 12 and 18 months. Furthermore, Mdk has been identified as a negative regulator of mechanically induced bone formation and it induces pro-chondrogenic, pro-angiogenic and pro-inflammatory effects. Together with the finding that Mdk is expressed in chondrocytes during fracture healing, we hypothesized that Mdk could play a complex role in endochondral ossification during the bone healing process. Femoral osteotomies stabilized using an external fixator were created in wildtype and Mdk-deficient mice. Fracture healing was evaluated 4, 10, 21 and 28 days after surgery using 3-point-bending, micro-computed tomography, histology and immunohistology. We demonstrated that Mdk-deficient mice displayed delayed chondrogenesis during the early phase of fracture healing as well as significantly decreased flexural rigidity and moment of inertia of the fracture callus 21 days after fracture. Mdk-deficiency diminished beta-catenin expression in chondrocytes and delayed presence of macrophages during early fracture healing. We also investigated the impact of Mdk knockdown using siRNA on ATDC5 chondroprogenitor cells in vitro. Knockdown of Mdk expression resulted in a decrease of beta-catenin and chondrogenic differentiation-related matrix proteins, suggesting that delayed chondrogenesis during fracture healing in Mdk-deficient mice may be due to a cell-autonomous mechanism involving reduced beta-catenin signaling. Our results demonstrated that Mdk plays a crucial role in the early inflammation phase and during the development of cartilaginous callus in the fracture healing process.

  5. Mode II fracture toughening and healing of composites using supramolecular polymer interlayers

    Directory of Open Access Journals (Sweden)

    V. Kostopoulos

    2016-11-01

    Full Text Available This study focuses on the transfer of the healing functionality of supramolecular polymers (SP to fibre reinforced composites through interleaving. SPs exhibiting self-healing based on hydrogen bonds were formed into films and were successfully incorporated into carbon fibre composites. The effect of the SP interleaves on in-plane fracture toughness and the subsequent healing capability of the hybrid composites were investigated under mode II fracture loading. The fracture toughness showed considerable increase since the maximum load (Pmax of the hybrid composite approximately doubled, and consequently the mode II interlaminar fracture toughness energy (GIIC exhibited an increase reaching nearly 100% compared to the reference composite. The healing component was activated using external heat. Pmax and GIIC recovery after activation were measured, exhibiting a healing efficiency after the first healing cycle close to 85% for Pmax and 100% for GIIC, eventually dropping to 80% for Pmax while GIIC was retained around 100% even after the fourth healing cycle. Acoustic Emission activity during the tests was monitored and was found to be strongly reduced due to the presence of the SP.

  6. Pulsed electromagnetic field treatment enhances healing callus biomechanical properties in an animal model of osteoporotic fracture.

    Science.gov (United States)

    Androjna, Caroline; Fort, Brian; Zborowski, Maciej; Midura, Ronald J

    2014-09-01

    Delayed bone healing has been noted in osteoporosis patients and in the ovariectomized (OVX) rat model of estrogen-depletion osteopenia. Pulsed electromagnetic field (PEMF) devices are clinically approved as an adjunct to cervical fusion surgery in patients at high risk for non-fusion and for the treatment of fracture non-unions. These bone growth stimulating devices also accelerate the healing of fresh fracture repair in skeletally mature normal rats but have not been tested for efficacy to accelerate and/or enhance the delayed bone repair process in OVX rats. The current study tested the hypothesis that daily PEMF treatments would improve the fracture healing response in skeletally mature OVX rats. By 6 weeks of healing, PEMF treatments resulted in improved hard callus elastic modulus across fibula fractures normalizing the healing process in OVX rats with respect to this mechanical property. Radiographic evidence showed an improved hard callus bridging across fibula fractures in OVX rats treated with PEMF as compared to sham treatments. These findings provide a scientific rationale for investigating whether PEMF might improve bone-healing responses in at-risk osteoporotic patients.

  7. The Effect of Osteoporosis on Healing of Distal Radius Fragility Fractures.

    Science.gov (United States)

    Tulipan, Jacob; Jones, Christopher M; Ilyas, Asif M

    2015-10-01

    Although the decision for operative versus nonoperative treatment of distal radius fractures remains subjective and is performed on a case-by-case basis, evaluation and treatment of patients with concomitant osteoporosis requires understanding of the behavior of this injury as a distinct subset of distal radius fractures. Age, infirmity, and osteoporosis affect every aspect of the fracture. Understanding what makes these fractures unique assists surgeons in more effective and efficient treatment. The authors present the current understanding of osteoporotic fragility fractures of the distal radius, focusing on epidemiology, biomechanics of bone healing, and its implication on strategies for management.

  8. The Effect of GSM Mobile Phone Electromagnetic Field on Femur Fracture Healing in a Rat Model

    Directory of Open Access Journals (Sweden)

    Ali Kalender

    2012-10-01

    Full Text Available Aim: Biological effects of electromagnetic field (EMF and their consequences on human health have been the subject of much interest and research in recent years. The aim of this study was to investigate the effects of 900 MHz EMF on femur fracture healing in a rat model. Material and Method: After sixty male Sprague-Dawley rats were exposed to a closed right femur fracture under anesthesia, the reduction and fixation were done with a 21 g needle. Then, 900 MHz radiation (2 W peak output power and 1.04 mW/cm2 power density was applied to EM group for one hour/day for seven days. The healing was assessed using radiological (Lane and Sandhu classification, histological (Huo scale for callus evaluation, and biomechanical (3-point bending measures at 2nd, 4th and 6th weeks after fracture. Results: Fracture healing, as assessed radiologically and histopathologically, in Group EM and control animals was similar at 2nd, 4th and 6th weeks. Fracture healing, as assessed biomechanically, was significantly better in Group EM compared to controls in those sacrificed at 2nd week post-procedure (p<0.05. Biomechanical strength was not different between the groups at 4th and 6th weeks. Discussion: 900 MHz EMF from a mobile phone in this rat femur fracture model resulted in no significant difference in healing from controls not exposed to EM radiation.

  9. Strontium Is Incorporated into the Fracture Callus but Does Not Influence the Mechanical Strength of Healing Rat Fractures

    DEFF Research Database (Denmark)

    Brüel, Annemarie; Olsen, Jakob; Birkedal, Henrik

    2011-01-01

    to study fracture healing in rats after 3 and 8 weeks of healing. Two groups of rats were treated with SrR (900 mg/kg/day) mixed into the food, while two groups served as control animals. The healing fractures were investigated by three-point bending, dual energy X-ray absorptiometry, energy-dispersive X......Strontium ranelate (SrR) is a new agent used in the treatment of osteoporosis and is suggested to reduce bone resorption and increase bone formation. We investigated whether SrR influences the macro- and nanomechnical properties of healing fractures in rats. A closed tibia fracture model was used......-ray spectroscopy (EDX), and nanoindentation. There was a 100-fold increase (P\\0.001) in serum Sr after 3 and 8 weeks of SrR treatment. The callus volume was significantly higher in the SrR-treated group than in control animals (P\\0.01) after 3 weeks of healing. This was accompanied by a significant increase...

  10. Healing and prognosis of teeth with intra-alveolar fractures involving the cervical part of the root.

    Science.gov (United States)

    Cvek, Miomir; Mejàre, Ingegerd; Andreasen, Jens Ove

    2002-04-01

    Healing and long-term prognosis of 94 cervical root fractures were evaluated. The teeth were divided into two groups according to type of fracture: transverse fractures limited to the cervical third of the root (51 incisors) and oblique fractures involving both the cervical and middle parts of the root (43 incisors). Neither the frequency nor the type of fracture healing differed significantly between the two groups. In the material as a whole, healing of the fracture with hard tissue formation was observed in 17 teeth (18%), and healing with interposition of periodontal ligament (PDL) and, in some cases, hard tissue between the fragments in 62 teeth (66%). Fifteen teeth (16%) showed no healing and a radiolucency adjacent to the fracture. Statistical analyses revealed that incomplete root formation and a positive sensibility test at the time of injury were significantly related to both healing and hard tissue repair. The same applied to concussion or subluxation compared with dislocation of coronal fragment, as well as optimal compared with suboptimal reposition of displaced coronal fragments. The type and duration of splinting (or no splinting) appeared to be of no significance for frequency or type of healing of cervical root fractures. During the observation time (mean = 75 months), 19 (44%) of the teeth with transverse fractures and 3 (8%) of those with oblique fractures were lost after healing. In conclusion, fractures in the cervical part of the root had a healing potential and the predictive parameters identified for fractures in other parts of the root seemed to be valid for the healing of cervical root fractures. Transverse fractures appeared to have a significantly poorer long-term prognosis compared to oblique fractures, apparently due to a marked post-treatment mobility, which often led to new luxation caused by even minor impacts.

  11. Analyzing the cellular contribution of bone marrow to fracture healing using bone marrow transplantation in mice.

    Science.gov (United States)

    Colnot, C; Huang, S; Helms, J

    2006-11-24

    The bone marrow is believed to play important roles during fracture healing such as providing progenitor cells for inflammation, matrix remodeling, and cartilage and bone formation. Given the complex nature of bone repair, it remains difficult to distinguish the contributions of various cell types. Here we describe a mouse model based on bone marrow transplantation and genetic labeling to track cells originating from bone marrow during fracture healing. Following lethal irradiation and engraftment of bone marrow expressing the LacZ transgene constitutively, wild type mice underwent tibial fracture. Donor bone marrow-derived cells, which originated from the hematopoietic compartment, did not participate in the chondrogenic and osteogenic lineages during fracture healing. Instead, the donor bone marrow contributed to inflammatory and bone resorbing cells. This model can be exploited in the future to investigate the role of inflammation and matrix remodeling during bone repair, independent from osteogenesis and chondrogenesis.

  12. Effect of Cervus and Cucumis Peptides on Osteoblast Activity and Fracture Healing in Osteoporotic Bone

    Directory of Open Access Journals (Sweden)

    Ai-Yuan Wang

    2014-01-01

    Full Text Available Osteoporosis is associated with delayed and/or reduced fracture healing. As cervus and cucumis are the traditional Chinese treatments for rheumatoid arthritis, we investigated the effect of supplementation of these peptides (CCP on bone fracture healing in ovariectomized (OVX osteoporotic rats in vitro and in vivo. CCP enhanced osteoblast proliferation and increased alkaline phosphatase activity, matrix mineralization, and expression of runt-related transcription factor 2 (Runx2, bone morphogenetic protein 4 (BMP4, and osteopontin. In vivo, female Sprague-Dawley rats underwent ovariectomy and the right femora were fractured and fixed by intramedullary nailing 3 months later. Rats received intraperitoneal injections of either CCP (1.67 mg/kg or physiological saline every day for 30 days. Fracture healing and callus formation were evaluated by radiography, micro-CT, biomechanical testing, and histology. At 12 weeks after fracture, calluses in CCP-treated bones showed significantly higher torsional strength and greater stiffness than control-treated bones. Bones in CCP-treated rats reunified and were thoroughly remodeled, while two saline-treated rats showed no bone union and incomplete remodeling. Taken together, these results indicate that use of CCP after fracture in osteoporotic rats accelerates mineralization and osteogenesis and improves fracture healing.

  13. Fracture-induced mechanophore activation and solvent healing in poly(methyl methacrylate)

    Science.gov (United States)

    Celestine, Asha-Dee N.

    of the crack tip. Control specimens in which the mechanophore is absent or tethered in positions in which no mechanochemical activation is expected are also tested and exhibit no change in color or fluorescence intensity with crack propagation. The relationship between fracture-induced mechanophore activation in rubber toughened SP-PMMA and the strain and stress ahead of the propagating crack is also studied. SP activation is again detected and quantified by in situ fluorescence imaging. Digital Image Correlation (DIC) is used to measure the strain ahead of the crack tip. The corresponding stress is generated through the use of the Hutchinson-Rice-Rosengren (HRR) singularity field equations. Mechanophore activation ahead of the crack tip is shown to follow a power law distribution that is closely aligned with strain. The potential of SP as a damage sensor is explored further by incorporating the spiropyran into the core of rubber nanoparticles. SP-linked rubber nanoparticles are synthesized using a seeded emulsion polymerization process and incorporated into cross-linked PMMA at a concentration of 5 wt%. Cylindrical specimens are torsion tested and the activation of the SP within the nanoparticles is monitored via full field fluorescence imaging. SP activation within the core is shown to increase with shear strain. Autonomous damage repair in PMMA is also investigated. The first demonstration of fully autonomous self-healing in PMMA is achieved through the use of solvent microcapsules. Solvent microcapsules with a PMMA-anisole liquid core are prepared and embedded within a linear PMMA matrix. Specimens of the microcapsule-loaded material are then fabricated for Double Cleavage Drilled Compression (DCDC) fracture testing. The DCDC specimens, containing increasing concentrations of solvent microcapsules, are tested and then allowed to heal for a fixed period of time before a second DCDC test. The healing efficiency of each material system is evaluated based on the

  14. Accelerated fracture healing in transgenic mice overexpressing an anabolic isoform of fibroblast growth factor 2.

    Science.gov (United States)

    Hurley, Marja M; Adams, Douglas J; Wang, Liping; Jiang, Xi; Burt, Patience Meo; Du, Erxia; Xiao, Liping

    2016-03-01

    The effect of targeted expression of an anabolic isoform of basic fibroblast growth factor (FGF2) in osteoblastic lineage on tibial fracture healing was assessed in mice. Closed fracture of the tibiae was performed in Col3.6-18 kDaFgf2-IRES-GFPsaph mice in which a 3.6 kb fragment of type I collagen promoter (Col3.6) drives the expression of only the 18 kD isoform of FGF2 (18 kDaFgf2/LMW) with green fluorescent protein-sapphire (GFPsaph) as well as Vector mice (Col3.6-IRES-GFPsaph, Vector) that did not harbor the FGF2 transgene. Radiographic, micro-CT, DEXA, and histologic analysis of fracture healing of tibiae harvested at 3, 10 and 20 days showed a smaller fracture callus but accelerated fracture healing in LMWTg compared with Vector mice. At post fracture day 3, FGF receptor 3 and Sox 9 mRNA were significantly increased in LMWTg compared with Vector. Accelerated fracture healing was associated with higher FGF receptor 1, platelet derived growth factors B, C, and D, type X collagen, vascular endothelial cell growth factor, matrix metalloproteinase 9, tartrate resistant acid phosphatase, cathepsin K, runt-related transcription factor-2, Osterix and Osteocalcin and lower Sox9, and type II collagen expression at 10 days post fracture. We postulate that overexpression of LMW FGF2 accelerated the fracture healing process due to its effects on factors that are important in chondrocyte and osteoblast differentiation and vascular invasion.

  15. Laboratory tests of hydraulic fracturing and swell healing

    DEFF Research Database (Denmark)

    Thunbo, Christensen Claes; Foged, Christensen Helle; Foged, Niels

    1998-01-01

    New laboratory test set-ups and test procedures are described - for testing the formation of hydraulically induced fractures as well as the potential for subsequent fracture closurefrom the relase of a swelling potential. The main purpose with the tests is to provide information on fracturing...

  16. Interface contact profiles of a novel locking plate and its effect on fracture healing in goat

    Institute of Scientific and Technical Information of China (English)

    WEI Da-cheng; ZHAO Yu-feng; XING Shu-xing; WANG Ai-min

    2010-01-01

    Objective: To evaluate the interface characteristics of the new-designed locking plate (LP) and limited contact-dynamic compression plate (LC-DCP) and compare the fracture healing between LP and LC-DCP in a goat tibia fracture model.Methods: Eight-hole LP and LC-DCP were applied to fix flesh goat tibiae in a reproducible manner. The average pressure, force and interface contact area were calculated using Fuji prescale pressure sensitive film interposed among the plate and the bone and image analysis system. Eighthole LP and LC-DCP were applied to each tibia in a goat tibia fracture model. The fracture healing was evaluated by X-ray photography at postoperative 8 weeks. The goats were sacrificed at postoperative 12 weeks. Three-point bending test was conducted in the tibiae.Results: The interface contact of LP system was smaller than that ofLC-DCP (P<0.05), while interface contact force of LP system was higher than that of LC-DCP (P<0.05). Radiographs revealed that the fracture line disappeared in the LP group, while the fracture line was visible in DCP group at postoperative 8 weeks. At postoperative 12 weeks, the bending strength and bending load of fractured tibia were higher in LP group than in DCP group, respectively.Conclusion: The new-designed locking plate can significantly decrease the contact area on the bone interface,which further provides better fracture healing than conventional plates.

  17. Novel perfused compression bioreactor system as an in vitro model to investigate fracture healing

    Directory of Open Access Journals (Sweden)

    Waldemar eHoffmann

    2015-02-01

    Full Text Available Secondary bone fracture healing is a physiological process that leads to functional tissue regeneration via endochondral bone formation. In vivo studies have demonstrated that early mobilization and the application of mechanical loads enhances the process of fracture healing. However, the influence of specific mechanical stimuli and particular effects during specific phases of fracture healing remain to be elucidated. In this work, we have developed and provided proof-of-concept of an in vitro human organotypic model of physiological loading of a cartilage callus, based on a novel perfused compression bioreactor system (PCB. We then used the fracture callus model to investigate the regulatory role of dynamic mechanical loading. Our findings provide a proof-of-principle that dynamic mechanical loading applied by the PCB can enhance the maturation process of mesenchymal stromal cells towards late hypertrophic chondrocytes and the mineralization of the deposited extracellular matrix. The PCB provides a promising tool to study fracture healing and for the in vitro assessment of alternative fracture treatments based on engineered tissue grafts or pharmaceutical compounds, allowing for the reduction of animal experiments.

  18. Current Role and Application of Teriparatide in Fracture Healing of Osteoporotic Patients: A Systematic Review

    Science.gov (United States)

    Kim, Sang-Min; Kang, Kyung-Chung; Kim, Ji Wan; Lim, Seung-Jae

    2017-01-01

    Background The use of osteoanabolic agents to facilitate fracture healing has been of heightened interest to the field of orthopaedic trauma. This study aimed to evaluate the evidence of teriparatide for fracture healing and functional recovery in osteoporotic patients. Methods We performed a literature search in PubMed, EMBASE, Web of Science, and the Cochrane Library using terms including “Fracture” [tiab] AND “Teriparatide [tiab] OR “PTH” [tiab]. Results This systematic review included 6 randomized clinical trials, 4 well-controlled retrospective studies, and 1 retrospective post hoc subgroup analysis. Fracture location was 2 in pelvis, 3 in proximal femur, 1 in distal femur, 1 in shoulder, 2 in wrist and 2 in spine. The use of teriparatide yielded positive effects on radiographic bone healing in 6 studies, but was not associated with better radiographic outcome in 3. In terms of functional recovery, teriparatide injection was related with decrease in pain or shorter time to mobilization in 6 studies, but not related with pain numerical scale and mobility in 3. Conclusions Our findings suggest that teriparatide provide selective advantages to fracture healing or functional recovery in the management of osteoporotic fractures. A better understanding of the role of teriparatide on osteoporotic fractures requires greater evidences from large volume prospective trials. PMID:28326303

  19. Changes in the Serum Level of Vitamin D During Healing of Tibial and Femoral Shaft Fractures

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    Ettehad

    2014-01-01

    Full Text Available Background: Several systemic factors and hormones are thought to regulate the fracture healing process. Vitamin D has emerged as a compound or hormone that actively participates in the regulation of calcium homeostasis and bone metabolism. Objectives: The aim of this study is to determine the serum changes in the level of vitamin D during the acute healing period of tibial and femoral shaft fractures. Patients and Methods: This cross-sectional study included of 73 patients with tibial and femoral shaft fractures referred to the Poursina Hospital between February 2011 and February 2012. Changes in the serum levels of vitamin D were assessed three times in a period of three weeks (at the first visit, end of first week, and end of the third week. Variables such as age, gender, fractured bone, concomitant fracture of tibia and fibula, type of fracture, time of measurement and serum levels of 25-hydroxyvitamin D were assessed. All statistical analyses were performed using the SPSS software. Results: Forty tibial fractures and 33 femoral fractures were recorded. Mean vitamin D levels at the time of admission, after one week and at the end of the third week for the 73 participants included in the study were 39.23, 31.49, and 28.57 ng/mL, respectively. The overall reduction of vitamin D level was significantly more evident in the first week versus the following (P < 0.0001. Conclusions: Serum levels of vitamin D in patients with tibial or femoral fractures were reduced during the curative period of the fracture. This can be related the role of vitamin D in the formation and mineralization of the callus. Patients with tibial or femoral shaft fractures may benefit from the administration of vitamin D supplements during the fracture healing process.

  20. INTRAPSYCHIC CONFLICT, TRANSFERENCE, AND A HEALING RELATIONSHIP

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    Richard G. Erskine

    2013-10-01

    Full Text Available In this rejoinder to “Responses to Relational Healing of Early Affect-Confusion: Part 3 of a Case Study Trilogy”, the author defines an Integrative Psychotherapy perspective of transference and addresses the significance of working within a transference-countertransference milieu. Descriptions of how to understand and therapeutically use client’s “idealization” are provided. The concept of avoidant and disorganized attachment is related to a clinical case.

  1. Extracorporeal shock wave therapy for non-unions and delayed fracture healing

    Science.gov (United States)

    Schaden, Wolfgang; Fischer, Andreas; Sailler, Andreas; Karadas, Ender

    2005-04-01

    Although the primary management of fractures is highly developed in Central Europe 1% of fractures develop a non-union. After successful pilot studies the Traumacenter Meidling started in December 1998 to treat non-unions regularly with shock wave therapy. From December 1998 to August 2004, 1153 patients with non-union and delayed healing fractures were treated. The results of 755 patients are available up to September 2004. The patients consisted of 250 (33%) female and 505 (67%) male. The mean age was 44.1 years (10; 90). The mean age of the non-union was 15.5 months. In 74 (10%) osteomyelitis was present before shockwave therapy. Out of 755 non-unions 593 (79%) achieved bony healing. As expected, the subgroup of 284 delayed unions (shockwave therapy 3-6 months after the trauma or the last surgery concerning the bone) showed the best results. 245 (86%) healed. Out of 471 non-unions being older than 6 months 348 (72%) achieved bony healing. Because of the efficacy and the lack of complications as well as the economic advantage in comparison to surgery, shockwave therapy is considered as therapy of first choice in the treatment of non-union and delayed healing fractures.

  2. Vitamin E and the Healing of Bone Fracture: The Current State of Evidence

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    Boekhtiar Borhanuddin

    2012-01-01

    Full Text Available Background. The effect of vitamin E on health-related conditions has been extensively researched, with varied results. However, to date, there was no published review of the effect of vitamin E on bone fracture healing. Purpose. This paper systematically audited past studies of the effect of vitamin E on bone fracture healing. Methods. Related articles were identified from Medline, CINAHL, and Scopus databases. Screenings were performed based on the criteria that the study must be an original study that investigated the independent effect of vitamin E on bone fracture healing. Data were extracted using standardised forms, followed by evaluation of quality of reporting using ARRIVE Guidelines, plus recalculation procedure for the effect size and statistical power of the results. Results. Six animal studies fulfilled the selection criteria. The study methods were heterogeneous with mediocre reporting quality and focused on the antioxidant-related mechanism of vitamin E. The metasynthesis showed α-tocopherol may have a significant effect on bone formation during the normal bone remodeling phase of secondary bone healing. Conclusion. In general, the effect of vitamin E on bone fracture healing remained inconclusive due to the small number of heterogeneous and mediocre studies included in this paper.

  3. Enhancement of albumin expression in bone tissues with healing rat fractures.

    Science.gov (United States)

    Yamaguchi, Masayoshi; Igarashi, Aki; Misawa, Hiroyuki; Tsurusaki, Yoshinori

    2003-05-15

    The characterization of 66 kDa protein molecule, a major protein component which is produced from femoral-diaphyseal tissues with fracture healing (Igarashi and Yamaguchi [2002] Int. J. Mol. Med. 9:503-508), was investigated. Weaning rats were killed at 7 and 14 days after femoral fracture. When the femoral-diaphyseal tissues with fracture healing were cultured for 48 h in a serum-free medium, many proteins in the bone tissues were released into the medium. Analysis with sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) showed that a protein molecule of approximately 66 kDa was markedly increased in culture medium from bone tissues with fracture healing. N-terminal sequencing of 66 kDa protein indicated that its N-terminus was identical to that of rat albumin. Western blot analysis of medium 66 kDa protein showed expression of albumin. This expression was significantly enhanced by fracture healing. The expression of albumin was seen in the diaphyseal (cortical bone) and metaphyseal (trabecular bone) tissues of rat femur. When the femoral-diaphyseal tissues obtained at 7 days after femoral fracture were cultured in a serum-free medium containing either vehicle, parathyroid hormone (1-34) (10(-7) M), insulin-like growth factor-I (10(-8) M) or zinc acexamate (10(-4) M), medium albumin was significantly increased in the presence of those bone-stimulating factors. The addition of albumin (0.5 or 1.0 mg/ml of medium) caused a significant increase in calcium and deoxyribonucleic acid contents in the femoral-diaphyseal and -metaphyseal tissues obtained from normal rats in vitro. The present study demonstrates that fracture healing induces a remarkable production of albumin which is a major protein component produced from femoral-diaphyseal tissues of rats, and that albumin has an anabolic effect on bone components.

  4. AN IMMUNOCYTOCHEMICAL STUDY OF BONEMORPHOGENETIC PROTEIN IN EXPERIMENTAL FRACTURE HEALING OF THE RABBIT MANDIBLE

    Institute of Scientific and Technical Information of China (English)

    金岩; 杨连甲; FrankH.White

    1994-01-01

    A monoclonal antibody raised against bone morphogenetic protein (BMP-McAb)has been used to demonstrate the presence of bone mrphogenetic protein(BMP) in experimental fracture healing.Rabbit mandibles were frac-tured using standrdized methods and left to heal for 3,7,14,21and 24 d,respectively.The avidin-biotin com- plex(ABC)method demonstrated an accumulation of positively stained primitive mesenchyman cells at the fracture site in the hematoma stage of bone repair.These cells appeared to undergo differentiation into positively-stained chondroblasts and osteoblasts during the phase of callus formation.Undifferentiated mesenchymal cells showed a high positive reactivity in the early post-fracture stages but a much lower reactivity during the remodelling phase.The results of our study suggest that bone inductive processes are accompanied by the presence of BMP in osteopro-genitor cells during fracture healing of the mandible and that BMP may plqy a significant role in osteogenesis dur-ing bone healing.

  5. Is Sonic Hedgehog Involved in Human Fracture Healing? - A Prospective Study on Local and Systemic Concentrations of SHH

    Science.gov (United States)

    Eipeldauer, Stefan; Thomas, Anita; Hoechtl-Lee, Leonard; Kecht, Mathias; Binder, Harald; Koettstorfer, Julia; Gregori, Markus; Sarahrudi, Kambiz

    2014-01-01

    Introduction Sonic Hedgehog (SHH) is a new signalling pathway in bone repair. Evidence exist that SHH pathway plays a significant role in vasculogenesis and limb development during embryogenesis. Some in vitro and animal studies has already proven its potential for bone regeneration. However, no data on the role of SHH in the human fracture healing have been published so far. Methods Seventy-five patients with long bone fractures were included into the study and divided in 2 groups. First group contained 69 patients with normal fracture healing. Four patients with impaired fracture healing formed the second group. 34 volunteers donated blood samples as control. Serum samples were collected over a period of 1 year following a standardized time schedule. In addition, SHH levels were measured in fracture haematoma and serum of 16 patients with bone fractures. Results Fracture haematoma and patients serum both contained lower SHH concentrations compared to control serum. The comparison between the patients' serum SHH level and the control serum revealed lower levels for the patients at all measurement time points. Significantly lower concentrations were observed at weeks 1 and 2 after fracture. SHH levels were slightly decreased in patients with impaired fracture healing without statistical significance. Conclusion This is the first study to report local and systemic concentration of SHH in human fracture healing and SHH serum levels in healthy adults. A significant reduction of the SHH levels during the inflammatory phase of fracture healing was found. SHH concentrations in fracture haematoma and serum were lower than the concentration in control serum for the rest of the healing period. Our findings indicate that there is no relevant involvement of SHH in human fracture healing. Fracture repair process seem to reduce the SHH level in human. Further studies are definitely needed to clarify the underlying mechanisms. PMID:25501422

  6. Naringin promotes fracture healing through stimulation of angiogenesis by regulating the VEGF/VEGFR-2 signaling pathway in osteoporotic rats.

    Science.gov (United States)

    Song, Nan; Zhao, Zhihu; Ma, Xinlong; Sun, Xiaolei; Ma, Jianxiong; Li, Fengbo; Sun, Lei; Lv, Jianwei

    2017-01-05

    Postmenopausal osteoporosis is characterized by a reduction in the number of sinusoidal and arterial capillaries in the bone marrow and reduced bone perfusion. Thus, osteogenesis and angiogenesis are coupled in the process of osteoporosis formation and fracture healing. Naringin is the main ingredient of the root Rhizoma Drynariae, a traditional Chinese medicine, and it has potential effects on promoting fracture healing. However, whether naringin stimulates angiogenesis in the process of bone healing is unclear. Here, we show that naringin promotes fracture healing through stimulating angiogenesis by regulating the VEGF/VEGFR-2 signaling pathway in osteoporotic rats.

  7. The Difference between Growth Factor Expression after Single and Multiple Fractures: Preliminary Results in Human Fracture Healing

    Science.gov (United States)

    Binder, Harald; Eipeldauer, Stefan; Gregori, Markus; Höchtl-Lee, Leonard; Thomas, Anita; Tiefenboeck, Thomas M.; Hajdu, Stefan; Sarahrudi, Kambiz

    2015-01-01

    Objectives. Circulating levels of VEGF-A (Vascular Endothelia Growth Factor-A), TGF-β1 (Transforming Growth Factor-beta 1), and M-CSF (Macrophage-Colony Stimulating Factor) were found to be predictors of bone healing and therefore prognostic criteria of delayed bone healing or nonunion. The aim of this study was to evaluate a potential rise of these markers in patients with multiple fractures of long bones compared to patients with single fractured long bone. Methods. 92 patients were included in the study and finally after excluding all female patients 45 male patients were left for final analysis and divided into the single or multiple fracture group. TGF-β1, M-CSF, and VEGF-A serum levels were analysed over a time period of two weeks. Results. MCSF serum concentrations were higher in the group with multiple fractures as also TGF-β1 serum concentrations were at one and two weeks after trauma. No statistically significant difference was observed in the VEGF-A serum concentrations of both groups at either measurement point. Conclusion. We did observe a correlation between the quantity of the M-CSF and TGF-β1 expressions in serum and the number of fractured bones; surprisingly there was no statistically significant difference in the serum levels between patients with single and multiple fractures of long bones. PMID:26246654

  8. Influence of mechanical rock properties and fracture healing rate on crustal fluid flow dynamics

    Science.gov (United States)

    Sachau, Till; Bons, Paul; Gomez-Rivas, Enrique; Koehn, Daniel; de Riese, Tamara

    2016-04-01

    Fluid flow in the Earth's crust is very slow over extended periods of time, during which it occurs within the connected pore space of rocks. If the fluid production rate exceeds a certain threshold, matrix permeability alone is insufficient to drain the fluid volume and fluid pressure builds up, thereby reducing the effective stress supported by the rock matrix. Hydraulic fractures form once the effective pressure exceeds the tensile strength of the rock matrix and act subsequently as highly effective fluid conduits. Once local fluid pressure is sufficiently low again, flow ceases and fractures begin to heal. Since fluid flow is controlled by the alternation of fracture permeability and matrix permeability, the flow rate in the system is strongly discontinuous and occurs in intermittent pulses. Resulting hydraulic fracture networks are largely self-organized: opening and subsequent healing of hydraulic fractures depends on the local fluid pressure and on the time-span between fluid pulses. We simulate this process with a computer model and describe the resulting dynamics statistically. Special interest is given to a) the spatially and temporally discontinuous formation and closure of fractures and fracture networks and b) the total flow rate over time. The computer model consists of a crustal-scale dual-porosity setup. Control parameters are the pressure- and time-dependent fracture healing rate, and the strength and the permeability of the intact rock. Statistical analysis involves determination of the multifractal properties and of the power spectral density of the temporal development of the total drainage rate and hydraulic fractures. References Bons, P. D. (2001). The formation of large quartz veins by rapid ascent of fluids in mobile hydrofractures. Tectonophysics, 336, 1-17. Miller, S. a., & Nur, A. (2000). Permeability as a toggle switch in fluid-controlled crustal processes. Earth and Planetary Science Letters, 183(1-2), 133-146. Sachau, T., Bons, P. D

  9. Exogenous PTHrP Repairs the Damaged Fracture Healing of PTHrP+/− Mice and Accelerates Fracture Healing of Wild Mice

    Directory of Open Access Journals (Sweden)

    Yinhe Wang

    2017-02-01

    Full Text Available Bone fracture healing is a complicated physiological regenerative process initiated in response to injury and is similar to bone development. To demonstrate whether an exogenous supply of parathyroid hormone–related protein (PTHrP helps in bone fracture healing, closed mid-diaphyseal femur fractures were created and stabilized with intramedullary pins in eight-week-old wild-type (WT PTHrP+/+ and PTHrP+/− mice. After administering PTHrP for two weeks, callus tissue properties were analyzed at one, two, and four weeks post-fracture (PF by various methods. Bone formation–related genes and protein expression levels were evaluated by real-time reverse transcriptase–polymerase chain reaction and Western blots. At two weeks PF, mineral density of callus, bony callus areas, mRNA levels of alkaline phosphatase (ALP, type I collagen, Runt-related transcription factor 2 (Runx-2, and protein levels of Runx-2 and insulin-like growth factor-1 decreased in PTHrP+/− mice compared with WT mice. At four weeks PF, total collagen-positive bony callus areas, osteoblast number, ALP-positive areas, and type I collagen-positive areas all decreased in PTHrP+/− mice. At both two and four weeks PF, tartrate-resistant acid phosphatase–positive osteoclast number and surface decreased a little in PTHrP+/− mice. The study indicates that exogenous PTHrP provided by subcutaneous injection could redress impaired bone fracture healing, leading to mutation of activated PTHrP by influencing callus areas, endochondral bone formation, osteoblastic bone formation, and bone turnover.

  10. Influence of fracture gap size on the pattern of long bone healing: a computational study.

    Science.gov (United States)

    Gómez-Benito, M J; García-Aznar, J M; Kuiper, J H; Doblaré, M

    2005-07-07

    Following fractures, bones restore their original structural integrity through a complex process in which several cellular events are involved. Among other factors, this process is highly influenced by the mechanical environment of the fracture site. In this study, we present a mathematical model to simulate the effect of mechanical stimuli on most of the cellular processes that occur during fracture healing, namely proliferation, migration and differentiation. On the basis of these three processes, the model then simulates the evolution of geometry, distributions of cell types and elastic properties inside a healing fracture. The three processes were implemented in a Finite Element code as a combination of three coupled analysis stages: a biphasic, a diffusion and a thermoelastic step. We tested the mechano-biological regulatory model thus created by simulating the healing patterns of fractures with different gap sizes and different mechanical stimuli. The callus geometry, tissue differentiation patterns and fracture stiffness predicted by the model were similar to experimental observations for every analysed situation.

  11. [Bone fracture and the healing mechanisms. Fragility fracture and bone quality].

    Science.gov (United States)

    Mawatari, Taro; Iwamoto, Yukihide

    2009-05-01

    Fracture occurs in bone having less than normal elastic resistance without any violence. Numerous terms have been used to classify various types of fractures from low trauma events; "fragility fracture", "stress fracture", "insufficiency fracture", "fatigue fracture", "pathologic fracture", etc. The definitions of these terms and clinical characteristics of these fractures are discussed. Also state-of-the-art bone quality assessments; Finite element analysis of clinical CT scans, assessments of the Microdamage, and the Cross-links of Collagen are introduced in this review.

  12. CaMKK2 Inhibition in Enhancing Bone Fracture Healing

    Science.gov (United States)

    2014-08-01

    study to establish the following: (1) Reliable and reproducible surgical procedures for creating a transverse femoral fracture and fixing it with an...Reliable and reproducible surgical procedures for creating a transverse femoral fracture and fixing it with an intramedullary device. 2) The treatment...disinfected with alternating scrubs of betadine and alcohol. Sterile instruments were used to make a small incision (approximately 2 mm). A 25 gauge

  13. Laboratory study of fracture healing in Topopah Spring tuff: Implications for near field hydrology

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Wunan; Daily, W.D.

    1989-09-01

    Seven Topopah Spring tuff samples were studied to determine water permeability in this rock under pressure and temperature conditions similar to those expected in the near field of a nuclear waste package. Six of the seven samples were studied under isothermal condition; the other was subjected to a thermal gradient. Four of the six fractured samples contained a reopened, healed, natural fracture; one contained an induced tensile fracture and the other contained a saw-cut. The fracture surfaces were examined using scanning electron microscope (SEM) before and after the experiments and the water that flowed through the samples was sampled for chemical analysis. The experimental durations ranged from about 3 months to almost 6 months. Water permeability of the fractured samples was found to decrease by more than three orders of magnitude when the sample temperature increased to 150{degree}C. The sharpest decrease in permeability occurred when the temperature was increased above 90{degree}C. Permeability of the intact sample did not change significantly under the similar experimental conditions. When the temperature returned to room conditions, the water permeability did not recover. The mechanical strength of one healed sample was about half that of the intact rock. SEM studies of the fracture surfaces and water chemical analysis of the water suggested that both dissolution and deposition occurred on the fracture surfaces. Smoothing of fracture asperities because of dissolution and deposition was probably the main cause of the permeability decrease. Deposition of dissolved silica was probably the main cause of fracture healing. 12 refs., 6 figs., 1 tab.

  14. Treatment with Carnitine Enhances Bone Fracture Healing under Osteoporotic and/or Inflammatory Conditions.

    Science.gov (United States)

    Aydin, Ali; Halici, Zekai; Albayrak, Abdulmecit; Polat, Beyzagul; Karakus, Emre; Yildirim, Omer Selim; Bayir, Yasin; Cadirci, Elif; Ayan, Arif Kursad; Aksakal, Ahmet Murat

    2015-09-01

    The aim of this study was to examine the effects of carnitine on bone healing in ovariectomy (OVX) and inflammation (INF)-induced osteoporotic rats. The rats were randomly divided into nine groups (n = 8 animals per group): sham-operated (Group 1: SHAM); sham + magnesium silicate (Mg-silicate) (Group 2: SHAM + INF); ovariectomy (Group 3: OVX); ovariectomy + femoral fracture (Group 4: OVX + FRC); ovariectomy + femoral fracture + Mg-silicate (Group 5: OVX + FRC + INF); ovariectomy + femoral fracture + carnitine 50 mg/kg (Group 6: OVX + FRC + CAR50); ovariectomy + femoral fracture + carnitine 100 mg/kg (Group 7: OVX + FRC + CAR100); ovariectomy + femoral fracture + Mg-silicate + carnitine 50 mg/kg (Group 8: OVX + FRC + INF + CAR50); and ovariectomy + femoral fracture + Mg-silicate + carnitine 100 mg/kg (Group 9: OVX + FRC + INF + CAR100). Eight weeks after OVX, which allowed for osteoporosis to develop, INF was induced with subcutaneous Mg-silicate. On day 80, all of the rats in groups 4-9 underwent fracture operation on the right femur. Bone mineral density (BMD) showed statistically significant improvements in the treatment groups. The serum markers of bone turnover (osteocalcin and osteopontin) and pro-inflammatory cytokines (tumour necrosis factor α, interleukin 1β and interleukin 6) were decreased in the treatment group. The X-ray images showed significantly increased callus formation and fracture healing in the groups treated with carnitine. The present results show that in a rat model with osteoporosis induced by ovariectomy and Mg-silicate, treatment with carnitine improves the healing of femur fractures.

  15. Analysis of fracture healing in osteopenic bone caused by disuse: experimental study.

    Science.gov (United States)

    Paiva, A G; Yanagihara, G R; Macedo, A P; Ramos, J; Issa, J P M; Shimano, A C

    2016-03-01

    Osteoporosis has become a serious global public health issue. Hence, osteoporotic fracture healing has been investigated in several previous studies because there is still controversy over the effect osteoporosis has on the healing process. The current study aimed to analyze two different periods of bone healing in normal and osteopenic rats. Sixty, 7-week-old female Wistar rats were randomly divided into four groups: unrestricted and immobilized for 2 weeks after osteotomy (OU2), suspended and immobilized for 2 weeks after osteotomy (OS2), unrestricted and immobilized for 6 weeks after osteotomy (OU6), and suspended and immobilized for 6 weeks after osteotomy (OS6). Osteotomy was performed in the middle third of the right tibia 21 days after tail suspension, when the osteopenic condition was already set. The fractured limb was then immobilized by orthosis. Tibias were collected 2 and 6 weeks after osteotomy, and were analyzed by bone densitometry, mechanical testing, and histomorphometry. Bone mineral density values from bony calluses were significantly lower in the 2-week post-osteotomy groups compared with the 6-week post-osteotomy groups (multivariate general linear model analysis, Pbones 6 weeks after osteotomy compared with 2 weeks after osteotomy (multivariate general linear model analysis, Pbone healing. Results showed that osteopenia did not influence the bone healing process, and that time was an independent determinant factor regardless of whether the fracture was osteopenic. This suggests that the body is able to compensate for the negative effects of suspension.

  16. Erythropoietin (EPO): EPO-receptor signaling improves early endochondral ossification and mechanical strength in fracture healing.

    Science.gov (United States)

    Holstein, Joerg H; Menger, Michael D; Scheuer, Claudia; Meier, Christoph; Culemann, Ulf; Wirbel, Rainer J; Garcia, Patric; Pohlemann, Tim

    2007-02-13

    Beyond its role in the regulation of red blood cell proliferation, the glycoprotein erythropoietin (EPO) has been shown to promote cell regeneration and angiogenesis in a variety of different tissues. In addition, EPO has been indicated to share significant functional and structural homologies with the vascular endothelial growth factor (VEGF), a cytokine essential in the process of fracture healing. However, there is complete lack of information on the action of EPO in bone repair and fracture healing. Therefore, we investigated the effect of EPO treatment on bone healing in a murine closed femur fracture model using radiological, histomorphometric, immunohistochemical, biomechanical and protein biochemical analysis. Thirty-six SKH1-hr mice were treated with daily i.p. injections of 5000 U/kg EPO from day 1 before fracture until day 4 after fracture. Controls received equivalent amounts of the vehicle. After 2 weeks of fracture healing, we could demonstrate expression of the EPO-receptor (EPOR) in terminally differentiating chondrocytes within the callus. At this time point EPO-treated animals showed a higher torsional stiffness (biomechanical analysis: 39.6+/-19.4% of the contralateral unfractured femur) and an increased callus density (X-ray analysis (callus density/spongiosa density): 110.5+/-7.1%) when compared to vehicle-treated controls (14.3+/-8.2% and 105.9+/-6.6%; pEPO treatment had vanished at 5 weeks after fracture. We conclude that EPO-EPOR signaling is involved in the process of early endochondral ossification, enhancing the transition of soft callus to hard callus.

  17. Effect of extracorporeal shock wave therapy on fracture healing in rat femural fractures with intact and excised periosteum.

    Science.gov (United States)

    Oktaş, Birhan; Orhan, Zafer; Erbil, Barış; Değirmenci, Erdem; Ustündağ, Nil

    2014-01-01

    The aim of this study is to compare the effect of extracorporeal shock wave therapy (ESWT) on fractures with intact periosteum and excised periosteum. Thirty-seven Wistar albino rats were randomized into four groups. Osteotomy and intramedullary Kirschner wire fixation were performed on all right femurs under ketamin anesthesia. The first group (n=10) was identified as control group. In the second group (n=10), periosteum located at the osteotomy site was excised circumferentially during surgery. In the third group (n=9), periosteum was left intact and ESWT was applied. In the forth group (n=8), periosteums of all rats were excised and ESWT was applied. All fracture lines were evaluated radiographically each two weeks and histologically at the sixth week. Results were evaluated statistically. In periosteum excised group which represents a model of open fractures with soft tissue defect, ESWT application had a significantly positive histologic effect on bone healing. However, radiological evaluation did not reveal any statistically significant difference between groups with intact and excised periosteums. According to our findings, ESWT can be used to improve fracture healing and prevent pseudoarthrosis in the treatment of open fractures with accompanying soft tissue and periosteum damage. However, further clinical studies are required to include ESWT in routine practice.

  18. Stimulation of bone formation and fracture healing with pulsed electromagnetic fields: biologic responses and clinical implications.

    Science.gov (United States)

    Chalidis, B; Sachinis, N; Assiotis, A; Maccauro, G

    2011-01-01

    Pulsed electromagnetic fields (PEMF) have been used for several years to supplement bone healing. However, the mode of action of this non-invasive method is still debated and quantification of its effect on fracture healing is widely varied. At cellular and molecular level, PEMF has been advocated to promote the synthesis of extracellular matrix proteins and exert a direct effect on the production of proteins that regulate gene transcription. Electromagnetic fields may also affect several membrane receptors and stimulate osteoblasts to secrete several growth factors such as bone morphogenic proteins 2 and 4 and TGF-beta. They could also accelerate intramedullary angiogenesis and improve the load to failure and stiffness of the bone. Although healing rates have been reported in up to 87 % of delayed unions and non-unions, the efficacy of the method is significantly varied while patient or fracture related variables could not be clearly associated with a successful outcome.

  19. Expression and Role of Sonic Hedgehog in the Process of Fracture Healing with Aging.

    Science.gov (United States)

    Matsumoto, Kenichi; Shimo, Tsuyoshi; Kurio, Naito; Okui, Tatsuo; Obata, Kyoichi; Masui, Masanori; Pang, Pai; Horikiri, Yuu; Sasaki, Akira

    2016-01-01

    Aging is one of the risk factors for delayed fracture healing. Sonic hedgehog (SHH) protein, an inducer of embryonic development, has been demonstrated to be activated in osteoblasts at the dynamic remodeling site of a bone fracture. Herein, we compared and examined the distribution patterns of SHH and the functional effect of SHH signaling on osteogenesis and osteoclastogenesis between young (5-week-old) and aged (60-week-old) mice during fracture healing. We found that SHH was expressed in bone marrow cells from the fractured site of the rib of young mice on day 5, but was barely detectable in the corresponding cells from the rib of aged mice. SHH was also detected in osteoblasts and bone marrow cells at the callus remodeling stage on days 14 and 28 in both young and aged mice. The number of alkaline phosphatase (ALP)-positive osteoblasts was significantly higher in young mice on days 5 and 14, whereas the number of tartrate-resistant acid phosphatase (TRAP)-positive osteoclasts was significantly higher in aged mice. SHH stimulated significantly more osteoblast formation in the young compared to old mice. SHH stimulated the osteoclast formation directly in the aged mice and suppressed the formation indirectly through osteoprotegerin expression in the young mice. Results indicate that an aged-related delay of fracture healing may contribute to the unbalanced bone formation and resorption, regulated by hedgehog signaling.

  20. Chondrocyte BMP2 signaling plays an essential role in bone fracture healing.

    Science.gov (United States)

    Mi, Meng; Jin, Hongting; Wang, Baoli; Yukata, Kiminori; Sheu, Tzong-Jen; Ke, Qiao Han; Tong, Peijian; Im, Hee-Jeong; Xiao, Guozhi; Chen, Di

    2013-01-10

    The specific role of endogenous Bmp2 gene in chondrocytes and in osteoblasts in fracture healing was investigated by generation and analysis of chondrocyte- and osteoblast-specific Bmp2 conditional knockout (cKO) mice. The unilateral open transverse tibial fractures were created in these Bmp2 cKO mice. Bone fracture callus samples were collected and analyzed by X-ray, micro-CT, histology analyses, biomechanical testing and gene expression assays. The results demonstrated that the lack of Bmp2 expression in chondrocytes leads to a prolonged cartilage callus formation and a delayed osteogenesis initiation and progression into mineralization phase with lower biomechanical properties. In contrast, when the Bmp2 gene was deleted in osteoblasts, the mice showed no significant difference in the fracture healing process compared to control mice. These findings suggest that endogenous BMP2 expression in chondrocytes may play an essential role in cartilage callus maturation at an early stage of fracture healing. Our studies may provide important information for clinical application of BMP2.

  1. Enhancement of fracture healing in the rat, modulated by compounds that stimulate inducible nitric oxide synthase

    Science.gov (United States)

    Rajfer, R. A.; Kilic, A.; Neviaser, A. S.; Schulte, L. M.; Hlaing, S. M.; Landeros, J.; Ferrini, M. G.; Ebramzadeh, E.

    2017-01-01

    Objectives We investigated the effects on fracture healing of two up-regulators of inducible nitric oxide synthase (iNOS) in a rat model of an open femoral osteotomy: tadalafil, a phosphodiesterase inhibitor, and the recently reported nutraceutical, COMB-4 (consisting of L-citrulline, Paullinia cupana, ginger and muira puama), given orally for either 14 or 42 days. Materials and Methods Unilateral femoral osteotomies were created in 58 male rats and fixed with an intramedullary compression nail. Rats were treated daily either with vehicle, tadalafil or COMB-4. Biomechanical testing of the healed fracture was performed on day 42. The volume, mineral content and bone density of the callus were measured by quantitative CT on days 14 and 42. Expression of iNOS was measured by immunohistochemistry. Results When compared with the control group, the COMB-4 group exhibited 46% higher maximum strength (t-test, p = 0.029) and 92% higher stiffness (t-test, p = 0.023), but no significant changes were observed in the tadalafil group. At days 14 and 42, there was no significant difference between the three groups with respect to callus volume, mineral content and bone density. Expression of iNOS at day 14 was significantly higher in the COMB-4 group which, as expected, had returned to baseline levels at day 42. Conclusion This study demonstrates an enhancement in fracture healing by an oral natural product known to augment iNOS expression. Cite this article: R. A. Rajfer, A. Kilic, A. S. Neviaser, L. M. Schulte, S. M. Hlaing, J. Landeros, M. G. Ferrini, E. Ebramzadeh, S-H. Park. Enhancement of fracture healing in the rat, modulated by compounds that stimulate inducible nitric oxide synthase: Acceleration of fracture healing via inducible nitric oxide synthase. Bone Joint Res 2017:6:–97. DOI: 10.1302/2046-3758.62.BJR-2016-0164.R2. PMID:28188129

  2. Effect of recombinant human basic fibroblast growth factor on angiogenesis during mandible fracture healing in rabbits

    Institute of Scientific and Technical Information of China (English)

    龚振宇; 周树夏; 顾晓明; 李涤尘; 孙明林

    2003-01-01

    Objective: To investigate the effect of recombinant human basic fibroblast growth factor (rhbFGF) on angiogenesis during mandible fracture healing in rabbit. Methods: Fifty adult white rabbits were used for animal model and randomly divided into a control group (25 rabbits) and an experimental group (25 rabbits). The membranous complex of rhbFGF and bovine type I collagen was prepared and implanted into the rabbit mandible fracture site under periosteum. The animals were sacrificed on 7, 14, 28, 56 and 84 days respectively after operation and the whole mandibles were harvested. The expression of factor VIII related antigen (F8-RA) in callus was examined with immunohistochemical staining. Results: The amounts of microvascular formation in calluses in the rhbFGF-treating group on days 7, 14, 28 and 56 were more than those of the control group (P<0.01).Conclusions: The results indicated that rhbFGF could stimulate microvascular formation during mandible fracture healing in rabbits.

  3. Cosmos caudatus enhances fracture healing in ovariectomised rats: A preliminary biomechanical evaluation

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    Pamela Godspower Rufus

    2015-01-01

    Full Text Available Summary. Osteoporotic fractures occur in osteoporotic states and affect patients’ quality of life. Cosmos caudatus (ulam raja is a local plant known for its high calcium content and anti-oxidant properties. The present study aimed to investigate the fracture healing properties of C. caudatus water extract in ovariectomised rats by studying the biomechanical properties of tibia. Twenty-four female Sprague-Dawley rats were divided into 4 groups: (i sham operated (ii ovariectomised control (iii ovariectomised + estrogen (100µg/kg/day and (iv ovariectomised + C. caudatus (500mg/kg. Following six weeks of sham operation or ovariectomy, the right tibia of the rats were fractured. Rats were then given their respective treatment for 8 weeks with body weight monitored weekly. Biomechanical analysis indicated that the maximum load, stress and Young’s modulus of the ovariectomised control group (36.2 ± 4.7N, 10.01 ± 1.41MPa, 29.2 ± 9.39MPa respectively were significantly lower compared to sham operated (150.32 ± 32. 6N, 36.75 ± 7.98MPa, 183 ± 53.2MPa respectively and the C. caudatus treated group (136.86 ± 16.95N, 33.45 ± 4.14MPa, 155.13± 58.58MPa respectively. Therefore, C. caudatus extract improved the biomechanical property of the healed bone and may be beneficial for fracture healing in the estrogen deficient state.Industrial Relevance. Post-menopausal osteoporosis is a debilitating disease affecting women worldwide. Hormone replacement therapy (HRT, commonly used for the prevention and treatment of post-menopausal osteoporosis has been associated with several side effects. Thus, in finding alternatives in the treatment of osteoporosis, C. caudatus is a plant of interest. Previous study showed that C. caudatus improved bone histomorphometry in ovariectomized rats by increasing double-labeled surface (dLS/BS, mineral appositional rate (MAR, osteoid volume (OV/BV and osteoblast surface (Ob.S/BS. Therefore, the present study aimed to assess

  4. Experimental fracture healing: evaluation using radionuclide bone imaging: concise communication. [/sup 99m/Tc-methylene diphosphonate; rabbits

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    Gumerman, L.W.; Fogel, S.R.; Goodman, M.A.; Hanley, E.N. Jr.; Kappakas, G.S.; Rutkowski, R.; Levine, G.

    1978-12-01

    Radionuclide bone imaging was performed in a rabbit model to observe the course of fracture healing and to establish criteria for distinguishing nonunion and delayed healing from normal healing. Sequential gamma-camera images (with pinhole collimator) were collected and subjected to computer analysis. Five groups were established: (a) control--immobilization; (b) control--immobilization plus periosteal stripping; (c) simple fracture--osteotomy; (d) delayed union--osteotomy plus periosteal stripping; and (e) nonunion--osteotomy, periosteal stripping and polymethyl methacrylate interposed between fracture fragments. Histographic representation of absolute count rates along rabbit tibias followed a predictable pattern in the simple-fracture and delayed-union groups. They differed only in the time of appearance of phases. The non-union group demonstrated no recognizable sequential pattern. In this experimental model, serial bone scanning the quantitative data analysis has shown potential for indicating the course of healing in fractures and for serving as a guide to treatment.

  5. Improving Impact Strength Recovery of Fractured and Healed Rice Husks Fibre Reinforced Polypropylene Composites.

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    Odhong, O.V.E

    2016-10-01

    Full Text Available Rice husks fibre reinforced polypropylene composite (rhfrpc is a natural plant fibre reinforced polymer composite having advantages of high strength, light weight and affordability. They are commonly used for light load structural and non structural applications. They are mainly used as particle boards, for fencing post, roofing tiles, for interiors of car and aircrafts among other usages. This material once cracked by impact forces cannot be repaired using traditional repair methods for engineering materials such as metals or other composites that can be repaired by welding or by patch repair methods respectively, thus a method of repair of rice husks fibre reinforced polypropylene composites by refilling the damaged volume by injection of various healing agents has been investigated. The composite coupons were produced by injection moulding, cooled sufficiently and prepared for charpy impact tests. Test results for pristine coupons were a maximum of 48 J/mm2 . The destroyed coupons were then subjected to healing in a fabricated healing fixture. Healing agents such as epoxy resin, ethyl cyanoacrylate, and tannin gum have been investigated for their use as possible healing agents to fill the damaged volume and perform healing action at the fractured surfaces. The impact test results were recorded and compared with those of unhealed pristine coupons. The recovered strengths were a maximum of 60 J/mm2 translating into a 125% impact strength recovery, and this is good enough for the healed composites to be recommended for reuse in their second lives of their respective original functions.

  6. Tooth in the line of angle fractures: the impact in the healing process. A retrospective study of 112 patients.

    Science.gov (United States)

    Zanakis, Stylianos; Tasoulas, Jason; Angelidis, Ioannis; Dendrinos, Christos

    2015-01-01

    There is no consensus regarding the prophylactic removal of mandibular third molars (TM) in fracture lines to facilitate healing. Recent evidence suggests that poor healing is attributed to the limited use of antimicrobials, delayed care and semi-rigid fixation as a treatment method, favoring retention of TM. A retrospective cohort study of all patients presenting with mandibular angle fractures at the Hippokration General Hospital of Athens (2006-2011) was designed to examine the association between the presence versus absence of TMs in the line of mandibular fractures and the fracture healing process. Development of complications during the healing process was the outcome of interest. Additional factors considered were patient age, sex, and fracture etiology. Data were extracted from a retrospective chart review, including information from clinical and radiological examinations. The analytical sample included 112 patients with 121 angle fractures. Bivariate methods including Fisher's exact and chi-square tests were used to test the association between TM presence in the fracture line and healing complications. This study found no association between the presence of mandibular TM in the fracture line and postoperative complications and the healing process when combined with light intermaxillary fixation for 15 days. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  7. Electromagnetic stimulation as coadjuvant in the healing of diaphyseal femoral fractures: a randomized controlled trial

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    Alfredo Martinez Rondanelli

    2014-07-01

    Full Text Available Introduction: There is controversy in medical literature regarding the use of electromagnetic fields to promote bone healing.Methods: After designing and building devices capable of generating an electromagnetic field for this study, their safety was confirmed and the electromagnetic therapy was randomly allocated and compared to placebo in patients with fracture of the femoral diaphysis. Treatment began six weeks after the fracture and it was administered once a day, during 1 h, for eight consecutive weeks. Twenty devices were built, 10 of which were placebo-devices. Between June 2008 and October 2009, 64 patients were randomized in two different hospitals and were followed for 24 weeks. The mean age was 30 years (18-59 and 81% were males.Results: Healing observed at week 12 was 75% vs. 58% (p= 0.1; at week 18, it was 94% vs. 80% (p= 0.15; and at week 24, it was 94% vs. 87% (p= 0.43 for the device group and the placebo group, respectively.Discussion: This study suggests that an electromagnetic field stimulus can promote earlier bone healing compared to placebo in femoral diaphyseal fractures. Faster bone healing translates into sooner weight bearing, which – in turn – permits quicker return to normal daily activities.

  8. Determining the Role of Sost and Sostdc1 During Fracture Healing

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    Yee, Cristal Sook Ngei [Univ. of California, Merced, CA (United States)

    2016-01-01

    The bone is a dynamic organ, often changing throughout the course of the human lifespan with its continuous remodeling, laying down new bone and resorbing old bone. With age, the bone becomes increasingly porous and mechanically unstable, leading to the development of osteoporosis in some individuals. Elderly patients with osteoporosis are at an increased risk of fracturing their bones which contributes to a higher mortality rate. Recent studies have revealed that type 1 diabetic mellitus (T1DM) patients also have an osteoporotic bone phenotype and impaired fracture healing, independent of age. Currently, there is a lack of available treatments that can improve impaired healing and directly enhance bone formation. Therefore, there is a great need for developing new therapies that can not only aid type 1 diabetic patients with osteoporosis to improve bone phenotype, but that could also aid patients with difficult or impaired fracture healing. In this thesis, I will be discussing the role of Wnt signaling and Sclerostin, a Wnt antagonist that negatively regulates bone formation, in the content of fracture repair.

  9. Vitamin D in Foot and Ankle Fracture Healing: A Literature Review and Research Design.

    Science.gov (United States)

    Bernhard, Andrew; Matuk, Jorge

    2015-10-01

    Vitamin D is a generic name for a group of essential vitamins, or secosteroids, important in calcium homeostasis and bone metabolism. Specifically, efficacy of vitamin D with regard to bone healing is in question. A literature review was performed, finding mostly large studies involving vitamin D effects on prevention of fractures and randomized animal model studies consisting of controlled fractures with vitamin D interventions. The prevention articles generally focus on at-risk populations, including menopausal women and osteoporotic patients, and also most often include calcium in the treatment group. Few studies look at vitamin D specifically. The animal model studies often focus more on vitamin D supplementation; however the results are still largely inconclusive. While recent case reports appear promising, the ambiguity of results on the topic of fracture healing suggests a need for more, higher level research. A novel study design is proposed to help determine the efficacy on vitamin D in fracture healing. Therapeutic, Level IV: Systematic Review. © 2015 The Author(s).

  10. Exposure to 100% Oxygen Abolishes the Impairment of Fracture Healing after Thoracic Trauma.

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    Julia Kemmler

    Full Text Available In polytrauma patients a thoracic trauma is one of the most critical injuries and an important trigger of post-traumatic inflammation. About 50% of patients with thoracic trauma are additionally affected by bone fractures. The risk for fracture malunion is considerably increased in such patients, the pathomechanisms being poorly understood. Thoracic trauma causes regional alveolar hypoxia and, subsequently, hypoxemia, which in turn triggers local and systemic inflammation. Therefore, we aimed to unravel the role of oxygen in impaired bone regeneration after thoracic trauma. We hypothesized that short-term breathing of 100% oxygen in the early post-traumatic phase ameliorates inflammation and improves bone regeneration. Mice underwent a femur osteotomy alone or combined with blunt chest trauma 100% oxygen was administered immediately after trauma for two separate 3 hour intervals. Arterial blood gas tensions, microcirculatory perfusion and oxygenation were assessed at 3, 9 and 24 hours after injury. Inflammatory cytokines and markers of oxidative/nitrosative stress were measured in plasma, lung and fracture hematoma. Bone healing was assessed on day 7, 14 and 21. Thoracic trauma induced pulmonary and systemic inflammation and impaired bone healing. Short-term exposure to 100% oxygen in the acute post-traumatic phase significantly attenuated systemic and local inflammatory responses and improved fracture healing without provoking toxic side effects, suggesting that hyperoxia could induce anti-inflammatory and pro-regenerative effects after severe injury. These results suggest that breathing of 100% oxygen in the acute post-traumatic phase might reduce the risk of poorly healing fractures in severely injured patients.

  11. Stimulatory effect of zinc acexamate administration on fracture healing of the femoral-diaphyseal tissues in rats.

    Science.gov (United States)

    Igarashi, A; Yamaguchi, M

    1999-04-01

    The effect of zinc acexamate on fracture healing of the femoral-diaphyseal tissues in rats was investigated in vivo. Zinc acexamate (0.3 and 10.0 mg Zn/100 g body weight per day) was orally administered to rats (4 weeks old) surgically fractured the femoral diaphysis for 14 to 28 days. Calcium content and alkaline phosphatase activity in the femoral-diaphyseal tissues were significantly decreased in rats with fracture healing, while bone acid phosphatase activity and protein content were markedly increased. The administration of zinc acexamate (10.0 mg Zn/100 g) for 28 days caused a significant increase in calcium content, alkaline and acid phosphatases activities, protein and deoxyribonucleic acid (DNA) contents in the femoral-diaphyseal tissues of rats with fracture healing. With the lower dose (3.0 mg Zn/100 g), zinc compound had a partial effect on bone components. Femoral mineral density in rats with fracture healing was significantly increased by the administration of zinc acexamate (10.0 mg Zn/100 g) for 28 days. Femoral-diaphyseal zinc content was significantly decreased in rats with fracture healing. This decrease was completely restored by the administration of zinc acexamate (10.0 mg Zn/100 g) for 28 days. The present study suggests that the supplement of zinc compound stimulates fracture healing of the femoral-diaphyseal tissues in rats.

  12. Experimental study on healing process of rat mandibular bone fracture examined by radiological procedures

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    Iuchi, Yukio; Furumoto, Keiichi (Nippon Dental Univ., Tokyo (Japan))

    1994-06-01

    The healing process of rat mandibular fractures was stereoscopically observed daily, using plain roentgenography in the lateral-oblique and tooth axis directions and bone scintigraphy using 99m-Tc-methylene diphosphoric acid (Tc-99m-MDP). The findings were compared with microradiograms of regional polished specimens. X-ray findings included the following. Up to 3 days after bone fracture, the fracture mesiodistally showed distinct radiolucency, with sharp and irregular fracture stump. Radiopacity of the fracture site gradually increased 7 days or later, and bone trabecular formation by callus and stump bridging started to occur at 14 days. Findings similar to those in the control group were observed 49 days or later. The inside was difficult to differentiate, irrespective of the observation time. Bone scans in the mesiodistal and buccolingual planes revealed tracer uptake in the areas of mandibular and soft tissue damage one day after bone fracture. Tracer uptake began to be seen in the fracture site 3 days later, and became marked at 14 days. Then Tc-99m DMP began to be localized and returned to the findings similar to those at 49 days. Bone scanning tended to show wider areas earlier than roentgenography. Microradiographic mesiodistal examination revealed distinct radiopacy of the fracture line for 3 days after bone fracture. Seven days later, bone resorption cavity occurred in the cortical bone around the fracture stump, along with neogenesis of callus. Neogenesis and calcification began to occur gradually, and 14 days later, the fracture osteoremodeling of the internal bone trabeculae was observed. Bone trabecular formation within the bone, however, occurred later. (N.K.).

  13. Collagenases and gelatinases in bone healing. The focus on mandibular fractures

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    Kurzepa Jacek

    2014-06-01

    Full Text Available Due to high amount of collagen fibres in the structure of bone, the enzymes capable of collagen digestion play a key role in bone remodelling. Matrix metalloproteinases (MMPs, prevailing extracellular endopeptideses, can digest extracellularly located proteins, e.g. collagen, proteoglycans, elastin or fibronectin. Among MMPs, collagenases (MMP-1, MMP-8 and MMP-13 and gelatinases (MMP-2 and MMP-9 can cleave collagen particles to forms that are able to undergo further steps of catabolism intracellularly. In addition, activity of the gelatinases (as an activation of proinflammatory cytokines facilitates spreading inflammation that is necessary during the first stage of bone healing. Further studies related to the role of various MMPs in mandibular fractures should precisely explain their function in the bone healing and evaluate the influence of MMPs inhibitors on that process. This review provides the basic information about two groups among MMPs family, collagenases and gelatinases, and their role in repairing processes after mandibular fractures.

  14. A review of locking compression plate biomechanics and their advantages as internal fixators in fracture healing.

    Science.gov (United States)

    Miller, Danielle L; Goswami, Tarun

    2007-12-01

    Metallic implants are often involved in the open reduction and internal fixation of fractures. Open reduction and internal fixation is commonly used in cases of trauma when the bone cannot be healed using external methods such as casting. The locking compression plate combines the conventional screw hole, which uses non-locking screws, with a locking screw hole, which uses locking head screws. This allows for more versatility in the application of the plate. There are many factors which affect the functionality of the plate (e.g., screw placement, screw choice, length of plate, distance from bone, etc.). This paper presents a review of the literature related to the biomechanics of locking compression plates and their use as internal fixators in fracture healing. Furthermore, this paper also addresses the materials used for locking compression plates and their mechanical behavior, parameters that control the overall success, as well as inherent bone quality results.

  15. Relationship between New Osteoporotic Vertebral Fracture and Instrumented Lumbar Arthrodesis

    OpenAIRE

    Kim, Bung-Hak; Choi, Dong-Hyuk; Jeon, Seong-Hun; Choi, Yong-Soo

    2010-01-01

    Study Design Retrospective study. Purpose To evaluate the relationship between a new osteoporotic vertebral fracture and instrumented lumbar arthrodesis. Overview of Literature In contrast to the growing recognition of the importance of adjacent segment disease after lumbar arthrodesis, relatively little attention has been paid to the relationship between osteoporotic vertebral fractures and instrumented lumbar arthrodesis. Methods Twenty five patients with a thoracolumbar vertebral fracture ...

  16. To evaluate the role of platelet-rich plasma in healing of acute diaphyseal fractures of the femur

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    Roop Singh

    2017-02-01

    Conclusion: PRP has no effect on femoral shaft fracture healing treated with closed intramedullary nailing. However, PRP and matrix scaffold provided by fibrin membrane may provide an artificial hematoma effect in the initial phase of healing in open or failed closed intramedullary nailing.

  17. Effect of autocontrol micromotion intramedullary interlocking nail on fracture healing: an experimental study

    Institute of Scientific and Technical Information of China (English)

    XU Wei-zhou; GUO Xiao-dong; ZHAO Ju-cai; WANG Yi-jin

    2006-01-01

    Objective: To investigate the effect of autocontrol micromotion locking nail (AMLN) on experimental fracture healing and its mechanism.Methods: 16 goats undergoing both sides of transverse osteotomy of the femoral shafts were fixed intramedullary with AMLN and Gross-Kempf (GK) nail,respectively. The follow-up time was 7, 14, 28 and 56days. Roentgenographic, biomechanical, histological,scanning electromicroscopic and biochemical analyses were done.Results: ( 1 ) The strength of anticompression,antiflexion and antitorsion in the fractural end in the AMLN-fixed group was higher than that of GK nail-fixed group; whereas, the rate of stress shelter in the fractured end decreased significantly (P < 0.01 ). (2) The content of the total collagen, insoluble collagen, calcium and phosphate in the AMLN-fixed group was higher than that in the GK nail-fixed group ( P < 0.05 ). ( 3 ) Histological observation and quantitative analysis of calluses revealed that AMLN could promote the growth of bridge calluses and periosteum calluses. Hence the facture healing and remolding process achieved early, which was much better than traditional GK nail fixation. (P < 0.05). ( 4 ) 7-14days postoperation, the calluses of AMLN-fixed group was flourish and camellarly arranged and the collagen fibril formed constantly in the absorption lacuna of bone trabecula. 28-56 days postoperation, the collagen fibril was flourish around the absorption lacuna and was parallel to the bone's longitudinal axis. Active bony absorption and formation were seen, so was remolding and rebuilding.Haversian system was intact and the bony structural net was very tenacious because of the deposition of calcium salt.None of the above findings was observed in the GK nailfixed group.Conclusions: The design of AMLN accords well with the plastic fixation theory. As the geometry ametabolic system constituted by the intramedullary fixation instruments and the proximal and distal end of the fracture is very firm and stable

  18. Review of techniques for monitoring the healing fracture of bones for implementation in an internally fixated pelvis.

    Science.gov (United States)

    Wong, Lydia Chwang Yuh; Chiu, Wing Kong; Russ, Matthias; Liew, Susan

    2012-03-01

    Sacral fractures from high-impact trauma often cause instability in the pelvic ring structure. Treatment is by internal fixation which clamps the fractured edges together to promote healing. Healing could take up to 12 weeks whereby patients are bedridden to avoid hindrances to the fracture from movement or weight bearing activities. Immobility can lead to muscle degradation and longer periods of rehabilitation. The ability to determine the time at which the fracture is stable enough to allow partial weight-bearing is important to reduce hospitalisation time. This review looks into different techniques used for monitoring the fracture healing of bones which could lead to possible methods for in situ and non-invasive assessment of healing fracture in a fixated pelvis. Traditional techniques being used include radiology and CT scans but were found to be unreliable at times and very subjective in addition to being non in situ. Strain gauges have proven to be very effective for accurate assessment of fracture healing as well as stability for long bones with external fixators but may not be suitable for an internally fixated pelvis. Ultrasound provides in situ monitoring of stiffness recovery but only assesses local fracture sites close to the skin surface and has only been tested on long bones. Vibration analysis can detect non-uniform healing due to its assessment of the overall structure but may suffer from low signal-to-noise ratio due to damping. Impedance techniques have been used to assess properties of non-long bones but recent studies have only been conducted on non-biological materials and more research needs to be done before it can be applicable for monitoring healing in the fixated pelvis.

  19. Osteoporosis influences the middle and late periods of fracture healing in a rat osteoporotic model

    Institute of Scientific and Technical Information of China (English)

    WANG Jian-wei; LI Wei; XU Shao-wen; YANG Di-sheng; WANG Yun; LIN Min; ZHAO Guang-feng

    2005-01-01

    Objective: To evaluate the influence of osteoporosis on the middle and late periods of fracture healing process through observing the histomorphological changes, bone mineral density and biomechanical properties in ovariectomized rats. Methods: Eighty-four female SD rats of 4 months old were randomly divided into osteoporosis group and sham operation group, 42 in each. Rats in osteoporosis group were performed ovariectomy operation while those in sham operation group were given sham operation. A midshaft tibia fracture model was established 10 weeks after ovariectomy. Tibias were harvested 2, 4, 6, 12, 18 weeks after fracture for bone mineral density, histomorphological and biomechanical evaluation. Results: Compared with the sham operation group, callus bone mineral density was 12.8%, 18.0%, 17.0% lower in osteoporosis group 6, 12, 18 weeks after fracture, respectively (P<0.05); callus failure load was 24.3%, 31.5%, 26.6%, 28.8% lower in osteoporosis group, and callus failure stress was 23.9%, 33.6%, 19.1%, 24.9% lower in osteoporosis group 4, 6, 12, 18 weeks after fracture, respectively (P<0.05). In osteoporosis group, endochondral bone formation was delayed, more osteoclast cells could be seen around the trabecula, and the new bone trabecula arranged loosely and irregularly. Conclusions: Osteoporosis influences the middle and late periods of fracture healing in the rat osteoporotic model. The impairment is considered to be the result of combined effects of prolonged endochondral calcification, high activated osteoclast cell and the deceleration of the increase in bone mineral density.

  20. Effect of Absorbable Hydroxyapatite/Poly-DL-Lactide Rods on Experimental Fracture Healing

    Institute of Scientific and Technical Information of China (English)

    GUO Xiaodong; ZHENG Qixin; DU Jingyuan; LIU Yong

    2000-01-01

    In order to investigate the effect of a new institute-designed absorbable hydroxyapatite microparticles/poly-DL-lactide (HA/PDLLA) fracture fixation devices on experimental fracture healing, 25 rabbits with a transverse transcondylar osteotomy of the distal femur were fixed intramedullary by a HA/PDLLA rod (4.5 mm in diameter, 30-40 mm in length). The follow-up time lasted 1, 2, 4, 6 and 12 week(s). Roentgenographic, histological and ultrastructural analyses were conducted. The results showed that allosteotomies united within 6 weeks without delay.No accumulation of inflammatory cells was seen. Ultrastructural studies showed that polymorphonuclear neutrophils and macrophages were observed mainly at the 1st week, but only few were noted at the 2nd week. The inflammatory and debridement stages were not prolonged. Large amount of active fibroblasts and some chondroblasts were observed at the 2nd week, suggesting a fibrous callus stage. The main cellularity at 4th week was osteoblasts and osteocytes. Part of osteocytes had already entered the static stage at the 6th week. Our experiment showed that the HA/PDLLA had good biocompatibility, sufficient mechanical streugth and caused no delay to the fracture healing.

  1. Great increase in bone 66 kDa protein and osteocalcin at later stages with healing rat fractures: effect of zinc treatment.

    Science.gov (United States)

    Igarashi, Aki; Yamaguchi, Masayoshi

    2003-02-01

    Fracture healing has been demonstrated to increase production of bone growth factors, and this elevation has been shown to be enhanced by zinc treatment. Moreover, the effect of zinc treatment on production of bone osteocalcin, which is a kind of Ca2+-binding protein localized in bone matrix, at the later stages with bone fracture was investigated. Rats were sacrificed 7 (earlier stage) or 21 (later stage) days after fracture of femoral diaphysis. Femoral-diaphyseal tissues with fracture healing were cultured in a serum-free medium for 24 h. Many proteins in the bone tissues were released into the medium. Bone protein production was markedly elevated 21 days after bone fracture as compared with that of 7 days. A approximately 66 kDa protein molecule, a major protein component which was produced by the diaphyseal tissues during fracture healing, was predominantly increased at the later stages with fracture healing. Bone osteocalcin production was significantly increased during fracture healing. This increase was enhanced at the later stages with fracture healing. The presence of zinc acexamate (10(-4) M) in culture medium caused a significant increase in bone protein and osteocalcin production at 7 or 21 days after bone fracture. The effect of zinc acexamate in increasing bone total protein and osteocalcin production was remarkable at the later stages with fracture healing. Moreover, zinc treatment caused a significant increase in alkaline phosphatase activity, deoxyribonucleic acid (DNA) and calcium content in the femoral-diaphyseal tissues of the later stages with fracture healing in vitro. The present study demonstrates that bone protein production is markedly increased at the later stages with fracture healing, and that zinc treatment can enhance production of bone protein components including osteocalcin in vitro. Zinc treatment may stimulate the healing of femoral fracture at earlier and later stages.

  2. Enhancement of fracture healing by electrical stimulation in the comminuted intraarticular fracture of distal radius.

    Science.gov (United States)

    Kohata, Kazuhiro; Itoh, Soichiro; Takeda, Shu; Kanai, Misa; Yoshioka, Taro; Suzuki, Hiroyuki; Yamashita, Kimihiro

    2013-01-01

    Effectiveness of an alternating electric current (AC) stimulation in prevention of bone deformity for comminuted intraarticular fracture of distal radius were verified by comparing postoperative results treated with a wrist-bridging external fixator combined with or without an AC stimulator (EF and NEF, respectively), and a palmar locking plate (LP). This study evaluated 92 cases (mean age 67.9 ± 11.4 years) of type C2 and 60 cases (mean age 69.7 ± 9.5 years) of type C3 distal radius fractures, as classified by the Association for Osteosynthesis. In total, 55 and 24 cases were treated with EF and NEF, respectively; and 73 cases were treated with LP. Callus appeared 27.5 ± 4.6 days postoperatively and the external skeletal fixation period was significantly shorter in the EF group than in the NEF group. The decrease in radial length was significantly lower in the EF group when compared to the LP group. There were no significant differences among the groups for the other radiographic and functional parameters. AC stimulation combined to the external fixation may be a promising method to prevent postoperative deformity in the severely comminuted intraarticular fractures by accelerating callus maturation and facilitating new bone bridging across the gap of fracture site.

  3. Healing of delayed management of double traumatized incisors with complicated crown: Root fracture and apical pathosis

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    Abdullah M Alsaedan

    2017-01-01

    Full Text Available The present case report shows a 23-year-old male who was subjected to trauma in his maxillary right central and lateral incisors with crown and transverse apical third root fractures. Root canal therapy was started, but the patient did not complete it. After 6 years, the patient was subjected to another trauma on the same teeth and showed up after 3 weeks of the second trauma to continue his treatment. Clinical examination revealed that both incisors were sensitive to percussion and palpation with labial sinus tract and pus discharge through the open access cavity of the central incisor. Radiographic evaluation demonstrated root fracture of the central incisor with large radiolucency. Root canal treatment for both incisors and periradicular surgery was done. Histopathologic examination of the periapical lesion demonstrated tissue necrosis and fungal hyphae. Follow-up showed no symptoms with good healing. The treatment modality appears to be effective in dealing with delayed management of traumatized anterior teeth.

  4. Healing patterns of clavicular birth injuries as a guide to fracture dating in cases of possible infant abuse

    Energy Technology Data Exchange (ETDEWEB)

    Walters, Michele M.; Forbes, Peter W.; Buonomo, Carlo; Kleinman, Paul K. [Boston Children' s Hospital, Department of Radiology, Boston, MA (United States)

    2014-10-15

    Dating fractures is critical in cases of suspected infant abuse. There are little scientific data to guide radiologists, and dating is generally based on personal experience and conventional wisdom. Since birth-related clavicular fractures are not immobilized and their age is known, we propose that an assessment of these injuries may serve as a guide for dating inflicted fractures in young infants, acknowledging that patterns observed in the clavicle may not be entirely generalizable to other bones injured in the setting of abuse. One hundred thirty-one radiographs of presumed birth-related clavicular fractures in infants between 0 and 3 months of age were reviewed by two pediatric radiologists with 30 and 15 years' experience. Readers were asked to evaluate images based on several parameters of fracture healing, with a focus on subperiosteal new bone formation (SPNBF) and callus formation. SPNBF and callus were each evaluated with regard to presence, thickness and character. Responses were correlated with known fracture ages. SPNBF was rarely seen in fractures less than 7 days old and was most often present by 10 days. Callus formation was rarely seen in fractures less than 9 days old and was most often present by 15 days. SPNBF thickness increased with fracture age and the character of SPNBF evolved from single-layered to solid/multilayered. Callus thickness decreased with fracture age and callus matrix evolved from soft to intermediate to hard in character. There is an evolution in clavicular fracture healing in young infants that follows a predictable pattern. These findings afford the prospect that predictable patterns of infant clavicular fracture healing can provide an evidence base that may be applicable in cases of suspected infant abuse. (orig.)

  5. Effects of recombinant human growth hormone (r-hGH) on experimental osteoporotic fracture healing

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To observe the effect of recombinant human growthhormone (r-hGH) on osteoporotic fracture healing in rats, and to provide an effective therapy for osteoporotic fracture.Methods: Thirty-six female 8-month-old SD rats were randomized into two groups: therapy group and control group. After the experimental model of osteoporotic fracture was established, the therapy group was treated with r-hGH of 2.7 mg/kg body weigh/day (1 mg=3 IU) for 10 days continuously by daily subcutaneous injection; whereas the control group was treated with equivalent saline. Plasma insulin-like growth factor I concentration was detected and bone mineral density (BMD) as well as biomechanical strength of callus were measured at 2, 4, 8 weeks.Results: Plasma insulin-like growth factor I concentration in the therapy group was higher than that in the control group (P<0.005) at 2nd week and began to decline at 4th week. At 8th week, there was no significant difference between the two groups. At 4th week, callus area and BMD in therapy group were higher than those in the control group, but at 8th week, they were lower and BMD had a significant difference between the two groups (P<0.001). Biomechanical testing of callus showed that torsional strength of the therapy group was higher than that of the control group at 4th or 8th week, meanwhile maximum torsional angle had a significant difference between the two groups (P<0.005).Conclusions: The results show that exogenous r-hGH can stimulate osteoporotic fracture healing in rats.

  6. Systemic inhibition of canonical Notch signaling results in sustained callus inflammation and alters multiple phases of fracture healing.

    Directory of Open Access Journals (Sweden)

    Michael I Dishowitz

    Full Text Available The Notch signaling pathway is an important regulator of embryological bone development, and many aspects of development are recapitulated during bone repair. We have previously reported that Notch signaling components are upregulated during bone fracture healing. However, the significance of the Notch pathway in bone regeneration has not been described. Therefore, the objective of this study was to determine the importance of Notch signaling in regulating bone fracture healing by using a temporally controlled inducible transgenic mouse model (Mx1-Cre;dnMAML(f/- to impair RBPjκ-mediated canonical Notch signaling. The Mx1 promoter was synthetically activated resulting in temporally regulated systemic dnMAML expression just prior to creation of bilateral tibial fractures. This allowed for mice to undergo unaltered embryological and post-natal skeletal development. Results showed that systemic Notch inhibition prolonged expression of inflammatory cytokines and neutrophil cell inflammation, and reduced the proportion of cartilage formation within the callus at 10 days-post-fracture (dpf Notch inhibition did not affect early bone formation at 10dpf, but significantly altered bone maturation and remodeling at 20dpf. Increased bone volume fraction in dnMAML fractures, which was due to a moderate decrease in callus size with no change in bone mass, coincided with increased trabecular thickness but decreased connectivity density, indicating that patterning of bone was altered. Notch inhibition decreased total osteogenic cell density, which was comprised of more osteocytes rather than osteoblasts. dnMAML also decreased osteoclast density, suggesting that osteoclast activity may also be important for altered fracture healing. It is likely that systemic Notch inhibition had both direct effects within cell types as well as indirect effects initiated by temporally upstream events in the fracture healing cascade. Surprisingly, Notch inhibition did not alter

  7. In vivo study of microarc oxidation coated biodegradable magnesium plate to heal bone fracture defect of 3mm width.

    Science.gov (United States)

    Wu, Y F; Wang, Y M; Jing, Y B; Zhuang, J P; Yan, J L; Shao, Z K; Jin, M S; Wu, C J; Zhou, Y

    2017-06-23

    Microarc oxidation (MAO) coated magnesium (Mg) with improved corrosion resistance appeal increasing interests as a revolutionary biodegradable metal for fractured bone fixing implants application. However, the in vivo corrosion degradation of the implants and bone healing response are not well understood, which is highly required in clinic. In the present work, 10μm and 20μm thick biocompatible MAO coatings mainly composed of MgO, Mg2SiO4, CaSiO3 and Mg3(PO4)2 phases were fabricated on AZ31 magnesium alloy. The electrochemical tests indicated an improved corrosion resistance of magnesium by the MAO coatings. The 10μm and 20μm coated and uncoated magnesium plates were separately implanted into the radius bone fracture site of adult New Zealand white rabbits using a 3mm width bone fracture defect model to investigate the magnesium implants degradation and uninhibited bone healing. Taking advantage of the good biocompatibility of the MAO coatings, no adverse effects were detected through the blood test and histological examination. The implantation groups of coated and uncoated magnesium plates were both observed the promoting effect of bone fracture healing compared with the simple fracture group without implant. The releasing Mg(2+) by the degradation of implants into the fracture site improved the bone fracture healing, which is attributed to the magnesium promoting CGRP-mediated osteogenic differentiation. Mg degradation and bone fracture healing promoting must be tailored by microarc oxidation coating with different thickness for potential clinic application. Copyright © 2017. Published by Elsevier B.V.

  8. Experimental studies of healing process of rat mandibular condylar fracture, using /sup 45/Ca as tracer

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    Shimizu, Tatsuaki (Gifu Univ. (Japan). Faculty of Medicine)

    1982-09-01

    The cervical region of the mandibular condylus of young rats was fractured. The healing process was observed pathohistologically, autoradiographically using /sup 45/Ca as a tracer, and by ultra soft roentgenography. Condylectomy of the mandibular condylus was done at the same time and its regeneration observed. The results of the observation are as follows: The fractured portion is bonded with the soft tissue 1 - 2 weeks postoperatively. Histologically, new-blood vessels in the granulation tissue and the connective tissue's change into fibers are seen. On the second week chondrocytes appeared in the neck of the capitulum mandibulae and the stump of the ascending branch. On the 3rd postoperative week, the stump of the fracture of the bone is bonded with proliferated cartilaginous tissue and an osseous bond was seen in part by autoradiograph and ultra soft x-ray picture. New bone due to periosteal ossification is seen around the stump on the ascending branch side, and the bone reconstruction with osteoclasts was seen in the inside the trabeculae. On the 4th postoperative week, osseous concrescence is observed in the fractured portion. Regeneration of the capitulum mandibulae after extirpation of the capitulum mandibulae is seen in all the cases. On the postoperative 12th week, the macroscopic form of the degenerated capitulum mandibulae which seemed to be excessive becomes almost the same morphologically with that of the contralateral side and it was observed histologically that the construction of the capitulum mandibulae is completely restored.

  9. The Role of Radiographs and Office Visits in the Follow-Up of Healed Intertrochanteric Hip Fractures: An Economic Analysis.

    Science.gov (United States)

    Kempegowda, Harish; Richard, Raveesh; Borade, Amrut; Tawari, Akhil; Howenstein, Abby M; Kubiak, Erik N; Suk, Michael; Horwitz, Daniel S

    2016-12-01

    The purpose of this study was to evaluate the role and the necessity of radiographs and office visits obtained during follow-up of intertrochanteric hip injuries. Retrospective study. Two level I trauma centers. Four hundred sixty-five elderly patients who were surgically treated for an intertrochanteric fracture of the femur at 2 level I trauma centers between January 2009 and August 2014 were retrospectively identified from orthopaedic trauma databases. Analysis of all healed intertrochanteric hip fractures, including demographic characteristics, quality of reduction, time of healing, number of office visits, number of radiographs obtained, and each radiograph for fracture alignment, implant position or any pathological changes. The surgical fixation of 465 fractures included 155 short nails (33%), 232 long nails (50%), 69 sliding hip screw devices (15%), 7 trochanteric stabilizing plates (1.5%), and 2 proximal femur locking plates (0.5%). The average fracture healing time was 12.8 weeks and the average follow-up was 81.2 weeks. Radiographs of any patient obtained after the fracture had healed did not reveal any changes, including fracture alignment or implant position and hardware failure. In 9 patients, pathological changes, including arthritis (3), avascular necrosis (3), and ectopic ossification (3) were noted. The average number of elective office visits and radiographs obtained after the fracture had healed were 2.8 (range: 1-8) and 2.6 (range: 1-8), respectively. According to Medicare payments to the institution, these radiographs and office visits account for a direct cost of $360.81 and $192, respectively, per patient. The current study strongly suggests that there is a negligible role for radiographs and office visits during the follow-up of a well-healed hip fracture when there is documented evidence of radiographic and clinical healing with acceptable fracture alignment and implant position. Implementation of this simple measure will help in reducing

  10. Healing

    Science.gov (United States)

    Ventres, William B.

    2016-01-01

    My personal ethos of healing is an expression of the belief that I can and do act to heal patients while I attend to the traditional goals of medicine. The 7 supporting principles that inform my ethos are dignity, authenticity, integrity, transparency, solidarity, generosity, and resiliency. I invite others, including medical students, residents, and practicing physicians, to reflect and discover their own ethos of healing and the principles that guide their professional growth. A short digital documentary accompanies this essay for use as a reflective prompt to encourage personal and professional development. PMID:26755787

  11. RELATIONSHIP BETWEEN J-INTEGRAL AND FRACTURE SURFACE AVERAGE PROFILE

    Institute of Scientific and Technical Information of China (English)

    Y.G. Cao; S.F. Xue; K.Tanaka

    2007-01-01

    To investigate the causes that led to the formation of cracks in materials, a novel method that only considered the fracture surfaces for determining the fracture toughness parameters of J-integral for plain strain was proposed. The principle of the fracture-surface topography analysis (FRASTA) was used. In FRASTA, the fracture surfaces were scanned by laser microscope and the elevation data was recorded for analysis. The relationship between J-integral and fracture surface average profile for plain strain was deduced. It was also verified that the J-integral determined by the novel method and by the compliance method matches each other well.

  12. Power Doppler assessment of the neovascularization during uncomplicated fracture healing of long bones in dogs and cats.

    Science.gov (United States)

    Risselada, Marije; Kramer, Martin; Saunders, Jimmy H; Verleyen, Piet; Van Bree, Henri

    2006-01-01

    The aims of this prospective study were to test the feasibility of assessing neovascularization with power Doppler ultrasonography and to investigate its usefulness to follow fracture healing of long bones in dogs and cats. A total of 51 patients (44 dogs and seven cats) were followed. Fracture types differed from simple to comminuted. Therapy ranged from external coaptation to plate osteosynthesis. Patients were followed with radiography, B-mode real time and power Doppler ultrasonography every 2-4 weeks until the fracture was healed. All fractures healed uneventfully. A semi-quantitative numerical score based on signal intensity, vessel area, and number of Doppler signals was assigned and the mean value was used to compare patients and examinations. Time postoperatively was divided into periods of 10 days. No Doppler signal was present during the first 10 days. The mean of the scores was highest between 11 and 20 days postoperatively and the median of the scores peaked between 21 and 30 days. A gradual decrease was seen thereafter. The mean of the scores was zero at 71-80 days and the median at 51-0 days postoperatively for the grouped results. In all positive power Doppler examinations, signals were present in and close to the callus. In seven patients (five dogs and two cats) signals were also present in the peripheral soft tissues in one of the follow up examinations. The normal healing process of fractured bones can be visualized using power Doppler ultrasonography and follows a distinctive time-dependent pattern.

  13. The Relationship between Mid-face Fractures and Brain Injuries

    Directory of Open Access Journals (Sweden)

    Khalighi Sigaroudi A.

    2012-03-01

    Full Text Available Statement of Problem: Although advances in technology have led to improvements in man’s life in different aspects, statistics show that the incidence of fractures is increasing in different regions of the body. Recent studies show that midface fractures are strongly associated with patient's death. The exact relationship between different types of facial fractures and brain injuries is still controversial. Purpose: To evaluate individuals with midface fractures from different causes and determine if there is any relationship between various midface fractures and brain injuries. Materials and Methods: In this descriptive cross-sectional retrospective study, we assessed the hospital charts of all the patients with midface fractures at the trauma center of Poursina hospital. The complete medical record of each patient was reviewed. The etiologic and demographic data, the type of midface fracture and brain injury, and Glasgow coma scale (GCS were assessed. The data were analyzed by, the Chi-square, and the Fisher’s exact tests. The statistical package SPSS was used for all the analyses.Results: Of all the patients 47% had brain injury. The Important significant correlations were as follows: Le Fort III with Brain Contusion ( p =0.0001, nasal orbital ethmoid fractures with subdural hematoma ( p =0.0001, frontal fracture with subdural hematoma ( p =0.0001. Zygomatic complex fracture with Brain Contusion ( p =0.009. Nasal fracture correlated with Brain Contusion ( p =0.0001. The zygomatic complex fracture was the most prevalent fracture.Conclusion: Different midface fracture patterns have the risk of brain injury simultaneously. So midface fractures need more attention. According to the results, more attention is needed to be paid to driving rules specially the use of helmet and seat belt.

  14. Optimal Treatment of Malignant Long Bone Fracture: Influence of Method of Repair and External Beam Irradiation on the Pathway and Efficacy of Fracture Healing

    Science.gov (United States)

    2015-10-01

    Medical University of South Carolina Department of Orthopaedics 96 Jonathan Lucas Street Suite 708 MSC 622 8. PERFORMING ORGANIZATION REPORT NUMBER...analysis is completed in year 3. Nothing to report. Publications, Abstracts, and Presentations: Abstracts accepted for Orthopaedic Conferences: 1...Fracture Healing. The 32nd Annual Meeting of the Southern Orthopaedic Association, Asheville, NC. 2015. (Podium presentation) Abstract included in

  15. BMP-7 stimulates early diaphyseal fracture healing in estrogen deficient rats

    NARCIS (Netherlands)

    Blokhuis, T.J.; Buma, P.; Verdonschot, N.J.J.; Gotthardt, M.; Hendriks, T.

    2012-01-01

    Estrogen deficiency causes postmenopausal osteoporosis. The relationship between estrogen deficiency and the high failure rate after osteoporotic fracture treatment is unclear, as is the effect of possible interventions, either with anti-resorptive agents or with anabolic agents such as bone morphog

  16. BMP-7 stimulates early diaphyseal fracture healing in estrogen deficient rats.

    NARCIS (Netherlands)

    Blokhuis, T.J.; Buma, P.; Verdonschot, N.J.; Gotthardt, M.; Hendriks, T.

    2012-01-01

    Estrogen deficiency causes postmenopausal osteoporosis. The relationship between estrogen deficiency and the high failure rate after osteoporotic fracture treatment is unclear, as is the effect of possible interventions, either with anti-resorptive agents or with anabolic agents such as bone morphog

  17. Characterization of the increase in bone 66 kDa protein component with healing rat fractures: stimulatory effect of zinc.

    Science.gov (United States)

    Igarashi, A; Yamaguchi, M

    2002-05-01

    The characterization of protein components produced from bone tissues with fracture healing was investigated. Weanling rats were sacrificed between 1 and 7 days after the femoral fracture. Protein content in the femoral-diaphyseal tissues was markedly elevated by fracture healing. Moreover, when the femoral-diaphyseal tissues with fracture healing were cultured for 24 h in a serum-free medium, many proteins in the bone tissues were released into the medium. Analysis with sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) showed that many protein molecules were released from the diaphyseal tissues with fracture healing. Especially, a protein molecule of approximately 66 kDa was markedly increased by fracture healing. This protein molecule was significantly increased, when the diaphyseal tissues with fracture healing were cultured in the presence of zinc acexamate (10(-6)-10(-4) M). Zinc acexamate (10(-4) M)-induced increase in medium 66 kDa protein molecule was significantly inhibited in the presence of actinomycin D (10(-7) M) or cycloheximide (10(-6) M). The zinc effect was completely blocked in the presence of PD98059 (10(-5) M), an inhibitor of MAPK kinase, or staurosporine (10(-6) M), an inhibitor of protein kinase C. The medium 66 kDa protein molecule was significantly elevated in the presence of parathyroid hormone (1-34) (10(-7) M), insulin-like growth factor-I (10(-8) M) or transforming growth factor-beta (10(-11) M), while 17beta-estradiol (10(-9) M) did not have an effect. The effect of these bone-stimulating factors was equal to the zinc effect. Zinc did not significantly enhance the effect of insulin-like growth factor-I in increasing medium 66 kDa protein molecule. The present study demonstrates that fracture healing increases production of the approximately 66 kDa protein molecule which is a major component produced from femoral-diaphyseal tissues of weanling rats, and that this elevation is enhanced by zinc treatment.

  18. Effect of amino acids lysine and arginine on fracture healing in rabbits: A radiological and histomorphological analysis

    Directory of Open Access Journals (Sweden)

    Sinha Shivam

    2009-01-01

    Full Text Available Background: Amino acids like arginine and lysine have been suggested to hasten the process of fracture healing by improving the local blood supply, supplementing growth factors, and improving collagen synthesis. We studied the role of lysine and arginine in the fracture repair process with regard to the rate of healing, probable mechanisms involved in the process, and mutual synergism between these agents. Materials and Methods: In an experimental study, 40 rabbits were subjected to ulnar osteotomy. They were distributed in control (14 and test groups (26. Twenty-six animals in the test group were fed with a diet rich in lysine and arginine. Both the groups were followed radiologically and histologically till union. Results: There was better healing of osteotomy in terms of better vascularization, callus formation, and mineralization in the test group. The time of healing in the test group was reduced by a period of 2 weeks. Conclusion: We conclude that amino acids like arginine and lysine may hasten fracture healing.

  19. A Biomechanical Comparison of Two Intramedullary Implants for Subtrochanteric Fracture in Two Healing Stages: A Finite Element Analysis

    Directory of Open Access Journals (Sweden)

    Xinlei Wu

    2015-01-01

    Full Text Available Background. The biomechanical effect of two implants, namely, proximal femoral nail antirotation for Asia (PFNA-II and Expert Asian Femoral Nail (A2FN, for treating subtrochanteric fracture during healing stages, is still unclear. Methods. A 3D finite element model of an intact femur was constructed and validated. The fractured and postoperative models were accordingly produced. The postoperative models were loaded with the peak joint forces during gait for the soft and hard callus stages. The effects of stress distribution on the implants, femoral head and callus, and the deformation of the proximal femur were examined. Results. Both implants showed similar biomechanical effect in two healing stages. As the healing duration increased, the von Mises stress of two implants and the tensile stress of the femoral head decreased, whereas the compressive stress of the femoral head increased. However, the PFNA-II operation resulted in higher stress on the implant, lower stress on the proximal femur, and lower compressive stress and higher tensile stress on the callus than A2FN operation. Conclusions. The A2FN implant may provide a biomechanically superior construct for subtrochanteric fracture healing. However, the upper screw of the A2FN implant may be more likely to be loose in the healing process.

  20. Targeted delivery of lovastatin and tocotrienol to fracture site promotes fracture healing in osteoporosis model: micro-computed tomography and biomechanical evaluation.

    Directory of Open Access Journals (Sweden)

    Nurul 'Izzah Ibrahim

    Full Text Available Osteoporosis is becoming a major health problem that is associated with increased fracture risk. Previous studies have shown that osteoporosis could delay fracture healing. Although there are potential agents available to promote fracture healing of osteoporotic bone such as statins and tocotrienol, studies on direct delivery of these agents to the fracture site are limited. This study was designed to investigate the effects of two potential agents, lovastatin and tocotrienol using targeted drug delivery system on fracture healing of postmenopausal osteoporosis rats. The fracture healing was evaluated using micro CT and biomechanical parameters. Forty-eight Sprague-Dawley female rats were divided into 6 groups. The first group was sham-operated (SO, while the others were ovariectomized (OVx. After two months, the right tibiae of all rats were fractured at metaphysis region using pulsed ultrasound and were fixed with plates and screws. The SO and OVxC groups were given two single injections of lovastatin and tocotrienol carriers. The estrogen group (OVx+EST was given daily oral gavages of Premarin (64.5 µg/kg. The Lovastatin treatment group (OVx+Lov was given a single injection of 750 µg/kg lovastatin particles. The tocotrienol group (OVx+TT was given a single injection of 60 mg/kg tocotrienol particles. The combination treatment group (OVx+Lov+TT was given two single injections of 750 µg/kg lovastatin particles and 60 mg/kg tocotrienol particles. After 4 weeks of treatment, the fractured tibiae were dissected out for micro-CT and biomechanical assessments. The combined treatment group (OVx+Lov+TT showed significantly higher callus volume and callus strength than the OVxC group (p<0.05. Both the OVx+Lov and OVx+TT groups showed significantly higher callus strength than the OVxC group (p<0.05, but not for callus volume. In conclusion, combined lovastatin and tocotrienol may promote better fracture healing of osteoporotic bone.

  1. Effect of bone marrow and low power lasers on fracture healing with destruction of both periosteum and endosteum in rabbits

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    M. G. Thanoon

    2010-01-01

    Full Text Available Ten mature rabbits of local breed were used in this study; weighing between 1.5 to 1.75 kg and aged about 1–2 years. These animals were divided into two equal groups; in group A destruction of both periosteum and endosteum was done one centimeter from each side of mid-shaft femoral bone fracture, then sufficient amount of autogenously bone marrow was injected directly at the fracture site after immobilization by intramedullary pin. In group B a similar procedure was achieved as in group A, but in additional to that He-Ne infrared laser therapy was used for several sessions. The result of radiological findings indicated that, the fracture healing occurred within group B at fifteen weeks, whereas in group A the healing occurred at eighteen weeks after operation. The implantation of autologous bone marrow enhanced the fracture healing, whereas using of combinations of autologous bone marrow and He-Ne infrared laser therapy hastened the healing.

  2. Piper sarmentosum enhances fracture healing in ovariectomized osteoporotic rats: a radiological study.

    Science.gov (United States)

    Estai, Mohamed Abdalla; Suhaimi, Farihah Haji; Das, Srijit; Fadzilah, Fazalina Mohd; Alhabshi, Sharifah Majedah Idrus; Shuid, Ahmad Nazrun; Soelaiman, Ima-Nirwana

    2011-01-01

    Osteoporotic fractures are common during osteoporotic states. Piper sarmentosum extract is known to possess antioxidant and anti-inflammatory properties. To observe the radiological changes in fracture calluses following administration of a Piper sarmentosum extract during an estrogen-deficient state. A total of 24 female Sprague-Dawley rats (200-250 g) were randomly divided into 4 groups: (i) the sham-operated group; (ii) the ovariectomized-control group; (iii) the ovariectomized + estrogen-replacement therapy (ovariectomized-control + estrogen replacement therapy) group, which was supplemented with estrogen (100 μg/kg/day); and (iv) the ovariectomized + Piper sarmentosum (ovariectomized + Piper sarmentosum) group, which was supplemented with a water-based Piper sarmentosum extract (125 mg/kg). Six weeks after an ovariectomy, the right femora were fractured at the mid-diaphysis, and a K-wire was inserted. Each group of rats received their respective treatment for 6 weeks. Following sacrifice, the right femora were subjected to radiological assessment. The mean axial callus volume was significantly higher in the ovariectomized-control group (68.2 ± 11.74 mm³) than in the sham-operated, estrogen-replacement-therapy and Piper sarmentosum groups (20.4 ± 4.05, 22.4 ± 4.14 and 17.5 ± 3.68 mm³, respectively). The median callus scores for the sham-operated, estrogen-replacement-therapy and Piper sarmentosum groups had median (range, minimum - maximum value) as 1.0 (0 - 2), 1.0 (1 - 2) and 1.0 (1 - 2), respectively, which were significantly lower than the ovariectomized-control group score of 2.0 (2 - 3). The median fracture scores for the sham-operated, estrogen-replacement-therapy and Piper sarmentosum groups were 3.0 (3 - 4), 3.0 (2 - 3) and 3.0 (2 - 3), respectively, which were significantly higher than the ovariectomized-control group score of 2.0 (1 - 2) (pPiper sarmentosum extract improved fracture healing, as assessed by the reduced callus volumes and

  3. Open-wedge high tibial osteotomy: incidence of lateral cortex fractures and influence of fixation device on osteotomy healing.

    Science.gov (United States)

    Dexel, Julian; Fritzsche, Hagen; Beyer, Franziska; Harman, Melinda K; Lützner, Jörg

    2017-03-01

    Open-wedge high tibial osteotomy (HTO) is an established treatment for young and middle-aged patients with medial compartment knee osteoarthritis and varus malalignment. Although not intended, a lateral cortex fracture might occur during this procedure. Different fixation devices are available to repair such fractures. This study was performed to evaluate osteotomy healing after fixation with two different locking plates. Sixty-nine medial open-wedge HTO without bone grafting were followed until osteotomy healing. In patients with an intact lateral hinge, no problems were noted with either locking plate. A fracture of the lateral cortex occurred in 21 patients (30.4 %). In ten patients, the fracture was not recognized during surgery but was visible on the radiographs at the 6-week follow-up. Lateral cortex fracture resulted in non-union with the need for surgical treatment in three out of eight (37.5 %) patients using the newly introduced locking plate (Position HTO Maxi Plate), while this did not occur with a well-established locking plate (TomoFix) (0 out of 13, p = 0.023). With regard to other adverse events, no differences between both implants were observed. In cases of lateral cortex fracture, fixation with a smaller locking plate resulted in a relevant number of non-unions. Therefore, it is recommended that bone grafting, another fixation system, or an additional lateral fixation should be used in cases with lateral cortex fracture. III.

  4. Effect of Pentoxifylline Administration on an Experimental Rat Model of Femur Fracture Healing With Intramedullary Fixation.

    Science.gov (United States)

    Vashghani Farahani, Mohammad Mahdi; Masteri Farahani, Reza; Mostafavinia, Ataroalsadat; Abbasian, Mohammad Reza; Pouriran, Ramin; Noruzian, Mohammad; Ghoreishi, Seyed Kamran; Aryan, Arefe; Bayat, Mohammad

    2015-12-01

    Globally, musculoskeletal injuries comprise a major public health problem that contributes to a large burden of disability and suffering. Pentoxifylline (PTX) has been originally used as a hemorheologic drug to treat intermittent claudication. Previous test tube and in vivo studies reported the beneficial effects of PTX on bony tissue. This study aims to evaluate the effects of different dosages of PTX on biomechanical properties that occur during the late phase of the fracture healing process following a complete femoral osteotomy in a rat model. We applied intramedullary pin fixation as the treatment of choice. This experimental study was conducted at the Shahid Beheshti University of Medical Sciences, Tehran, Iran. We used the simple random technique to divide 35 female rats into five groups. Group 1 received intraperitoneal (i.p.) PTX (50 mg/kg, once daily) injections, starting 15 days before surgery, and group 2, group 3, and group 4 received 50 mg/kg, 100 mg/kg, and 200 mg/kg i.p. PTX injections, respectively, once daily after surgery. All animals across groups received treatment for six weeks (until sacrificed). Complete surgical transverse osteotomy was performed in the right femur of all rats. At six weeks after surgery, the femurs were subjected to a three-point bending test. Daily administration of 50 mg/kg PTX (groups 1 and 2) decreased the high stress load in repairing osteotomized femurs when compared with the control group. The highest dose of PTX (200 mg/kg) significantly increased the high stress load when compared with the control group (P = 0.030), group 1 (P = 0.023), group 2 (P = 0.008), and group 3 (P = 0.010), per the LSD findings. Treatment with 200 mg/kg PTX accelerated fracture healing when compared with the control group.

  5. Effect of 900MHz electromagnetic fields emitted from cellular phones on fracture healing: an experimental study on rats.

    Science.gov (United States)

    Aslan, Ahmet; Atay, Tolga; Gülle, Kanat; Kırdemir, Vecihi; Ozden, Ahmet; Çömlekçi, Selçuk; Aydoğan, Nevres Hürriyet

    2013-01-01

    The aim of this study was to investigate the effect of electromagnetic fields (EMFs) at 900 MHz frequencies on bone fracture healing. The study included 30 adult male Wistar albino rats (average weight: 256 g) divided into two equal groups. Transverse fracture was created manually by pressing a finger on the right tibias of all rats and fractures were fixed intramedullary using a K-wire. Rats in Group 1 were exposed to EMF at 900 MHz frequency 30 minutes a day, 5 days a week for 8 weeks. Group 2, the control group, was kept under the same experimental conditions without EMF exposure. Radiological, mechanical and histological examination of tibial fracture healing was performed. There was a significant difference between radiological, histological and manual biomechanical scores of the study and control groups (p=0.020, p=0.006 and p=0.032, respectively). All scores were lower in the study group than the control group. Results of this study demonstrate that EMF at 900 MHz of frequency emitted from cellular phones has a significantly negative effect on bone fracture healing in a rat tibia model.

  6. Effects of recombinant human basic fibroblast growth factor on cell proliferation during mandibular fracture healing in rabbits

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To investigate the effects of recombinant human basicfibroblast growth factor (rhbFGF) on the cell proliferation during mandibular fracture healing in rabbits.Methods: The complex of rhbFGF and bovine type I collagen was implanted into the mandibular fracture site under periosteum of the animal. The whole mandible was harvested at 7, 14, 28, 56 and 84 days respectively after operation. The expression of proliferating cell nuclear antigen (PCNA) in callus was examined with immunohistochemical staining.Results: PCNA-positive cells in callus in the rhbFGF-treated group on days 7 and 14 were more than that in the control group (P<0.01).Conclusions: It indicates that rhbFGF can stimulate cell proliferation during mandibular fracture healing in rabbits.

  7. Functional outcomes, morbidity, mortality, and fracture healing in 58 consecutive patients with geriatric odontoid fracture treated with cervical collar or posterior fusion.

    Science.gov (United States)

    Molinari, William J; Molinari, Robert W; Khera, Oner A; Gruhn, William L

    2013-03-01

    Controversy exists as to the most effective management option for elderly patients with type II odontoid fractures. The purpose of this study is to evaluate outcomes associated with rigid cervical collar and posterior fusion surgery. Patients with ≥ 50% odontoid displacement were treated with posterior fusion surgery including C1-2 (PSF group, n = 25, average age = 80 years). Patients with cervical collar for 12 weeks (collar group, n = 33, average age = 83 years). These inhomogeneous groups were followed for an average of 14 months. Fracture healing rates were higher in the operative group (28% versus 6%). Neck Disability Index scores were slightly lower in the nonoperative group (13 versus 18.3, p = 0.23). Analogue pain scores were also slightly lower in the nonoperative group (1.3 versus 1.9, p = 0.26). The mortality rate was 12.5% in the collar group and 20% in the operative group. Complications were higher in the operative group (24% versus 6%). Rates of type II odontoid facture healing and stability appear to be higher in geriatric patients treated with posterior fusion surgery. Fracture healing and stability did not correlate with improved outcomes with respect to levels of pain, function, and satisfaction. Mortality and complication rates are lower in those patients with lesser-displaced fractures who are treated with a cervical collar and early mobilization.

  8. The effects of pentoxifylline adminstration on fracture healing in a postmenopausal osteoporotic rat model

    Science.gov (United States)

    Vashghani Farahani, Mohammad Mahdi; Ahadi, Reza; Abdollahifar, Mohammadamin

    2017-01-01

    Previous studies report positive effects of pentoxifylline (PTX) alone or in combination with other drugs on some pathologic bone diseases as well as an ability to accelerate osteogensis and fracture healing in both animal models and human patients. The aim of this present study was to evaluate the effects of PTX administration on Hounsfield unit and bone strength at catabolic response (bone resorbing) of a fracture in an experimental rat model of ovariectomy induced osteoporosis (OVX-D). Thirty adult female rats were divided into groups as follows: 1 (OVX, control, no treatment); 2 (OVX, sham: daily distilled water); 3 (OVX, daily alendronate: 3 mg/kg); 4 (OVX, twice daily 100 mg/kg PTX) and 5 (OVX, PTX+alenderonate). OVX was induced by bilateral ovariectomy in all rats. A complete standardized osteotomy of the right femur was made after 3.5 months. PTX and alendronate treatments were performed for eight weeks. Then, rats were euthanized and had its right femur subjected to computerized tomography scanning for measuring Hounsfield unit; eventually, the samples were sent for a three point bending test for evaluation of the bone strength. Administration of PTX with 200 mg/kg and alendronate alone and in combination showed no significant alteration in Hounsfield unit and biomechanical properties of repairing callus of the complete osteotomy compared with the control group. Results showed increased bending stiffness and stress high load mean values of repairing complete osteotomy in PTX-treated rats compared to the control OVX-D.

  9. Bisphosphonates and the fracture healing and atypical fracture%双膦酸盐与骨折愈合和非典型性骨折

    Institute of Scientific and Technical Information of China (English)

    王雪鹏; 郝永强

    2011-01-01

    Fracture healing is typically characterized by four overlapping stages that include the hematoma and inflammatory response, initial fibrocartilage callus formation, hard callus formation and bone remodeling.The remodeling process is driven by a coupled process of bone resorption and bone formation.The soft callus remodeling and hard callus remodeling are of great importance to fracture healing.Bisphosphonates act to affect fracture healing by intervening callus remodelling, based on its pharmacological action of inhibiting the osteoclast activity and bone turnover level.Long-term use of bisphosphonates does not favor the fracture healing, and has been associated with the possibility of atypical fracture of the femur.%典型的骨折愈合过程包括血肿和炎症反应、原始软骨痂形成、成熟板层骨形成以及骨板重建和塑形等4个时期.骨重建包括骨吸收和骨形成两个方面.软骨痂和硬骨痂重建对骨折愈合具有重要意义.双膦酸盐类药理基础在于抑制破骨细胞活性和骨转化水平,通过干预骨重建对骨折愈合产生影响.长期使用双膦酸盐不利于骨折愈合,有引起股骨非典型性骨折发生的危险.

  10. The effect of bisphosphonates on fracture healing and atypical fracture%双膦酸盐与骨折愈合和非典型性骨折

    Institute of Scientific and Technical Information of China (English)

    王雪鹏; 郝永强

    2011-01-01

    Fracture healing is typically characterized by four overlapping stages, including the hematoma and inflammatory response, initial fibrocartilage callus formation, hard callus formation, and bone remodeling. The remodeling process is driven by a coupled process of orderly bone resorption followed by bone formation. The soft callus remodeling and hard callus remodeling are of great importance to fracture healing. Bisphosphonates act to affect fracture healing by intervening callus remodelling, based on its pharmacological action on inhibiting osteoclast activity and bone turnover levels. The long-term use of bisphosphonates seems to be turning against fracture healing, and has been associated with the possibility of atypical fractures of the femur.%典型的骨折愈合过程包括血肿和炎症反应、原始软骨痂形成、成熟板层骨形成以及骨板重建和塑形等四个时期。骨重建包括骨吸收和骨形成两个方面。软骨痂和硬骨痂重建对骨折愈合具有重要意义。双膦酸盐类药理基础在于抑制破骨细胞活性和骨转化水平,通过干预骨重建对骨折愈合产生影响。长期使用双膦酸盐不利于骨折愈合,有引起股骨非典型性骨折发生的危险。

  11. Cannabidiol, a Major Non-Psychotropic Cannabis Constituent Enhances Fracture Healing and Stimulates Lysyl Hydroxylase Activity in Osteoblasts.

    Science.gov (United States)

    Kogan, Natalya M; Melamed, Eitan; Wasserman, Elad; Raphael, Bitya; Breuer, Aviva; Stok, Kathryn S; Sondergaard, Rachel; Escudero, Ana V Villarreal; Baraghithy, Saja; Attar-Namdar, Malka; Friedlander-Barenboim, Silvina; Mathavan, Neashan; Isaksson, Hanna; Mechoulam, Raphael; Müller, Ralph; Bajayo, Alon; Gabet, Yankel; Bab, Itai

    2015-10-01

    Cannabinoid ligands regulate bone mass, but skeletal effects of cannabis (marijuana and hashish) have not been reported. Bone fractures are highly prevalent, involving prolonged immobilization and discomfort. Here we report that the major non-psychoactive cannabis constituent, cannabidiol (CBD), enhances the biomechanical properties of healing rat mid-femoral fractures. The maximal load and work-to-failure, but not the stiffness, of femurs from rats given a mixture of CBD and Δ(9) -tetrahydrocannabinol (THC) for 8 weeks were markedly increased by CBD. This effect is not shared by THC (the psychoactive component of cannabis), but THC potentiates the CBD stimulated work-to-failure at 6 weeks postfracture followed by attenuation of the CBD effect at 8 weeks. Using micro-computed tomography (μCT), the fracture callus size was transiently reduced by either CBD or THC 4 weeks after fracture but reached control level after 6 and 8 weeks. The callus material density was unaffected by CBD and/or THC. By contrast, CBD stimulated mRNA expression of Plod1 in primary osteoblast cultures, encoding an enzyme that catalyzes lysine hydroxylation, which is in turn involved in collagen crosslinking and stabilization. Using Fourier transform infrared (FTIR) spectroscopy we confirmed the increase in collagen crosslink ratio by CBD, which is likely to contribute to the improved biomechanical properties of the fracture callus. Taken together, these data show that CBD leads to improvement in fracture healing and demonstrate the critical mechanical role of collagen crosslinking enzymes.

  12. Impaired angiogenesis during fracture healing in GPCR kinase 2 interacting protein-1 (GIT1 knock out mice.

    Directory of Open Access Journals (Sweden)

    Guoyong Yin

    Full Text Available G protein coupled receptor kinase 2 (GRK2 interacting protein-1 (GIT1, is a scaffold protein that plays an important role in angiogenesis and osteoclast activity. We have previously demonstrated that GIT1 knockout (GIT1 KO mice have impaired angiogenesis and dysregulated osteoclast podosome formation leading to a reduction in the bone resorbing ability of these cells. Since both angiogenesis and osteoclast-mediated bone remodeling are involved in the fracture healing process, we hypothesized that GIT1 participates in the normal progression of repair following bone injury. In the present study, comparison of fracture healing in wild type (WT and GIT1 KO mice revealed altered healing in mice with loss of GIT1 function. Alcian blue staining of fracture callus indicated a persistence of cartilagenous matrix in day 21 callus samples from GIT1 KO mice which was temporally correlated with increased type 2 collagen immunostaining. GIT1 KO mice also showed a decrease in chondrocyte proliferation and apoptosis at days 7 and 14, as determined by PCNA and TUNEL staining. Vascular microcomputed tomography analysis of callus samples at days 7, 14 and 21 revealed decreased blood vessel volume, number, and connection density in GIT1 KO mice compared to WT controls. Correlating with this, VEGF-A, phospho-VEGFR2 and PECAM1 (CD31 were decreased in GIT1 KO mice, indicating reduced angiogenesis with loss of GIT1. Finally, calluses from GIT1 KO mice displayed a reduced number of tartrate resistant acid phosphatase-positive osteoclasts at days 14 and 21. Collectively, these results indicate that GIT1 is an important signaling participant in fracture healing, with gene ablation leading to reduced callus vascularity and reduced osteoclast number in the healing callus.

  13. Characterising rock fracture aperture-spacing relationships using power-law relationships: some considerations

    Science.gov (United States)

    Brook, Martin; Hebblewhite, Bruce; Mitra, Rudrajit

    2016-04-01

    The size-scaling of rock fractures is a well-studied problem in geology, especially for permeability quantification. The intensity of fractures may control the economic exploitation of fractured reservoirs because fracture intensity describes the abundance of fractures potentially available for fluid flow. Moreover, in geotechnical engineering, fractures are important for parameterisation of stress models and excavation design. As fracture data is often collected from widely-spaced boreholes where core recovery is often incomplete, accurate interpretation and representation of fracture aperture-frequency relationships from sparse datasets is important. Fracture intensity is the number of fractures encountered per unit length along a sample scanline oriented perpendicular to the fractures in a set. Cumulative frequency of fractures (F) is commonly related to fracture aperture (A) in the form of a power-law (F = aA-b), with variations in the size of the a coefficient between sites interpreted to equate to fracture frequency for a given aperture (A). However, a common flaw in this approach is that even a small change in b can have a large effect on the response of the fracture frequency (F) parameter. We compare fracture data from the Late Permian Rangal Coal Measures from Australia's Bowen Basin, with fracture data from Jurassic carbonates from the Sierra Madre Oriental, northeastern Mexico. Both power-law coefficient a and exponent b control the fracture aperture-frequency relationship in conjunction with each other; that is, power-laws with relatively low a coefficients have relatively high b exponents and vice versa. Hence, any comparison of different power-laws must take both a and b into consideration. The corollary is that different sedimentary beds in the Sierra Madre carbonates do not show ˜8× the fracture frequency for a given fracture aperture, as based solely on the comparison of coefficient a. Rather, power-law "sensitivity factors" developed from both

  14. Effect of fluvastatin on vascular endothelial growth factor in rats with osteoporosis in process of fracture healing

    Institute of Scientific and Technical Information of China (English)

    YANG Mao-wei; ZHU Yue; TU Guan-jun; L(U) Gang

    2007-01-01

    Objective: To explore the effect of fluvastatin on vascular endothelial growth factor (VEGF) in rats with osteoporosis in the process of fracture healing.Methods: Fractures at the intermediate piece of the femur were made on 72 Sprague Dawley (SD) rats (weighing initially 290-340 g and aged 6 months ) with osteoporosis after ovariectomy for three months, then these rats were divided randomly into the medication administration group (the experimental group ) and the control group, 36 rats each. In the experimental group, the rats received fluvastatin lavage (10 mg/kg per day) since the next day of operation lasting for 6 weeks, and the rats in the control group received placebo. Then the expression of VEGF and VEGF mRNA in bony callus of the two groups was measured respectively with immunohistochemistry and in situ hybridization on days of 3rd, 7th, 14th, 21st, 28th, and 42nd, and image analysis was made with real-color image analysis machine.Results: No difference was found in the cellular localization of VEGF and VEGF mRNA gene expression between the experimental group and the control group in process of fracture healing and their expression modes were almost similar. On the 14th day postoperatively, the positive extent of positive cells in the experimental group was higher than that of the control group (P < 0.05).Conclusion: Fluvastatin can promote the VEGF level in rats with osteoporosis in process of fracture healing.

  15. Spontaneous isolated midtrimester fracture of tibia and fibula in a normal fetus with in utero healing and good long-term outcome.

    Science.gov (United States)

    Scheier, M; Peter, M; Hager, C; Lang, T; Barvinek, A; Marth, C

    2010-01-01

    We report a case of spontaneous intrauterine fracture of the right tibia and fibula in an otherwise healthy fetus at 20 weeks of gestation. The fracture healed in utero in an abnormal position. Postnatal development of the baby was normal with spontaneous correction of the angulation, and no underlying disease could be discovered. Spontaneous isolated fetal fractures are rare and need to be differentiated from fractures that occur due to trauma or underlying skeletal diseases.

  16. A study of radiological features of healing in long bone fractures among infants less than a year

    Energy Technology Data Exchange (ETDEWEB)

    Warner, Christopher; Miller, Angie; Weinman, Jason; Fadell, Michael [Children' s Hospital Colorado, Department of Radiology, Aurora, CO (United States); Maguire, Sabine; Trefan, Laszlo [Cardiff University, Institute of Primary Care and Child Health, Cardiff (United Kingdom)

    2017-03-15

    To create a timetable for dating long bone fractures in infants aged less than 1 year using previously defined radiographic signs of fracture healing. A retrospective cross-sectional time series of long bone fractures in infants aged less than 1 year was conducted from 2006 to 2013. After exclusion criteria were applied 59 digital image series were available for review from 40 infants. Utilizing published criteria for dating fractures, the presence or absence of four pre-defined features of healing was scored: periosteal reaction, callus, bridging, and remodeling. Three radiologists independently scored radiographs with a 3-point scale, marking each feature as present, absent, or equivocal. The times in days when features were first seen, peaked (feature agreed present in >40% of images), and last seen were noted. Statistical analysis using free marginal kappa was conducted. The level of agreement among the three radiologists was high (0.64-0.85). The sequence in which the features were seen was: periosteal reaction range 7-130 (present in the majority of cases between 9 and 49 days); callus range 9-130 (present in the majority of cases between days 9-26); bridging range 15-130 (seen in the majority of cases between 15 and 67 days); remodeling range 51-247 days. This study provides a timetable of radiological features of long bone healing among young infants for the first time. Dating of incomplete long bone fractures is challenging, beyond the presence of periosteal reaction, but a consistent sequence of changes is present in complete fractures. (orig.)

  17. Does Anticoagulant Medication Alter Fracture-Healing? A Morphological and Biomechanical Evaluation of the Possible Effects of Rivaroxaban and Enoxaparin Using a Rat Closed Fracture Model.

    Directory of Open Access Journals (Sweden)

    Peter Michael Prodinger

    Full Text Available Low molecular weight heparin (LMWH is routinely used to prevent thromboembolism in orthopaedic surgery, especially in the treatment of fractures or after joint-replacement. Impairment of fracture-healing due to increased bone-desorption, delayed remodelling and lower calcification caused by direct osteoclast stimulation is a well-known side effect of unfractioned heparin. However, the effect of LMWH is unclear and controversial. Recent studies strongly suggest impairment of bone-healing in-vitro and in animal models, characterized by a significant decrease in volume and quality of new-formed callus. Since October 2008, Rivaroxaban (Xarelto is available for prophylactic use in elective knee- and hip-arthroplasty. Recently, some evidence has been found indicating an in vitro dose independent reduction of osteoblast function after Rivaroxaban treatment. In this study, the possible influence of Rivaroxaban and Enoxaparin on bone-healing in vivo was studied using a standardized, closed rodent fracture-model. 70 male Wistar-rats were randomized to Rivaroxaban, Enoxaparin or control groups. After pinning the right femur, a closed, transverse fracture was produced. 21 days later, the animals were sacrificed and both femora harvested. Analysis was done by biomechanical testing (three-point bending and micro CT. Both investigated substances showed histomorphometric alterations of the newly formed callus assessed by micro CT analysis. In detail the bone (callus volume was enhanced (sign. for Rivaroxaban and the density reduced. The bone mineral content was enhanced accordingly (sign. for Rivaroxaban. Trabecular thickness was reduced (sign. for Rivaroxaban. Furthermore, both drugs showed significant enlarged bone (callus surface and degree of anisotropy. In contrast, the biomechanical properties of the treated bones were equal to controls. To summarize, the morphological alterations of the fracture-callus did not result in functionally relevant deficits.

  18. Does Anticoagulant Medication Alter Fracture-Healing? A Morphological and Biomechanical Evaluation of the Possible Effects of Rivaroxaban and Enoxaparin Using a Rat Closed Fracture Model

    Science.gov (United States)

    Prodinger, Peter Michael; Burgkart, Rainer; Kreutzer, Kilian; Liska, Franz; Pilge, Hakan; Schmitt, Andreas; Knödler, Martina; Holzapfel, Boris Michael; Hapfelmeier, Alexander; Tischer, Thomas; Bissinger, Oliver

    2016-01-01

    Low molecular weight heparin (LMWH) is routinely used to prevent thromboembolism in orthopaedic surgery, especially in the treatment of fractures or after joint-replacement. Impairment of fracture-healing due to increased bone-desorption, delayed remodelling and lower calcification caused by direct osteoclast stimulation is a well-known side effect of unfractioned heparin. However, the effect of LMWH is unclear and controversial. Recent studies strongly suggest impairment of bone-healing in-vitro and in animal models, characterized by a significant decrease in volume and quality of new-formed callus. Since October 2008, Rivaroxaban (Xarelto) is available for prophylactic use in elective knee- and hip-arthroplasty. Recently, some evidence has been found indicating an in vitro dose independent reduction of osteoblast function after Rivaroxaban treatment. In this study, the possible influence of Rivaroxaban and Enoxaparin on bone-healing in vivo was studied using a standardized, closed rodent fracture-model. 70 male Wistar-rats were randomized to Rivaroxaban, Enoxaparin or control groups. After pinning the right femur, a closed, transverse fracture was produced. 21 days later, the animals were sacrificed and both femora harvested. Analysis was done by biomechanical testing (three-point bending) and micro CT. Both investigated substances showed histomorphometric alterations of the newly formed callus assessed by micro CT analysis. In detail the bone (callus) volume was enhanced (sign. for Rivaroxaban) and the density reduced. The bone mineral content was enhanced accordingly (sign. for Rivaroxaban). Trabecular thickness was reduced (sign. for Rivaroxaban). Furthermore, both drugs showed significant enlarged bone (callus) surface and degree of anisotropy. In contrast, the biomechanical properties of the treated bones were equal to controls. To summarize, the morphological alterations of the fracture-callus did not result in functionally relevant deficits. PMID:27455072

  19. Relationship between serum adhesion molecules, trace elements and delayed union of tibial and fibula fractures

    Institute of Scientific and Technical Information of China (English)

    Xian-Yu Yan; Zhi-Bang Zhao; Wen-Liang Fan; Qing-Bo Zhu; Ya-Chang Xing

    2017-01-01

    Objective:To investigate the relationship between serum adhesion molecules, trace elements and delayed union of tibial and fibula fractures.Methods:A total of 46 patients with delayed union of tibial and fibula fractures in our hospital from May 2014 to June 2016 were selected as the observation group, 46 patients with normal healing of tibial and fibula fractures were selected as the control group, then the serum adhesion molecules and trace elements levels of two groups at forth, eighth and sixteenth week after the surgery were compared.Results:The serum dhesion molecules levels of observation group at forth, eighth and sixteenth week after the surgery were all higher than those of control group, the serum trace elements levels were all lower than those of control group, and the serum adhesion molecules levels of two groups at eighth week after the surgery were all higher than those at other time, the trace elements levels were all lower than those at other time (allP<0.05).Conclusions:The serum adhesion molecules and trace elements of patients with delayed union of tibial and fibula fractures show obviously abnormal state, so those indexes of those patients should be paid to more monitoring and improvement.

  20. The role of social relationship in HIV healing and its implications in HIV cure in China

    Science.gov (United States)

    Qiao, Shan; Nie, Jing-Bao; Tucker, Joseph; Rennie, Stuart; Li, Xiao-Ming

    2016-01-01

    HIV is both a biomedical disease and a social phenomenon that is constructed in particular cultural contexts. A successful and humane HIV cure requires not only the science of eradicating pathogens, but also the art of healing to restore harmony between mind and body. Healing in the context of HIV cure will be both personal and interpersonal, biological and social, and will involve rebuilding connections between HIV patients and their social environment. Social conceptions of healing have been highlighted in many regions with rich non-biomedical healing traditions, including China. Based on an adapted theoretical model on social relationships and health, we address the essential role of social relations for HIV healing in Chinese cultural context, and propose several recommendations for reforming practices and policies regarding HIV healing. In general, family is still a core social unit in HIV patients’ medical journey from diagnosis to treatment. A positive patient–physician relationship based on mutual respect and trust also has critical impact on patients’ physical and mental health. Physicians may become a key or the main source of social support in circumstances when families are not actively engaged in healing. Reconnecting HIV patients with their communities should be a necessary component of HIV cure, as this will help patients engage more fully in the HIV healing process. We call for a family-centered approach in HIV healing intervention to strengthen patient–family ties; a series of policies to build up and sustain positive patient–physician ties; and multi-level strategies to empower patients and rebuild their bonds to community and larger society. We also call for more empirical research on how non-biomedical healing approaches in various cultural settings could (directly or indirectly) inform HIV cure research. PMID:27042386

  1. Immediate versus delayed intramedullary nailing for open fractures of the tibial shaft: A multivariate analysis of factors affecting deep infection and fracture healing

    Directory of Open Access Journals (Sweden)

    Yokoyama Kazuhiko

    2008-01-01

    Full Text Available Background: The purpose of this study was to evaluate contributing factors affecting deep infection and fracture healing of open tibia fractures treated with locked intramedullary nailing (IMN by multivariate analysis. Materials and Methods: We examined 99 open tibial fractures (98 patients treated with immediate or delayed locked IMN in static fashion from 1991 to 2002. Multivariate analyses following univariate analyses were derived to determine predictors of deep infection, nonunion, and healing time to union. The following predictive variables of deep infection were selected for analysis: age, sex, Gustilo type, fracture grade by AO type, fracture location, timing or method of IMN, reamed or unreamed nailing, debridement time (≤6 h or> 6 h, method of soft-tissue management, skin closure time (≤1 week or> 1 week, existence of polytrauma (ISS< 18 or ISS≥18, existence of floating knee injury, and existence of superficial/pin site infection. The predictive variables of nonunion selected for analysis was the same as those for deep infection, with the addition of deep infection for exchange of pin site infection. The predictive variables of union time selected for analysis was the same as those for nonunion, excluding of location, debridement time, and existence of floating knee and superficial infection. Results: Six (6.1%; type II Gustilo n=1, type IIIB Gustilo n=5 of the 99 open tibial fractures developed deep infections. Multivariate analysis revealed that timing or method of IMN, debridement time, method of soft-tissue management, and existence of superficial or pin site infection significantly correlated with the occurrence of deep infection ( P < 0.0001. In the immediate nailing group alone, the deep infection rate in type IIIB + IIIC was significantly higher than those in type I + II and IIIA ( P = 0.016. Nonunion occurred in 17 fractures (20.3%, 17/84. Multivariate analysis revealed that Gustilo type, skin closure time, and

  2. A cohesive elements based model to describe fracture and cohesive healing in elastomers

    NARCIS (Netherlands)

    Baldi, A.; Grande, A.M.; Bose, R.K.; Airoldi, A.; Garcia Espallargas, S.J.; Di Landro, L.; Van der Zwaag, S.

    2013-01-01

    Several polymeric systems with intrinsic Self-Healing (SH) capabilities have been reported in literature. Many of them showed healing upon contact across the crack interface. Different parameters such as contact time, temperature, pressure or chemical activity determine the degree of healing obtaine

  3. Upregulation of inflammatory genes and downregulation of sclerostin gene expression are key elements in the early phase of fragility fracture healing.

    Directory of Open Access Journals (Sweden)

    Joana Caetano-Lopes

    Full Text Available BACKGROUND: Fracture healing is orchestrated by a specific set of events that culminates in the repair of bone and reachievement of its biomechanical properties. The aim of our work was to study the sequence of gene expression events involved in inflammation and bone remodeling occurring in the early phases of callus formation in osteoporotic patients. METHODOLOGY/PRINCIPAL FINDINGS: Fifty-six patients submitted to hip replacement surgery after a low-energy hip fracture were enrolled in this study. The patients were grouped according to the time interval between fracture and surgery: bone collected within 3 days after fracture (n = 13; between the 4(th and 7(th day (n = 33; and after one week from the fracture (n = 10. Inflammation- and bone metabolism-related genes were assessed at the fracture site. The expression of pro-inflammatory cytokines was increased in the first days after fracture. The genes responsible for bone formation and resorption were upregulated one week after fracture. The increase in RANKL expression occurred just before that, between the 4(th-7(th days after fracture. Sclerostin expression diminished during the first days after fracture. CONCLUSIONS: The expression of inflammation-related genes, especially IL-6, is highest at the very first days after fracture but from day 4 onwards there is a shift towards bone remodeling genes, suggesting that the inflammatory phase triggers bone healing. We propose that an initial inflammatory stimulus and a decrease in sclerostin-related effects are the key components in fracture healing. In osteoporotic patients, cellular machinery seems to adequately react to the inflammatory stimulus, therefore local promotion of these events might constitute a promising medical intervention to accelerate fracture healing.

  4. SDF-1/CXCR4 axis in Tie2-lineage cells including endothelial progenitor cells contributes to bone fracture healing.

    Science.gov (United States)

    Kawakami, Yohei; Ii, Masaaki; Matsumoto, Tomoyuki; Kuroda, Ryosuke; Kuroda, Tomoya; Kwon, Sang-Mo; Kawamoto, Atsuhiko; Akimaru, Hiroshi; Mifune, Yutaka; Shoji, Taro; Fukui, Tomoaki; Kurosaka, Masahiro; Asahara, Takayuki

    2015-01-01

    CXC chemokine receptor 4 (CXCR4) is a specific receptor for stromal-derived-factor 1 (SDF-1). SDF-1/CXCR4 interaction is reported to play an important role in vascular development. On the other hand, the therapeutic potential of endothelial progenitor cells (EPCs) in fracture healing has been demonstrated with mechanistic insight of vasculogenesis/angiogenesis and osteogenesis enhancement at sites of fracture. The purpose of this study was to investigate the influence of the SDF-1/CXCR4 pathway in Tie2-lineage cells (including EPCs) in bone formation. We created CXCR4 gene conditional knockout mice using the Cre/loxP system and set two groups of mice: Tie2-Cre(ER) CXCR4 knockout mice (CXCR4(-/-) ) and wild-type mice (WT). We report here that in vitro, EPCs derived from of CXCR4(-/-) mouse bone marrow demonstrated severe reduction of migration activity and EPC colony-forming activity when compared with those derived from WT mouse bone marrow. In vivo, radiological and morphological examinations showed fracture healing delayed in the CXCR4(-/-) group and the relative callus area at weeks 2 and 3 was significantly smaller in CXCR4(-/-) group mice. Quantitative analysis of capillary density at perifracture sites also showed a significant decrease in the CXCR4(-/-) group. Especially, CXCR4(-/-) group mice demonstrated significant early reduction of blood flow recovery at fracture sites compared with the WT group in laser Doppler perfusion imaging analysis. Real-time RT-PCR analysis showed that the gene expressions of angiogenic markers (CD31, VE-cadherin, vascular endothelial growth factor [VEGF]) and osteogenic markers (osteocalcin, collagen 1A1, bone morphogenetic protein 2 [BMP2]) were lower in the CXCR4(-/-) group. In the gain-of-function study, the fracture in the SDF-1 intraperitoneally injected WT group healed significantly faster with enough callus formation compared with the SDF-1 injected CXCR4(-/-) group. We demonstrated that an EPC SDF-1/CXCR4 axis plays an

  5. Insights on the fractal-fracture behaviour relationship

    Directory of Open Access Journals (Sweden)

    Rodrigues José de Anchieta

    1998-01-01

    Full Text Available The fractals theory has been increasingly applied in the field of materials science and engineering. Models of fractal lines and surfaces have been generated to describe the microstructural features of materials. Special interest is placed upon a description of the fracture surface based on a fractal geometry in order to understand the crack path in materials. Several papers have demonstrated the relationship between the fractal dimension of a fracture surface and the values of roughness and fracture toughness. In this work an extension of the theory of fractals for ceramic materials is proposed, to which the crack deflection toughening mechanism is thought to be related. In order to accomplish this objective, a review describing the concept of fractals and its relationship with the fracture toughness is presented. In the following part, a correlation between fractal dimension, total energy of fracture and the average resistance to crack propagation is proposed; all these parameters being dependent on the history and on the complexity of crack propagation path.

  6. Chondrocytes transdifferentiate into osteoblasts in endochondral bone during development, postnatal growth and fracture healing in mice.

    Science.gov (United States)

    Zhou, Xin; von der Mark, Klaus; Henry, Stephen; Norton, William; Adams, Henry; de Crombrugghe, Benoit

    2014-12-01

    One of the crucial steps in endochondral bone formation is the replacement of a cartilage matrix produced by chondrocytes with bone trabeculae made by osteoblasts. However, the precise sources of osteoblasts responsible for trabecular bone formation have not been fully defined. To investigate whether cells derived from hypertrophic chondrocytes contribute to the osteoblast pool in trabecular bones, we genetically labeled either hypertrophic chondrocytes by Col10a1-Cre or chondrocytes by tamoxifen-induced Agc1-CreERT2 using EGFP, LacZ or Tomato expression. Both Cre drivers were specifically active in chondrocytic cells and not in perichondrium, in periosteum or in any of the osteoblast lineage cells. These in vivo experiments allowed us to follow the fate of cells labeled in Col10a1-Cre or Agc1-CreERT2 -expressing chondrocytes. After the labeling of chondrocytes, both during prenatal development and after birth, abundant labeled non-chondrocytic cells were present in the primary spongiosa. These cells were distributed throughout trabeculae surfaces and later were present in the endosteum, and embedded within the bone matrix. Co-expression studies using osteoblast markers indicated that a proportion of the non-chondrocytic cells derived from chondrocytes labeled by Col10a1-Cre or by Agc1-CreERT2 were functional osteoblasts. Hence, our results show that both chondrocytes prior to initial ossification and growth plate chondrocytes before or after birth have the capacity to undergo transdifferentiation to become osteoblasts. The osteoblasts derived from Col10a1-expressing hypertrophic chondrocytes represent about sixty percent of all mature osteoblasts in endochondral bones of one month old mice. A similar process of chondrocyte to osteoblast transdifferentiation was involved during bone fracture healing in adult mice. Thus, in addition to cells in the periosteum chondrocytes represent a major source of osteoblasts contributing to endochondral bone formation in vivo.

  7. Multi-factors analysis on the healing of open fracture of tibia and fibula%影响胫腓骨开放性骨折愈合的多因素分析

    Institute of Scientific and Technical Information of China (English)

    赵国平; 苏伟; 赵劲民; 唐建东; 秦汉兴

    2012-01-01

    [Objective] To discuss the main factors affecting the healing of open fracture of tibia and fibula. [ Method ] Retrospective analysis of our hospital from May 2005 to February 201031 cases of treated open fractures of tibia and fibula information were gathered. Univariate logistic regression analysis were used including patients age,sex,cause of injury,associated injuries, fractures of other limbs,fracture type,the time from injury to debridement,fixation,the timing of the soft tissue closure, and the application of VSD etc. Above 10 factors were analyzed on the relationship to the healing rate. The binary logistic regression analysis of multiple factors was carried out. [ Result ] Univariate logistic regression revealed that causes of injury, fracture type, the time from injury to debridement, and the timing of the soft tissue closure were correlated with the healing rate of open fracture of tibia and fibula. Logistic regression analysis of multiple factors revealed that causes of injury, fracture type and the timing of the soft tissue closure were associated independently with the healing of open fracture of tibia and fibula, while the other factors were not statistically significant. [ Conclusion ] High-energy injuries is the risk factor of affecting healing of open fracture of tibia and fibula. There is a connection between the type and severity of fracture to the healing rate of open fractures of tibia and fibula. Early repair of soft tissue does have a benefit in the healing of open fractures of tibia and fibula.%[目的]探讨影响胫腓骨开放性骨折愈合的主要因素.[方法]回顾性分析本院从2005年5月~2010年2月5年间收治的81例胫腓骨开放性骨折的病历资料.采用单因素分析患者年龄、性别、致伤原因、合并伤、骨折肢别、骨折分型、从受伤至开始清创的时间、固定方式、软组织修复时机、VSD的应用等10项因素与骨折愈合率的关系,对以上有意义的因素进行二

  8. Time course of 25(OHD3 vitamin D3 as well as PTH (parathyroid hormone during fracture healing of patients with normal and low bone mineral density (BMD

    Directory of Open Access Journals (Sweden)

    Wöfl Christoph

    2013-01-01

    Full Text Available Abstract Background Until now the exact biochemical processes during healing of metaphyseal fractures of healthy and osteoporotic bone remain unclear. Especially the physiological time courses of 25(OHD3 (Vitamin D as well as PTH (Parathyroid Hormone the most important modulators of calcium and bone homeostasis are not yet examined sufficiently. The purpose of this study was to focus on the time course of these parameters during fracture healing. Methods In the presented study, we analyse the time course of 25(OHD3 and PTH during fracture healing of low BMD level fractures versus normal BMD level fractures in a matched pair analysis. Between March 2007 and February 2009 30 patients older than 50 years of age who had suffered a metaphyseal fracture of the proximal humerus, the distal radius or the proximal femur were included in our study. Osteoporosis was verified by DEXA measuring. The time courses of 25(OHD3 and PTH were examined over an eight week period. Friedmann test, the Wilcoxon signed rank test and the Mann-Withney U test were used as post-hoc tests. A p-value ≤ 0.05 was considered significant. Results Serum levels of 25(OHD3 showed no differences in both groups. In the first phase of fracture healing PTH levels in the low BMD level group remained below those of the normal BMD group in absolute figures. Over all no significant differences between low BMD level bone and normal BMD level bone could be detected in our study. Conclusions The time course of 25(OHD3 and PTH during fracture healing of patients with normal and low bone mineral density were examined for the first time in humans in this setting and allowing molecular biological insights into fracture healing in metaphyseal bones on a molecural level. There were no significant differences between patients with normal and low BMD levels. Hence further studies will be necessary to obtain more detailed insight into fracture healing in order to provide reliable decision criteria for

  9. Interaction of age and mechanical stability on bone defect healing: an early transcriptional analysis of fracture hematoma in rat.

    Directory of Open Access Journals (Sweden)

    Andrea Ode

    Full Text Available Among other stressors, age and mechanical constraints significantly influence regeneration cascades in bone healing. Here, our aim was to identify genes and, through their functional annotation, related biological processes that are influenced by an interaction between the effects of mechanical fixation stability and age. Therefore, at day three post-osteotomy, chip-based whole-genome gene expression analyses of fracture hematoma tissue were performed for four groups of Sprague-Dawley rats with a 1.5-mm osteotomy gap in the femora with varying age (12 vs. 52 weeks - biologically challenging and external fixator stiffness (mechanically challenging. From 31099 analysed genes, 1103 genes were differentially expressed between the six possible combinations of the four groups and from those 144 genes were identified as statistically significantly influenced by the interaction between age and fixation stability. Functional annotation of these differentially expressed genes revealed an association with extracellular space, cell migration or vasculature development. The chip-based whole-genome gene expression data was validated by q-RT-PCR at days three and seven post-osteotomy for MMP-9 and MMP-13, members of the mechanosensitive matrix metalloproteinase family and key players in cell migration and angiogenesis. Furthermore, we observed an interaction of age and mechanical stimuli in vitro on cell migration of mesenchymal stromal cells. These cells are a subpopulation of the fracture hematoma and are known to be key players in bone regeneration. In summary, these data correspond to and might explain our previously described biomechanical healing outcome after six weeks in response to fixation stiffness variation. In conclusion, our data highlight the importance of analysing the influence of risk factors of fracture healing (e.g. advanced age, suboptimal fixator stability in combination rather than alone.

  10. The use of {sup 18}F-fluoride and {sup 18}F-FDG PET scans to assess fracture healing in a rat femur model

    Energy Technology Data Exchange (ETDEWEB)

    Hsu, W.K.; Feeley, B.T.; Krenek, L.; Stout, D.B.; Chatziioannou, A.F. [David Geffen School of Medicine at UCLA, Center for Health Sciences, Department of Orthopaedic Surgery, Los Angeles, CA (United States); Lieberman, J.R. [University of Connecticut Health Center, The Musculoskeletal Institute, Department of Orthopaedic Surgery, Farmington, CT (United States)

    2007-08-15

    Currently available diagnostic techniques can be unreliable in the diagnosis of delayed fracture healing in certain clinical situations, which can lead to increased complication rates and costs to the health care system. This study sought to determine the utility of positron emission tomography (PET) scanning with {sup 18}F-fluoride ion, which localizes in regions of high osteoblastic activity, and {sup 18}F-fluorodeoxyglucose (FDG), an indicator of cellular glucose metabolism, in assessing bone healing in a rat femur fracture model. Fractures were created in the femurs of immunocompetent rats. Animals in group I had a fracture produced via a manual three-point bending technique. Group II animals underwent a femoral osteotomy with placement of a 2-mm silastic spacer at the fracture site. Fracture healing was assessed with plain radiographs, {sup 18}F-fluoride, and {sup 18}F-FDG PET scans at 1, 2, 3, and 4-week time points after surgery. Femoral specimens were harvested for histologic analysis and manual testing of torsional and bending strength 4 weeks after surgery. All fractures in group I revealed abundant callus formation and bone healing, while none of the nonunion femurs were healed via assessment with manual palpation, radiographic, and histologic evaluation at the 4-week time point. {sup 18}F-fluoride PET images of group I femurs at successive 1-week intervals revealed progressively increased signal uptake at the union site during fracture repair. In contrast, minimal tracer uptake was seen at the fracture sites in group II at all time points after surgery. Data analysis revealed statistically significant differences in mean signal intensity between groups I and II at each weekly interval. No significant differences between the two groups were seen using {sup 18}F-FDG PET imaging at any time point. This study suggests that {sup 18}F-fluoride PET imaging, which is an indicator of osteoblastic activity in vivo, can identify fracture nonunions at an early time

  11. Effect of safflower injection on lower limb fracture healing as well as blood viscosity and blood coagulation function

    Institute of Scientific and Technical Information of China (English)

    Ya-Zhong Wang; Yun Wen

    2016-01-01

    Objective:To analyze the effect of safflower injection on lower limb fracture healing as well as blood viscosity and blood coagulation function.Methods: A total of 118 patients with fracture of lower limb were randomly divided into observation group and control group (n=59), control group received conventional surgical treatment, observation group received surgery + postoperative safflower injection treatment, and then differences in serum content of bone turnover indexes and bone metabolism indexes as well as levels of thrombelastogram parameters and blood coagulation function indexes were compared between two groups after 1 month of treatment.Results:Bone turnover indexes sBAP, PINP and BGP content in serum of observation group after 1 month of treatment were higher than those of control group while sCTX, sTAP and TRAP-5b content were lower than those of control group; bone metabolism indexes Ca2+ and 25-OH-VitD content in serum were higher than those of control group while P, PTH andβ-CTX content were lower than those of control group; thrombelastogram parameters R time and K time were longer than those of control group while MA value, G value and angle level were lower than those of control group; blood coagulation function indexes PLT, FIB and D-D content in serum were lower than those of control group while PT, APTT and TT levels were higher than those of control group.Conclusions:Safflower injection can promote postoperative fracture end healing in patients with fracture of lower limb, and also plays a positive role in reducing blood viscosity and optimizing blood coagulation function.

  12. Evaluating petrophysical relationships in fractured rock using geophysical measurements

    Science.gov (United States)

    Robinson, J.; Slater, L. D.; Keating, K.; Parker, B. L.; Rose, C.; Meyer, J. R.; Johnson, C. D.; Robinson, T.; Pehme, P.; Chapman, S.; Day-Lewis, F. D.

    2015-12-01

    Quantification of the pore geometric properties controlling mass transfer rates in fractured rock aquifers is a challenging characterization problem, especially given the scales of heterogeneity. The efficiency of in-situ remediation efforts that target hydraulically connected and dead-end fracture zones is limited, in part, due to the diffusion of aqueous phase contaminants into and out of the less-mobile pore spaces in the matrix surrounding fractures. Two geophysical technologies, complex resistivity (CR) and nuclear magnetic resonance (NMR) are sensitive to pore geometry and may provide key information on transport parameters where diffusion can be a limiting factor in and around boreholes. We present laboratory CR and NMR data from cores collected from field sites with variable lithologies and examine the sensitivity of these measurements to less-mobile versus mobile porosity. Supporting data include surface area measurements using the Brunauer-Emmett-Teller (BET) method, pore size distributions from mercury porosimetry, gravimetric measurements of matrix total porosity and gas permeability. We examine the predictive capability of CR and NMR to determine these pore scale properties as a function of geological setting. The petrophysical relationships illustrate the potential for use of new borehole logging tools to determine the spatial variability of physical properties controlling mass transfer close to fractures. The correlations of measurements to rock-type specific relations indicate that minimal core measurements might be needed to calibrate the results to a specific site.

  13. [Advancement in methods of evaluation on bone fracture healing and its application in forensic medicine].

    Science.gov (United States)

    Li, Yu-fei

    2011-02-01

    It is frequently encountered to identify the time of bone fracture in forensic medicine. Hence it is important to develop the methods for evaluating the time of bone fracture. This article reviews the applications and values of the methods such as ultrasonic evaluation, impulse measurement, digital imaging technology and bone mineral density testing technology, etc. It is proposed that to use these methods jointly may provide more scientific evidence in determine the time of bone fracture.

  14. Demineralized Bone Matrix Add-On for Acceleration of Bone Healing in Atypical Subtrochanteric Femoral Fracture: A Consecutive Case-Control Study

    Directory of Open Access Journals (Sweden)

    Noratep Kulachote

    2016-01-01

    Full Text Available Background. Delayed union and nonunion are common complications in atypical femoral fractures (AFFs despite having good fracture fixation. Demineralized bone matrix (DBM is a successfully proven method for enhancing fracture healing of the long bone fracture and nonunion and should be used in AFFs. This study aimed to compare the outcome after subtrochanteric AFFs (ST-AFFs fixation with and without DBM. Materials and Methods. A prospective study was conducted on 9 ST-AFFs patients using DBM (DBM group during 2013-2014 and compared with a retrospective consecutive case series of ST-AFFs patients treated without DBM (2010–2012 (NDBM group, 9 patients. All patients were treated with the same standard guideline and followed up until fractures completely united. Postoperative outcomes were then compared. Results. DBM group showed a significant shorter healing time than NDBM group (28.1 ± 14.4 versus 57.9 ± 36.8 weeks, p=0.04. Delayed union was found in 4 patients (44% in DBM group compared with 7 patients (78% in NDBM group (p>0.05. No statistical difference of nonunion was demonstrated between both groups (DBM = 1 and NDBM = 2, p>0.05. Neither postoperative infection nor severe local tissue reaction was found. Conclusions. DBM is safe and effective for accelerating the fracture healing in ST-AFFx and possibly reduces nonunion after fracture fixation. Trial registration number is TCTR20151021001.

  15. The role of the lateral pterygoid muscle in the sagittal fracture of mandibular condyle (SFMC) healing process.

    Science.gov (United States)

    Liu, Chng-Kui; Liu, Ping; Meng, Fan-Wen; Deng, Bang-Lian; Xue, Yang; Mao, Tian-Qiu; Hu, Kai-Jin

    2012-06-01

    The aim of this study was to examine the role of the lateral peterygoid muscle in the reconstruction of the shape of the condyle during healing of a sagittal fracture of the mandibular condyle. Twenty adult sheep were divided into 2 groups: all had a unilateral operation on the right side when the anterior and posterior attachments of the discs were cut, and an oblique vertical osteotomy was made from the lateral pole of the condyle to the medial side of the condylar neck. Ten sheep had the lateral pterygoid muscle cut, and the other 10 sheep did not. Sheep were killed at 4 weeks (n=2 from each group), 12 weeks (n=4), and 24 weeks (n=4) postoperatively. Computed tomograms (CT) were taken before and after operations. We dissected the joints, and recorded with the naked eye the shape, degree of erosion, and amount of calcification of the temporomandibular joint (TMJ). In the group in which the lateral peterygoid muscle had not been cut the joints showed overgrowth of new bone and more advanced ankylosis. Our results show that the lateral pterygoid muscle plays an important part in reconstructing the shape of the condyle during the healing of a sagittal fracture of the mandibular condyle, and combined with the dislocated and damaged disc is an important factor in the aetiology of traumatic ankylosis of the TMJ.

  16. Research progress in mechanism of traumatic brain injury affecting speed of fracture healing

    Institute of Scientific and Technical Information of China (English)

    ZHAO Xiao-gang; ZHAO Guang-feng; MA Yue-feng; JIANG Guan-yu

    2007-01-01

    @@ In patients who have sustained traumatic brain injury with associated extremity fracture, there is often a clinical perception that the rate of new bone formation around the fracture site increases. 1 An overgrowth of callus is observed and ectopic ossification even occurs in the muscle,2 but the mechanism remains unclear.

  17. Frictional stability-permeability relationships for fractures in shales: Friction-Permeability Relationships

    Energy Technology Data Exchange (ETDEWEB)

    Fang, Yi [Department of Energy and Mineral Engineering, EMS Energy Institute, and G3 Center, Pennsylvania State University, University Park Pennsylvania USA; Elsworth, Derek [Department of Energy and Mineral Engineering, EMS Energy Institute, and G3 Center, Pennsylvania State University, University Park Pennsylvania USA; Department of Geosciences, EMS Energy Institute, and G3 Center, Pennsylvania State University, University Park Pennsylvania USA; Wang, Chaoyi [Department of Energy and Mineral Engineering, EMS Energy Institute, and G3 Center, Pennsylvania State University, University Park Pennsylvania USA; Ishibashi, Takuya [Department of Energy and Mineral Engineering, EMS Energy Institute, and G3 Center, Pennsylvania State University, University Park Pennsylvania USA; Fukushima Renewable Energy Institute, National Institute of Advanced Industrial Science and Technology, Koriyama Japan; Fitts, Jeffrey P. [Department of Civil and Environmental Engineering, Princeton University, Princeton New Jersey USA

    2017-01-01

    There is wide concern that fluid injection in the subsurface, such as for the stimulation of shale reservoirs or for geological CO2 sequestration (GCS), has the potential to induce seismicity that may change reservoir permeability due to fault slip. However, the impact of induced seismicity on fracture permeability evolution remains unclear due to the spectrum of modes of fault reactivation (e.g., stable versus unstable). As seismicity is controlled by the frictional response of fractures, we explore friction-stability-permeability relationships through the concurrent measurement of frictional and hydraulic properties of artificial fractures in Green River shale (GRS) and Opalinus shale (OPS). We observe that carbonate-rich GRS shows higher frictional strength but weak neutral frictional stability. The GRS fracture permeability declines during shearing while an increased sliding velocity reduces the rate of permeability decline. By comparison, the phyllosilicate-rich OPS has lower friction and strong stability while the fracture permeability is reduced due to the swelling behavior that dominates over the shearing induced permeability reduction. Hence, we conclude that the friction-stability-permeability relationship of a fracture is largely controlled by mineral composition and that shale mineral compositions with strong frictional stability may be particularly subject to permanent permeability reduction during fluid infiltration.

  18. The relationship between the change of Osx and Dlx5 expressed in the callus and fracture healing in type 2 diabetes rats%2型糖尿病大鼠骨痂内Osx、Dlx5表达变化与骨折愈合

    Institute of Scientific and Technical Information of China (English)

    刘振东; 蔡绪; 王魁向; 张远军; 刘志涛

    2015-01-01

    背景:研究表明Osx、Dlx5等基因的表达水平与骨折愈合障碍可能存在一定关系。目的:分析2型糖尿病大鼠牵引骨痂中Osx、Dlx5表达变化与骨折愈合障碍的关系。方法:选择8周龄SD大鼠32只,随机分为2组,实验组(18只)高糖高脂饲料喂养8周,链脲佐菌素腹腔注射制作2型糖尿病大鼠模型;对照组喂普通大鼠饲料予以同样剂量柠檬酸腹腔注射。2组大鼠同时建立骨折牵引模型,定期延长外固定架,牵引模型建立后15 d处死大鼠并收集血液标本检测生化指标,X射线观察骨痂生长情况,取左胫骨骨痂组织进行组织学观察,检测骨痂组织中Dlx5、Osx蛋白及相关基因的表达。结果与结论:X射线摄片结果:实验组牵引骨痂较对照组明显减少,骨痂组织苏木精-伊红染色显示:实验组较对照组的微骨柱明显减少;初始基质前沿浅染。而骨痂的组织学定量分析则显示:实验组新生骨痂的形成面积较对照组减少而骨折近端脂肪细胞数量增多(P end compared with the control group (P < 0.01). QPCR displayed that the expression of Osx and Dlx5 was lower in the experimental group than the control group (P < 0.05). These findings indicate that the poorer fracture healing in type 2 diabetes than the normal rats may be associated with the decrease of Osx and Dlx5 expression.

  19. Effects of " vitex agnus castus" extract and magnesium supplementation, alone and in combination, on osteogenic and angiogenic factors and fracture healing in women with long bone fracture

    Directory of Open Access Journals (Sweden)

    Mohammad Hassan Eftekhari

    2014-01-01

    Full Text Available Background: The purpose of this study was to investigate the effects of the combination of vitex agnus castus extract, as a source of phytoestrogens, plus magnesium supplementation on osteogenic and angiogenic factors and callus formation in women with long bone fracture. Material and Methods: In a double-blind randomized placebo controlled trial, 64 women with long bone fracture, 20-45 years old, were randomly allocated to receive 1 one Agnugol tablet (4 mg dried fruit extract of vitex agnus castus plus 250 mg magnesium oxide (VAC + Mg group (n = 10, 2 one Agnugol tablet plus placebo (VAC group (n = 15, 3 placebo plus 250 mg magnesium oxide (Mg group (n = 12, or 4 placebo plus placebo (placebo group (n = 14 per day for 8 weeks. At baseline and endpoint of the trial, serum alkaline phosphatase, osteocalcin, and vascular endothelial growth factor (VEGF were measured together with radiological bone assessment. Results: There were no significant differences in the characteristic aspects of concern between the four groups at baseline. Despite the increased level of alkaline phosphatase in the VAC group (188.33 ± 16.27 to 240.40 ± 21.49, P = 0.05, administration of VAC + Mg could not increase alkaline phosphatase activity. However, treatment with VAC + Mg significantly enhanced the osteocalcin level. The serum concentration of VEGF was increased in the VAC group (269.04 ± 116.63 to 640.03 ± 240.16, P < 0.05. Callus formation in the VAC + Mg group was higher than the other groups but the differences between the four groups were not significant (P = 0.39. No relevant side effect was observed in patients in each group. Conclusion : Our results suggest that administration of vitex agnus castus plus magnesium may promote fracture healing. However, more studies need to further explore the roles of vitex agnus castus in fracture repair processes.

  20. Cementless Titanium Mesh Fixation of Osteoporotic Burst Fractures of the Lumbar Spine Leads to Bony Healing: Results of an Experimental Sheep Model

    Directory of Open Access Journals (Sweden)

    Anica Eschler

    2016-01-01

    Full Text Available Introduction. Current treatment strategies for osteoporotic vertebral compression fractures (VCFs focus on cement-associated solutions. Complications associated with cement application are leakage, embolism, adjacent fractures, and compromise in bony healing. This study comprises a validated VCF model in osteoporotic sheep in order to (1 evaluate a new cementless fracture fixation technique using titanium mesh implants (TMIs and (2 demonstrate the healing capabilities in osteoporotic VCFs. Methods. Twelve 5-year-old Merino sheep received ovariectomy, corticosteroid injections, and a calcium/phosphorus/vitamin D-deficient diet for osteoporosis induction. Standardized VCFs (type AO A3.1 were created, reduced, and fixed using intravertebral TMIs. Randomly additional autologous spongiosa grafting (G1 or no augmentation was performed (G2, n=6 each. Two months postoperatively, macroscopic, micro-CT and biomechanical evaluation assessed bony consolidation. Results. Fracture reduction succeeded in all cases without intraoperative complications. Bony consolidation was proven for all cases with increased amounts of callus development for G2 (58.3%. Micro-CT revealed cage integration. Neither group showed improved results with biomechanical testing. Conclusions. Fracture reduction/fixation using TMIs without cement in osteoporotic sheep lumbar VCF resulted in bony fracture healing. Intravertebral application of autologous spongiosa showed no beneficial effects. The technique is now available for clinical use; thus, it offers an opportunity to abandon cement-associated complications.

  1. Radiographic evaluation of fracture healing after rigid plate fixation. Experiments in the rabbit

    Energy Technology Data Exchange (ETDEWEB)

    Paavolainen, P.; Karaharju, E.; Slaetis, P.; Waris, P. (Helsinki Univ. Central Hospital (Finland). Meilahti Clinic)

    1981-01-01

    Experimental osteotomies were made in 35 rabbit tibio-fibular bones and fixed with rigid stainless steel osteosynthesis plates (DCP/ASIF). The radiographic and histopathologic appearances in the healing osteotomies and adjacent bone were analysed at intervals from 3 up to 24 weeks postoperatively. Radiologically the osteotomy had closed at 9 weeks and microscopically this could be confirmed as longitudinal orientation of the cutter heads across the osteotomy gap with longitudinal orientation of the bone structure. The healing of the osteotomy was accompanied by gross structural changes in the adjacent cortical bone with loss of intracortical and subendosteal osteons, cementing lines and intermediate tissue between the osteons. This was characterized by decreasing attenuation of the cortical bone after healing of the osteotomy and should clinically be regarded as an indication for removal of the implant.

  2. The effect of PTH(1-34) on fracture healing during different loading conditions

    DEFF Research Database (Denmark)

    Ellegaard, Maria; Kringelbach, Tina; Syberg, Susanne

    2013-01-01

    . Five days before fracture, half of the animals received Botulinum Toxin A injections in the muscles of the fractured leg to induce muscle paralysis (unloaded group), whereas the other half received saline injections (control group). For the following 8 weeks, half of the animals in each group received...... and control animals. PTH(1-34) treatment increased ultimate force of the fracture by 63% in both control and unloaded animals and no interaction of the two interventions could be detected. PTH(1-34) was able to stimulate bone formation in normally loaded as well as unloaded intact bone. In conclusion...

  3. Fracture healing and transport properties of wellbore cement in the presence of supercritical CO2

    NARCIS (Netherlands)

    Liteanu, E.; Spiers, C.J.

    2011-01-01

    This paper investigates the process and rate of carbonation reaction of Class A wellbore cement exposed to CO2-saturated solution at confined conditions similar to those employed in geological storage of CO2. The main goal was to investigate whether reaction improves or degrades the sealing/healing

  4. Pharmacological agents and impairment of fracture healing: what is the evidence?

    NARCIS (Netherlands)

    Pountos, I.; Georgouli, T.; Blokhuis, T.J.; Pape, H.C.; Giannoudis, P.V.

    2008-01-01

    Bone healing is an extremely complex process which depends on the coordinated action of several cell lineages on a cascade of biological events, and has always been a major medical concern. The use of several drugs such as corticosteroids, chemotherapeutic agents, non-steroidal anti-inflammatory dru

  5. Gait and function as tools for the assessment of fracture repair - the role of movement analysis for the assessment of fracture healing.

    Science.gov (United States)

    Rosenbaum, Dieter; Macri, Felipe; Lupselo, Fernando Silva; Preis, Osvaldo Cristiano

    2014-06-01

    Assessment of gait and function might be as sensitive tool to monitor the progress of fracture healing. Currently available assessment tools for function use instrumented three dimensional gait analysis or pedobarography. The analysis is focused on gait or movement parameters and seeks to identify abnormalities or asymmetries between legs or arms. The additional inclusion of muscle function by electromyography can further elucidate functional performance and its temporal development. Alternative approaches abstain from directly assessing function in the laboratory but rather determine the amount of activities of daily living or the mere ability to perform defined tasks such as walking, stair climbing or running. Some of these methods have been applied to determine recovery after orthopaedic interventions including fracture repair. The combination of lab-based functional measurements and assessment of physical activities in daily live may offer a valuable level of information about the gait quality and quantity of individual patients which sheds light on functional limitations or rehabilitation of gait and mobility after a disease or injury and the respective conservative, medical or surgical treatment.

  6. The impact of low-magnitude high-frequency vibration on fracture healing is profoundly influenced by the oestrogen status in mice

    Directory of Open Access Journals (Sweden)

    Esther Wehrle

    2015-01-01

    Full Text Available Fracture healing is impaired in aged and osteoporotic individuals. Because adequate mechanical stimuli are able to increase bone formation, one therapeutical approach to treat poorly healing fractures could be the application of whole-body vibration, including low-magnitude high-frequency vibration (LMHFV. We investigated the effects of LMHFV on fracture healing in aged osteoporotic mice. Female C57BL/6NCrl mice (n=96 were either ovariectomised (OVX or sham operated (non-OVX at age 41 weeks. When aged to 49 weeks, all mice received a femur osteotomy that was stabilised using an external fixator. The mice received whole-body vibrations (20 minutes/day with 0.3 g peak-to-peak acceleration and a frequency of 45 Hz. After 10 and 21 days, the osteotomised femurs and intact bones (contra-lateral femurs, lumbar spine were evaluated using bending-testing, micro-computed tomography (μCT, histology and gene expression analyses. LMHFV disturbed fracture healing in aged non-OVX mice, with significantly reduced flexural rigidity (−81% and bone formation (−80% in the callus. Gene expression analyses demonstrated increased oestrogen receptor β (ERβ, encoded by Esr2 and Sost expression in the callus of the vibrated animals, but decreased β-catenin, suggesting that ERβ might mediate these negative effects through inhibition of osteoanabolic Wnt/β-catenin signalling. In contrast, in OVX mice, LMHFV significantly improved callus properties, with increased flexural rigidity (+1398% and bone formation (+637%, which could be abolished by subcutaneous oestrogen application (0.025 mg oestrogen administered in a 90-day-release pellet. On a molecular level, we found an upregulation of ERα in the callus of the vibrated OVX mice, whereas ERβ was unaffected, indicating that ERα might mediate the osteoanabolic response. Our results indicate a major role for oestrogen in the mechanostimulation of fracture healing and imply that LMHFV might only be safe and

  7. Means of enhancing bone fracture healing : Optimal cell source, isolation methods and acoustic stimulation

    NARCIS (Netherlands)

    Ghebes, Corina Adriana; Braham, Maaike Vera Jasmijn; Zeegers, Adelgunde Veronica Clemens Maria; Renard, Auke Jan Sijbe; Fernandes, Hugo; Saris, Daniel B F

    2016-01-01

    Background: The human body has an extensive capacity to regenerate bone tissue after trauma. However large defects such as long bone fractures of the lower limbs cannot be restored without intervention and often lead to nonunion. Therefore, the aim of the present study was to assess the pool and

  8. Healing Relationships: A Qualitative Study of Healers and Their Clients in Germany

    Directory of Open Access Journals (Sweden)

    B. M. H. Stöckigt

    2015-01-01

    Full Text Available Background. The aim of this study was to investigate the nature of the relationships between healers and their clients in Germany. Methods. An interdisciplinary research team performed semistructured interviews with healers and clients and participatory observation of healing sessions. All interviews were digitally recorded, transcribed, and analyzed using content analysis. Results. Fifteen healers and sixteen clients were included. The healer-client relationship was described as a profound and unique experience, which brought forth interpersonal and spiritual connections. The healers were seen as role models for healing to occur and support for being connected spiritually. The clients had to be open-minded and responsible. The importance of the healers’ empathy was emphasized. Discussion. The relationship between healer and client can be seen as a triangular connection between client, healer, and a transcendent source which is not the case in typical patient-doctor relationships. The spiritual connection is also said to enhance the empathetic understanding of the healer. The personality and a partner-like attitude of the healer supported the client in giving a more positive meaning to his life, in reconnecting to his spirituality, and in taking responsibility. Future studies should address the role of spirituality in health care and the development of enduring healer-client relationships.

  9. Observations concerning different patterns of bone healing using the Point Contact Fixator (PC-Fix) as a new technique for fracture fixation.

    Science.gov (United States)

    Hofer, H P; Wildburger, R; Szyszkowitz, R

    2001-09-01

    The recent trend in all surgical disciplines has been the development of techniques in minimally invasive surgery and the optimal maintenance of the blood supply to the bone fragments during osteosynthesis. Currently, the Point Contact Fixator (PC-Fix) has been introduced as a new implant for the stabilization of forearm bones. This plate-like splint and screw fixation system, which actually acts as an internal fixator, is characterized by minimized isolated contacts to the bone and proven angular stability of the monocortically locked screws. By using the PC-Fix, a further reduction of damage to the blood supply to the bone is achieved. Since 1994, 38 patients have been treated with this new device; we have reviewed the radiographs of 52 consolidated forearm fractures/osteotomies in accordance with the patterns of bone healing associated with the different methods of implant application according to the fracture type. In the groups in which traditionally precise reduction, interfragmentary compression and stable fixation was achieved (N=31), we found in 71% an absence of periosteal callus (direct bone healing). In the groups in which compression and adaptation were combined, or even main fragments adapted without compression, with wedges remaining unreduced in soft tissue connection (N=21), we found a visible external callus in 81% (indirect healing) (P = 0.002). Indirect healing after internal fixation is no longer regarded as a disturbance to healing, but is a goal in itself. The appearance of callus is a welcome sign indicating a prompt and positive reaction in the course of bone union which will lead to progressive fracture immobilization. When using the PC-Fix in a "biological way", callus formation and solid union take place earlier than in conventional plating. The new internal fixator offers substantial technical and mechanical advantages in fracture treatment. Therefore, it is an ideal implant to satisfy the requirements of modern biological

  10. Bone stimulation for fracture healing: What′s all the fuss?

    Directory of Open Access Journals (Sweden)

    Victoria Galkowski

    2009-01-01

    Full Text Available Approximately 10% of the 7.9 million annual fracture patients in the United States experience nonunion and/or delayed unions, which have a substantial economic and quality of life impact. A variety of devices are being marketed under the name of "bone growth stimulators." This article provides an overview of electrical and electromagnetic stimulation, ultrasound, and extracorporeal shock waves. More research is needed for knowledge of appropriate device configurations, advancement in the field, and encouragement in the initiation of new trials, particularly large multicenter trials and randomized control trials that have standardized device and protocol methods.

  11. Effects of low-dose microwave on healing of fractures with titanium alloy internal fixation: an experimental study in a rabbit model.

    Directory of Open Access Journals (Sweden)

    Dongmei Ye

    Full Text Available BACKGROUND: Microwave is a method for improving fracture repair. However, one of the contraindications for microwave treatment listed in the literature is surgically implanted metal plates in the treatment field. The reason is that the reflection of electromagnetic waves and the eddy current stimulated by microwave would increase the temperature of magnetic implants and cause heat damage in tissues. Comparing with traditional medical stainless steel, titanium alloy is a kind of medical implants with low magnetic permeability and electric conductivity. But the effects of microwave treatment on fracture with titanium alloy internal fixation in vivo were not reported. The aim of this article was to evaluate the security and effects of microwave on healing of a fracture with titanium alloy internal fixation. METHODS: Titanium alloy internal fixation systems were implanted in New Zealand rabbits with a 3.0 mm bone defect in the middle of femur. We applied a 30-day microwave treatment (2,450MHz, 25W, 10 min per day to the fracture 3 days after operation. Temperature changes of muscle tissues around implants were measured during the irradiation. Normalized radiographic density of the fracture gap was measured on the 10th day and 30th day of the microwave treatment. All of the animals were killed after 10 and 30 days microwave treatment with histologic and histomorphometric examinations performed on the harvested tissues. FINDINGS: The temperatures did not increase significantly in animals with titanium alloy implants. The security of microwave treatment was also supported by histology of muscles, nerve and bone around the implants. Radiographic assessment, histologic and histomorphometric examinations revealed significant improvement in the healing bone. CONCLUSION: Our results suggest that, in the healing of fracture with titanium alloy internal fixation, a low dose of microwave treatment may be a promising method.

  12. Diabetes mellitus affects the biomechanical function of the callus and the expression of TGF-beta1 and BMP2 in an early stage of fracture healing

    Directory of Open Access Journals (Sweden)

    M.T. Xu

    2016-01-01

    Full Text Available Transforming growth factor beta 1 (TGF-β1 and bone morphogenetic protein-2 (BMP-2 are important regulators of bone repair and regeneration. In this study, we examined whether TGF-β1 and BMP-2 expressions were delayed during bone healing in type 1 diabetes mellitus. Tibial fractures were created in 95 diabetic and 95 control adult male Wistar rats of 10 weeks of age. At 1, 2, 3, 4, and 5 weeks after fracture induction, five rats were sacrificed from each group. The expressions of TGF-β1 and BMP2 in the fractured tibias were measured by immunohistochemistry and quantitative reverse-transcription polymerase chain reaction, weekly for the first 5 weeks post-fracture. Mechanical parameters (bending rigidity, torsional rigidity, destruction torque of the healing bones were also assessed at 3, 4, and 5 weeks post-fracture, after the rats were sacrificed. The bending rigidity, torsional rigidity and destruction torque of the two groups increased continuously during the healing process. The diabetes group had lower mean values for bending rigidity, torsional rigidity and destruction torque compared with the control group (P<0.05. TGF-β1 and BMP-2 expression were significantly lower (P<0.05 in the control group than in the diabetes group at postoperative weeks 1, 2, and 3. Peak levels of TGF-β1 and BMP-2 expression were delayed by 1 week in the diabetes group compared with the control group. Our results demonstrate that there was a delayed recovery in the biomechanical function of the fractured bones in diabetic rats. This delay may be associated with a delayed expression of the growth factors TGF-β1 and BMP-2.

  13. Melt fracturing and healing: A mechanism for degassing and origin of silicic obsidian

    Science.gov (United States)

    Cabrera, A.; Weinberg, R.F.; Wright, H.M.N.; Zlotnik, S.; Cas, Ray A.F.

    2011-01-01

    We present water content transects across a healed fault in pyroclastic obsidian from Lami pumice cone, Lipari, Italy, using synchrotron Fourier transform infrared spectroscopy. Results indicate that rhyolite melt degassed through the fault surface. Transects define a trough of low water content coincident with the fault trace, surrounded on either side by high-water-content plateaus. Plateaus indicate that obsidian on either side of the fault equilibrated at different pressure-temperature (P-T) conditions before being juxtaposed. The curves into the troughs indicate disequilibrium and water loss through diffusion. If we assume constant T, melt equilibrated at pressures differing by 0.74 MPa before juxtaposition, and the fault acted as a low-P permeable path for H2O that diffused from the glass within time scales of 10 and 30 min. Assuming constant P instead, melt on either side could have equilibrated at temperatures differing by as much as 100 ??C, before being brought together. Water content on the fault trace is particularly sensitive to post-healing diffusion. Its preserved value indicates either higher temperature or lower pressure than the surroundings, indicative of shear heating and dynamic decompression. Our results reveal that water contents of obsidian on either side of the faults equilibrated under different P-T conditions and were out of equilibrium with each other when they were juxtaposed due to faulting immediately before the system was quenched. Degassing due to faulting could be linked to cyclical seismic activity and general degassing during silicic volcanic activity, and could be an efficient mechanism of producing low-water-content obsidian. ?? 2011 Geological Society of America.

  14. A novel coupled system of non-local integro-differential equations modelling Young's modulus evolution, nutrients' supply and consumption during bone fracture healing

    Science.gov (United States)

    Lu, Yanfei; Lekszycki, Tomasz

    2016-10-01

    During fracture healing, a series of complex coupled biological and mechanical phenomena occurs. They include: (i) growth and remodelling of bone, whose Young's modulus varies in space and time; (ii) nutrients' diffusion and consumption by living cells. In this paper, we newly propose to model these evolution phenomena. The considered features include: (i) a new constitutive equation for growth simulation involving the number of sensor cells; (ii) an improved equation for nutrient concentration accounting for the switch between Michaelis-Menten kinetics and linear consumption regime; (iii) a new constitutive equation for Young's modulus evolution accounting for its dependence on nutrient concentration and variable number of active cells. The effectiveness of the model and its predictive capability are qualitatively verified by numerical simulations (using COMSOL) describing the healing of bone in the presence of damaged tissue between fractured parts.

  15. Root fractures

    DEFF Research Database (Denmark)

    Andreasen, Jens Ove; Christensen, Søren Steno Ahrensburg; Tsilingaridis, Georgios

    2012-01-01

    The purpose of this study was to analyze tooth loss after root fractures and to assess the influence of the type of healing and the location of the root fracture. Furthermore, the actual cause of tooth loss was analyzed.......The purpose of this study was to analyze tooth loss after root fractures and to assess the influence of the type of healing and the location of the root fracture. Furthermore, the actual cause of tooth loss was analyzed....

  16. The 9/11 Decade: Social Imaginary and Healing Virtual Community Fracture

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    Charles A. Hays

    2011-01-01

    Full Text Available The initial events of 9/11 broke upon the awareness of people who turned first to traditional media for information, then to their networks of distant others when traditional media could not meet their needs. This study looks at two online community groups on Usenet. Though other technologies have supplanted Usenet to some degree, it provided a vibrant means of asynchronously connecting people interested in online discussion. As community members expressed their shock and horror, they also acted out the process of repairing the radical fracture to their virtual communal identity. The process by which they enacted this repair embodies a social imaginary, and is generally called “community repair”. This study finds that the process of community repair is very much driven by the culture inherent in the sodality represented by the participants to each newsgroup, reflecting the values that participants have communally agreed to hold valuable.

  17. Fracture Toughness of Carbon Fiber Composites Containing Various Fiber Sizings and a Puncture Self-Healing Thermoplastic Matrix

    Science.gov (United States)

    Cano, Roberto J.; Grimsley, Brian W.; Ratcliffe, James G.; Gordon, Keith L.; Smith, Joseph G.; Siochi, Emilie J.

    2015-01-01

    Ongoing efforts at NASA Langley Research Center (LaRC) have resulted in the identification of several commercially available thermoplastic resin systems which self-heal after ballistic impact and through penetration. One of these resins, polybutylene graft copolymer (PBg), was selected as a matrix for processing with unsized carbon fibers to fabricate reinforced composites for further evaluation. During process development, data from thermo-physical analyses was utilized to determine a processing cycle to fabricate laminate panels, which were analyzed by photo microscopy and acid digestion. The process cycle was further optimized based on these results to fabricate panels for mechanical property characterization. The results of the processing development effort of this composite material, as well as the results of the mechanical property characterization, indicated that bonding between the fiber and PBg was not adequate. Therefore, three sizings were investigated in this work to assess their potential to improve fiber/matrix bonding compared to previously tested unsized IM7 fiber. Unidirectional prepreg was made at NASA LaRC from three sized carbon fibers and utilized to fabricate test coupons that were tested in double cantilever beam configurations to determine GIc fracture toughness.

  18. Low-intensity pulsed ultrasound increases bone volume, osteoid thickness and mineral apposition rate in the area of fracture healing in patients with a delayed union of the osteotomized fibula

    NARCIS (Netherlands)

    Rutten, S.; Nolte, P.A.; Korstjens, C.M.; van Duin, M.A.; Klein-Nulend, J.

    2008-01-01

    Introduction Low-intensity pulsed ultrasound (LIPUS) accelerates impaired fracture healing, but the exact mechanism is unknown. The aim of this study was to investigate how LIPUS affects bone healing at the tissue level in patients with a delayed union of the osteotomized fibula, by using histology

  19. The use of MTA/blood mixture to induce hard tissue healing in a root fractured maxillary central incisor. Case report and treatment considerations.

    Science.gov (United States)

    Chaniotis, A

    2014-10-01

    To report the use of MTA/blood mixture for the induction of hard tissue healing of multiple horizontal root fractures in a maxillary incisor. An 18-year-old male patient was referred after suffering trauma to the anterior maxilla. Radiographic evaluation revealed multiple horizontal fractures in the middle and cervical third of his maxillary right central incisor. Clinical evaluation revealed third grade mobility of the coronal segment. The patient's accompanying radiographs revealed that root canal treatment of all segments had been previously initiated and both segments had been rendered pulpless. The coronal segment was repositioned and stabilized. A bi-antibiotic mixture, containing equal parts of ciprofloxacin and metronidazole, was used for the disinfection of the root canal segments. A blood clot was induced from the periapical area and MTA powder was mixed with the blood creating a bioceramic mixture covering all the fractures. Thick MTA was placed as a coronal barrier and the tooth was restored. Recall examination after 24 months revealed healing of the horizontal fractures. The MTA mixed with the blood lost its radio-opacity over time. Tooth mobility returned to normal limits. A low range of 5-25% of all horizontally root fractured cases develop pulp necrosis, confined in the coronal segment, leaving the apical segment with vital tissue. In the unfortunate situation that the pulp of both segments becomes necrotic or the entire pulp tissue is removed, the use of MTA/blood mixture may be beneficial for the induction of hard tissue healing. MTA when mixed with blood seems to lose its radio-opacity over time. © 2013 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  20. Fracture development in shale and its relationship to gas accumulation

    Directory of Open Access Journals (Sweden)

    Wenlong Ding

    2012-01-01

    Full Text Available Shale with high quartz, feldspar and carbonate, will have low Poisson’s ratio, high Young’s modulus and high brittleness. As a result, the shale is conducive to produce natural and induced fractures under external forces. In general, there is a good correlation between fracture development in shale and the volume of brittle minerals present. Shale with high TOC or abnormally high pressure has well-developed fractures. Shale fracture development also shows a positive correlation with total gas accumulation and free gas volume, i.e., the better shale fractures are developed, the greater the gas accumulation and therefore the higher the gas production. Fractures provide migration conduits and accumulation spaces for natural gas and formation water, which are favorable for the volumetric increase of free natural gas. Wider fractures in shale result in gas loss. In North America, there is a high success ratio of shale gas exploration and high gas production from high-angle fracture zones in shale. Good natural gas shows or low yield producers in the Lower Paleozoic marine organic matter-rich rocks in the Sichuan Basin are closely related to the degree of fracture development in brittle shales.

  1. EXPERIMENTAL ANALYSIS OF THE HEALING PROCESS IN THE AREA OF TIBIAL BONE FRACTURE

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    I. F. Аkhtyamov

    2016-01-01

    Full Text Available Purpose. To quantify the density of the cortical bone of the tibia in the area of reparative regeneration and the state of the vascular bed (hemodynamics of the operated limb under intramedullary osteosynthesis using pins coated with titanium and hafnium nitrides. Materials and methods. In the experiment, changes in the bone density and the characteristics of the local blood supply were studied on 40 outbred rabbits which underwent intramedullary osteosynthesis by the use of pins with a nanocoating based on superhard compounds which consist of titanium and hafnium nitrides and pins without a coating. Using color Doppler mode helped to evaluate the condition of the vascular bed proximally to the fracture site. Results. It is noted that the use of pins with the described coating above did not violate the osteoregeneration staging. The density of the cortical bone in the test group exceeded that of the comparison group by an average of 30%. Bone remodeling processes in the test group completed at an earlier date, as determined by the higher rates of its density. In the study of the vascular bed of the operated limb, it was found that on the 10th day of the experiment, an increase in the maximal velocity of the blood flow was recorded (TAMAX. In animals of the test group this index approached preoperative values on the 30th day, while in animals of the comparison group this index approached the initial values only by the 60th day. Conclusion. The use of implants coated with titanium and hafnium nitrides which are characterized by high strength, thermal and chemical stability is accompanied by the formation of a cortical bone in the area of osteotomy with higher density characteristics. The changes which are typical of the vasodilatation in the area of injury in the early postoperative period can be regarded as a positive factor in the formation of primary bone union. In the group where implants coated with titanium and hafnium nitrides were used

  2. Relationships between fracture toughness and other material properties. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Perra, M.; Finnie, I.

    1974-01-01

    The key experimental and analytical studies which have led to our present understanding of the mechanisms of ductile fracture are reviewed. It is concluded that insufficient progress has been made in the quantitative description of ductile separation mechanisms on a microscale to allow the realistic prediction of fracture toughness from material properties and microstructure. An experimental study of ductile fracture is underway which has the aim of determining the growth rate of voids in known plastic deformation fields as a function of triaxiality of stress and material work-hardening. Novel specimens of particularly well characterized microstructure are utilized.

  3. Bony healing of unstable thoracolumbar burst fractures in the elderly using percutaneously applied titanium mesh cages and a transpedicular fixation system with expandable screws.

    Directory of Open Access Journals (Sweden)

    Anica Eschler

    Full Text Available There is a high incidence of vertebral burst fractures following low velocity trauma in the elderly. Treatment of unstable vertebral burst fractures using the same principles like in stable vertebral burst fractures may show less favourable results in terms of fracture reduction, maintenance of reduction and cement leakage. In order to address these shortcomings this study introduces cementless fixation of unstable vertebral burst fractures using internal fixators and expandable intravertebral titanium mesh cages in a one-stage procedure via minimum-invasive techniques.A total of 16 consecutive patients (median age 76 years, range 58-94 with unstable thoracolumbar burst fractures and concomitant osteoporosis were treated by an internal fixator inserted via minimum invasive technique one level above and below the fractured vertebra. Fracture reduction was achieved and maintained by transpedicular placement of two titanium mesh cages into the fractured vertebral body during the same procedure. Intra- and postoperative safety of the procedure as well as analysis of reduction quality was analysed by 3D C-arm imaging or CT, respectively. Clinical and radiographic follow-up averaged 10.4 months (range 4.5-24.5.Stabilization of the collapsed vertebral body was achieved in all 16 cases without any intraoperative complication. Surgical time averaged 102 ± 6.6 minutes (71-194. The postoperative kyphotic angle (KA and Cobb angle revealed significant improvements (KA 13.7° to 7.4°, p < 0.001; Cobb 9.6° to 6.0°, p < 0.002 with partial loss of reduction at final follow-up (KA 8.3°, Cobb 8.7°. VAS (Visual Analogue Scale improved from 7.6 to 2.6 (p < 0.001. Adjacent fractures were not observed. One minor (malposition of pedicle screw complication was encountered.Cementless fixation of osteoporotic burst fractures revealed substantial pain relief, adequate maintenance of reduction and a low complication rate. Bony healing after unstable osteoporotic burst

  4. Relationship between expression of Bax and Bcl-2 proteins and apoptosis in radiation compound wound healing of rats

    Institute of Scientific and Technical Information of China (English)

    崔玉芳; 夏国伟; 付小兵; 杨红; 彭瑞云; 张莹; 谷庆阳; 高亚兵; 崔雪梅; 胡文华

    2003-01-01

    Objective: To study the relationship between the expression of Bax, Bcl-2 proteins, and apoptosis in radiation compound wound healing of rats.Methods: Apoptosis, Bax and Bcl-2 proteins were estimated by in situ terminal labeling (TUNEL) and immunohistochemical methods. Results: (1) Changes of the apoptosis in wound healing showed three typical characteristics: early occurrence, high frequency and delayed disappearance after radiation to rats when compared with those of simple wound group, which might be an important reason for radiation-induced delayed wound healing. (2) The expression of Bax protein increased evidently with the increment of apoptosis and showed a good corresponding relationship with the apoptotic frequency in the process of wound healing. While the expression of Bcl-2 protein decreased obviously as the apoptosis reached a maximum and showed increasing tendency up to normal level when the apoptosis decreased distinctively. Conclusions: Bax and Bcl-2 proteins play an important role in the apoptotic regulation of radiation compound wound healing in rats.

  5. A Phenomenological Exploration of Nurses' Perceptions of the Effect of Electronic Documentation on Healing Relationships

    Science.gov (United States)

    Bradley, Sharon Lee

    2011-01-01

    The qualitative phenomenological study was an exploration of nurses' perceptions of the effect of information technology on healing relationships between nurses and patients. Extensive advancements in health care information technology have developed over the last decade, and have affected the health care environment. The increased time and…

  6. Optical coherence tomography at follow-up after percutaneous coronary intervention: relationship between procedural dissections, stent strut malapposition and stent healing

    DEFF Research Database (Denmark)

    Radu, Maria; Jørgensen, Erik; Kelbæk, Henning;

    2011-01-01

    To analyse the relationship between strut apposition as visualised with optical coherence tomography (OCT) at follow-up and clinical and procedural characteristics at stent implantation, and to examine the relationship between strut apposition and stent healing.......To analyse the relationship between strut apposition as visualised with optical coherence tomography (OCT) at follow-up and clinical and procedural characteristics at stent implantation, and to examine the relationship between strut apposition and stent healing....

  7. The effect of calcium and vitamin D3 supplementation on the healing of the proximal humerus fracture: a randomized placebo-controlled study

    DEFF Research Database (Denmark)

    Doetsch, A M; Faber, J; Lynnerup, N

    2004-01-01

    scan, WHO criteria), and not taking any drugs related to bone formation, including calcium or vitamin D supplementation, were randomly assigned to either oral 800 IU vitamin D3 plus 1 g calcium or placebo, in a double-blind prospective study. We measured biochemical, radiographic, and bone mineral......The purpose of this study was to (1) quantify the healing process of the human osteoporotic proximal humerus fracture (PHF) expressed in terms of callus formation over the fracture region using BMD scanning, and (2) quantify the impact of medical intervention with vitamin D3 and calcium......, with peak levels in week 6. By week 6 BMD levels were higher in the active group (0.623 g/cm2) compared with the placebo group (0.570 g/cm2, P = 0.006). Thirty seven percent of the patients presented with vitamin D levels below 30 nmol/l, indicative of mild vitamin D insufficiency. In conclusion, we have...

  8. Relationship of electrical resistance end morphological changes thigh rats after modeling of open fracture (experimental study

    Directory of Open Access Journals (Sweden)

    Pavlova T.M.

    2016-06-01

    Full Text Available Background. Due to the development of industry, increasing number of vehicles on the roads rate of traumatic injuries among adult population causing disability and mortality is still high in all countries of the world. Among all fractures of long bones open diaphyseal fractures ranges from 28% to 53%. Objective. To study the relationship of electrical resistance and morphological features of the femur of white male rats after modeling the open fracture. Methods. Studies were conducted on white male rats aged about 3 months. Digital multimeter UT70B was used to measure the electrical resistance of bones in experimental animals after 1 and 3 hours of experimental modeling of opened bone fracture. Histological and electron microscopic studies were performed to evaluate bone structure. Results. 1 hour after modeling an open bone fracture it was detected the presence of empty lacunae or gaps filled with detritus. 3 hours after the experiment cellular density in the first studied area was reduced 4.1 times, in the second area - 3.2 times comparing with the control. Conclusion. These histological examination and study of the electrical resistance of bone fragments after re-fracture (with or without coagulation fragments indicate similar changes in direction of the bone. Electrical resistance after testing in the clinical setting can be used for testing the bone fragments after an open fracture to assess viability. We have developed a technique for evaluation the electrical resistance making it possible to predict the viability of bone tissue with opened diaphyseal fractures of extremities on early stages. Citation: Pavlova TM, Berezka MI. [Relationship of electrical resistance end morphological changes thigh rats after mod-eling of open fracture (experimental study]. Morphologia. 2016;10(2:31-9. Ukrainian.

  9. Effect of Simvastatin on Fracture Healing in Osteoporotic Rats%辛伐他汀对大鼠骨质疏松性骨折愈合的影响

    Institute of Scientific and Technical Information of China (English)

    田发明; 张柳; 骆阳; 宋亚琪; 杨方

    2012-01-01

    目的 观察骨质疏松对大鼠骨折愈合的影响及辛伐他汀对骨质疏松性骨折愈合的作用.方法 12周龄雌性Sprague-Dawley大鼠40只随机分成5组,每组8只:假手术组(A);卵巢切除组(B);正常骨折组(C);骨质疏松性骨折组(D);骨质疏松性骨折+辛伐他汀组(E).除A、C组外,其余各组大鼠行双侧卵巢切除术,C、D、E组于卵巢切除术4周后制作右股骨中段骨折模型;E组给予辛伐他汀灌胃干预(20 mg·kg-1·d-1),C、D组给等量生理盐水.A、B组于术后4周处死,测量右股骨骨密度;其余3组于骨折后6周处死,完整取出右侧股骨,行CR摄片并评分、骨密度测定、HE染色并镜下组织学观察.结果 ①卵巢切除后4周,B组骨密度(BMD)显著低于A组(P<0.05);②各骨折组右股骨骨密度:D、E组tBMD、mBMD和dBMD均显著低于C组(P<0.05),E组各段骨密度均高于D组,但差异无统计学意义(P>0.05);③CR摄片:D组与E组整体愈合情况较C组差,多数标本骨折线清晰,X线评分均显著低于C组,E组高于D组,但差别无统计学意义;④组织学观察:C组大鼠骨痂组织更为成熟,可见板层骨形成,D组、E组软骨成分比例明显较高,均未见板层骨形成.结论 骨质疏松大鼠骨折愈合较正常延迟,辛伐他汀可部分阻止去卵巢大鼠骨量丢失并表现出一定的促进骨折愈合的作用趋势,但效果并不显著.%OBJECTIVE To verify the delayed process of fracture healing in osteoporosis rats, as well as to investigate the effect of simvastatin on osteoprotic fracture healing. METHODS Fouty 12-week old female Sprague-Dawley rats were randomly divided into 5 groups with 8 animals in each group. All rats except those in group A and C rats received bilateral ovariectomy. The rats in group A received sham operation. The rats in group C, D and E underwent an operation 4 weeks after ovariectomy to establish the midshaft femur fracture model all fractured rats were

  10. 胫骨骨折不愈合28例临床分析%Analyses of 28 tibia fracture cases not healed

    Institute of Scientific and Technical Information of China (English)

    张庆凯

    2014-01-01

    目的:通过对28例胫骨骨折不愈合患者的临床治疗研究,分析造成其不愈合的原因。方法:收集我院自2005年6月至2013年5月8年间所收治的胫骨骨折不愈合患者28例,其中,男性16例,女性12例,年龄从12岁到73岁,平均38.7岁。交通事故所致17例,重物砸伤所致6例,摔伤所致4例,被别人打伤1例。闭合性骨折9例,开放性骨折19例。患者从首次治疗出院到再次入院时间在0.6—2年,均进行2次手术治疗,术后随访,并根据其症状、体征及影像学资料进行评估分析。结果:术后随访3-24个月,平均14个月,患者切口愈合良好,无感染,无皮肤坏死。全部患者未见骨不愈合、感染、畸形及再骨折发生。结论:胫骨骨折不愈合可以有胫骨本身解剖及生理特点,外伤程度及部位,手术治疗及术后功能锻炼等几个方面原因。%Objective:Through the clinic analyses of 20 cases of tibia fracture, found the reasons which caused the tibia fracture not healed Method:From Jane 2005 to May 2013, In the 8 Months, 28 cases with tibia fracture not healed were col ected. Including 16 males and 12 females , with an average of 38.7 years old .(range,12 to 73 years old).17 cases were caused by the traffic accident ,6 cases were caused by heavy parts ,4 cases were caused by fal damage,1 case was caused by a fight;9 closed fractures ,19 open fractures .It was about 0.6-2 years from the time that the patients left hospital after first treated to the time that the patients returned .Through the second operations, al the patients was fol owed up, According to the symptoms、signs and images, we carried a evaluate and analyses .Result:Al the cases were fol owed up for an average of 14 months (range, 3 to 24 months). The fractures of al the cases were recovered .There were no complications such as infection of wound , skin necrosis , yet infection of bone didn't healed, deformity and broken

  11. Parathyroid hormone and bone healing

    DEFF Research Database (Denmark)

    Ellegaard, M; Jørgensen, N R; Schwarz, P

    2010-01-01

    , no pharmacological treatments are available. There is therefore an unmet need for medications that can stimulate bone healing. Parathyroid hormone (PTH) is the first bone anabolic drug approved for the treatment of osteoporosis, and intriguingly a number of animal studies suggest that PTH could be beneficial...... in the treatment of fractures and could thus be a potentially new treatment option for induction of fracture healing in humans. Furthermore, fractures in animals with experimental conditions of impaired healing such as aging, estrogen withdrawal, and malnutrition can heal in an expedited manner after PTH treatment...

  12. Alveolar process fractures in the permanent dentition. Part 2. The risk of healing complications in teeth involved in an alveolar process fracture

    DEFF Research Database (Denmark)

    Lauridsen, Eva; Gerds, Thomas; Andreasen, Jens Ove

    2016-01-01

    for PN (age, fracture in relation to apex, displacement, gingival injury, degree of repositioning, type of splint, duration of splinting, treatment delay, and antibiotics) were analyzed for mature teeth using Cox regression. The level of significance was 5%. RESULTS: Immature: No severe complications (PN.......3-3.5), P = 0.003), and age >30 years (HR: 2.3 (95% CI: 1.1-4.6), P = 0.02). The type of splint (rigid or flexible), the duration of splinting (more or less than 4 weeks), and the administration of antibiotics did not affect the risk of PN. CONCLUSION: Teeth involved in alveolar process fractures appear......AIM: To analyze the risk of pulp canal obliteration (PCO), pulp necrosis (PN), repair-related resorption (RRR), infection-related resorption (IRR), ankylosis-related resorption (ARR), marginal bone loss (MBL), and tooth loss (TL) for teeth involved in an alveolar process fracture and to identify...

  13. Relationship between fracturing nominal stress and porosity for metal foams under biaxial tension

    Institute of Scientific and Technical Information of China (English)

    LIU; Peisheng; (刘培生)

    2003-01-01

    The relationship between two fracturing nominal stresses and porosity has been put forward for metal foams under biaxial tensile loading, and its mathematical formula is proved to be quite practical with the relative experimental data of the metal foam, which is obtained by electrodeposition method.

  14. The relationship between unilateral mandibular angle fracture and temporomandibular joint function.

    Science.gov (United States)

    Baltrusaityte, Ausra; Surna, Algimantas; Pileicikiene, Gaivile; Kubilius, Ricardas; Gleiznys, Alvydas; Zilinskas, Juozas

    2014-01-01

    PURPOSE. Aim of this study was to analyze relation of occlusal correction and alterations of temporomandibular joint function during treatment of unilateral mandibular fractures. MATERIALS AND METHODS. We compared 49 patients treated for unilateral mandibular fracture without occlusal correction with 21 patient treated for unilateral mandibular fracture along with early and consequent occlusal analysis and correction and with 49 control subjects. Patients' complaints, mandibular movements and occlusal parameters were evaluated during the period of healing. ZEBRIS ultrasound system (Jaw Motion Analyzer, Zebris Medical GmbH, Isny, Germany) was used for analysis of mandibular movements and T-Scan analyzer (Tekscan, Inc., Boston, MA, USA) was used for occlusal analysis. RESULTS. Findings of our study showed statistically significant (p<0.05) diminution of patients complaints, mandibular movement alterations and occlusal disturbances in patients who received occlusal correction during MF treatment if compared to patients treated without occlusal correction, except noises from the joint in the injured side and mandibular lateral track to the injured side in the final stage of investigation. Despite applied treatment recovery of the TMJ function was not complete and the investigated parameters remained worse if compared to the control group. CONCLUSIONS. Results of this study confirmed positive influence of early and subsequent occlusal analysis and correction during stages of MF treatment on diminution of functional alterations of the temporomandibular joint function. Timely occlusal correction improves and hastens process of rehabilitation therefore it is indispensable part of MF treatment.

  15. Relationship between Decrease in Serum Sodium Level and Bone Mineral Density in Osteoporotic Fracture Patients.

    Science.gov (United States)

    Kwak, Mi Kyung; Choi, Dughyun; Lee, Jae Hyuk; Kim, Hye Jeong; Park, Hyeong Kyu; Suh, Kyo Il; Yoo, Myung Hi; Byun, Dong Won

    2015-02-01

    Recently, it has been suggested that decrease in serum sodium level is associated with osteoporosis. However, no study in Korea has reported the association of decrease in serum sodium level with osteoporosis. In this study, we investigated the relationship between the decrease in serum sodium level and severity of osteoporotic fracture in patients. We enrolled 290 subjects who were admitted and operated at Soonchunhyang University Hospital due to major fractures. For the control group, we enrolled 1,027 subjects who visited a health promotion center. We carried a 1:1 matching with age and sex from the case group. In a total of 164 age- and sex-matched subjects, serum sodium level was significantly lower in the fracture group than in the non-fracture group (P=0.001). Serum sodium level was significantly lower in the severe osteoporosis group than that in the non-severe osteoporosis group (P=0.002). Old age and decrease in serum sodium level were independent risk factors of osteoporosis (odds ratio [OR]=1.088, P=0.008, confidence interval [CI]=[1.022-1.157]; OR= 0.840, P=0.037, CI=0.713-0.989). Serum sodium level was significantly lower in the fracture group than that in the non-fracture group and in the severe osteoporosis group than that in the non-severe osteoporosis group. Based on our results, the decrease in serum sodium level could be an independent risk factor for osteoporosis.

  16. The potential role of original fracture hematoma in fracture healing%骨折愈合过程中原始骨折血肿的潜在作用

    Institute of Scientific and Technical Information of China (English)

    林梁; 唐亚辉; 吾路汗; 谢增如

    2015-01-01

    BACKGROUND:In closed fractures, the initial hematoma that is inclined to remove is seldom considered as the important reasons for bone healing. OBJECTIVE:To observe the mechanism and potential role of original fracture hematoma in fracture healing. METHODS:Ninety-six patients with closed fractures of the long bones undergoing open reduction and internal fixation were randomly divided into experimental group (n=48) and control group (n=48). In the experimental group, original fracture hematoma, 1.0-2.0 mL, was first taken out during the internal fixation and placed into a special sterile plastic bag; then, 3-4 pieces of hematomas were filed into the fracture site and sutured layer by layer. On the contrary, original fracture hematomas from the control group were discarded. Blood samples were extracted to detect the biochemical indicators at 1 month after internal fixation. X-ray examination was done at 1, 3, 6 months after internal fixation for observation of fracture healing. RESULTS AND CONCLUSION: X-ray films showed that the healing rate at 3 months after operation was 95% in the experimental group and 78% in the control group, and there was a significant difference between the two groups (P < 0.05). Levels of bone glaprotein, I-type precolagen carboxy terminus peptide and serum bone alkaline phosphatase were significantly higher in the experimental group than the control group (P < 0.01 orP < 0.05). These findings indicate that the original fracture hematoma can accelerate calus formation, promote bone induction, provide nutrition to the fracture site, and participate in revascularization. Therefore, the original fracture hematomas is one of the effectively therapeutic methods for union and nonunion of fractures.%背景:临床实践中闭合性骨折内固定过程中,骨折原始血肿很少视为骨折愈合的重要因素,常被有意清除,非常可惜。目的:对比分析骨折血肿在骨折愈合过程中所发挥的机制及作用。方

  17. Evaluation of the relationship between pelvic fracture and abdominal compartment syndrome in traumatic patients

    Directory of Open Access Journals (Sweden)

    Sheikhi Rahim Ali

    2013-01-01

    Full Text Available Introduction: An increase in abdominal pressure can lead to so-called intra-abdominal compartment syndrome (ACS. Multiple factors such as an increase in retroperitoneal volume due to pancreatitis, bleeding and edema as a result of pelvic fracture can lead to compartment syndrome. Prevention is better than cure in compartment syndrome. By measuring the intra-abdominal pressure (IAP through the bladder, a quick and accurate assessment of abdominal pressure is achieved. Therefore, this study aimed to evaluate the relationship between pelvic fracture and ACS in traumatic patients. Materials and Methods: This research was a descriptive-analytical study conducted on 100 patients referring to the Shiraz Nemazee Hospital in 2010. IAP was monitored every 4 h in patients suspected to be at high risk for ACS, e.g., those undergoing severe abdominal trauma and pelvic fracture. The IAP was measured via the urinary bladder using the procedure described by Kron et al. Data collected were analyzed using SPSS software. Results: The findings showed that ACS occurred in 28 of 100 patients. With regard to the associated injuries with abdominal trauma, 19% of all patients and 46/42% of the patients with ACS had pelvic fracture. Chi-square test revealed a significant relationship between pelvic fracture and incidence rate of ACS ( P < 0.001. Conclusions: According to the collected data, pelvic fracture due to a trauma can be one of the important causes of an increase in IAP and ACS. In this lethal condition, prevention is better than cure. Therefore, serial measurement of IAP through the bladder in high-risk patients (those with pelvic fracture by trauma is recommended to the nurses to diagnose this condition and to decrease the incidence of mortality.

  18. Rectal prolapse associated with a healed pelvic fracture in a pregnant free-ranging African black rhinoceros (Diceros bicornis. Part 2 : surgery and necropsy : case report

    Directory of Open Access Journals (Sweden)

    A. Olivier

    2001-07-01

    Full Text Available The oedematous and traumatised protruding section of the rectal tissue of an adult free-ranging female African black rhinoceros (Diceros bicornis was surgically amputated. Immediately before completion of surgery, the rhinoceros died of anaesthetic-related cardiac arrest. At necropsy a deformed pelvis and sacrum associated with a healed fracture of the left ileal wing were noted. New bone formation in and around the left ventral sacral foramina may have resulted in neuropathy of particularly the 3rd and 4th left ventral sacral nerves, which (in the horse supply the majority of the nerve fibres innervating the caudal rectum and anus. The cause of the injury is not known, although back injuries, presumably sustained during mating by bulls, have been recorded in white rhinoceros. An encounter with elephants could also have been responsible for the injury in this case.

  19. Computational techniques for the assessment of fracture repair.

    Science.gov (United States)

    Anderson, Donald D; Thomas, Thaddeus P; Campos Marin, Ana; Elkins, Jacob M; Lack, William D; Lacroix, Damien

    2014-06-01

    The combination of high-resolution three-dimensional medical imaging, increased computing power, and modern computational methods provide unprecedented capabilities for assessing the repair and healing of fractured bone. Fracture healing is a natural process that restores the mechanical integrity of bone and is greatly influenced by the prevailing mechanical environment. Mechanobiological theories have been proposed to provide greater insight into the relationships between mechanics (stress and strain) and biology. Computational approaches for modelling these relationships have evolved from simple tools to analyze fracture healing at a single point in time to current models that capture complex biological events such as angiogenesis, stochasticity in cellular activities, and cell-phenotype specific activities. The predictive capacity of these models has been established using corroborating physical experiments. For clinical application, mechanobiological models accounting for patient-to-patient variability hold the potential to predict fracture healing and thereby help clinicians to customize treatment. Advanced imaging tools permit patient-specific geometries to be used in such models. Refining the models to study the strain fields within a fracture gap and adapting the models for case-specific simulation may provide more accurate examination of the relationship between strain and fracture healing in actual patients. Medical imaging systems have significantly advanced the capability for less invasive visualization of injured musculoskeletal tissues, but all too often the consideration of these rich datasets has stopped at the level of subjective observation. Computational image analysis methods have not yet been applied to study fracture healing, but two comparable challenges which have been addressed in this general area are the evaluation of fracture severity and of fracture-associated soft tissue injury. CT-based methodologies developed to assess and quantify

  20. Early changes of fracture healing on MRI%骨折愈合早期磁共振成像的实验研究

    Institute of Scientific and Technical Information of China (English)

    殷耀斌; 张力丹; 腾星; 程晓光; 王满宜

    2010-01-01

    Objective To observe MRI presentations of fracture healing process in the early stage.Methods Six New Zealand rabbits were used in the experiment. A union model of long oblique fracture of 1 mm in bone defect and 10 mm in vertical length was created on the right radius. A model of 10 mm bone defect was created on the left radius. X-ray and MRI examinations were performed in 1 w, 2 w, 4 w, 6 w, 8 w, 12 wafter the surgery and CT examination was performed in 4 w, 12 w after the surgery. The imaging presentations at the fracture sites were observed on T1, T2, FS-T2, PD, FS-PD sequences. Results The soft tissue around the fracture site presented high signals on T2, FS-T2, PD, FS-PD sequences in the early stage of fracture healing. The signals decreased as time went on, but turned intermediate at 6 w after surgery. The signals of bone marrow turned from high to intermediate on T1, T2 and PD sequences early after the surgery,but turned high again with the healing of medullary cavity. On FS-T2 and FS-PD sequences, bone marrow presented intermediate signals mixed with high signals, but the high signals subsided as time went by. Early changes of callus formation could be observed by MRI. Callus formation at the site of fracture showed intermediate signals in FS-T2 and FS-PD images obtained at 2 w after the surgery in the fracture union model. The changes above could not be observed in the bone defect model. Conclusions Callus formation may be predicted earlier by MRI than by X ray, especially on FS-T2 and FS-PD sequences. The MRI presentations of early fracture healing are to be confirmed by pathological examinations.%目的 探讨骨折愈合过程中磁共振成像(MRI)的表现及变化规律.方法 6只新西兰白兔右侧桡骨中段制造垂直长度为10 mm、断端间隙为1 mm的长斜形骨折愈合模型.左侧桡骨中段制造10 mm骨质缺损模型.于术后1、2、4、6、8、12周对动物模型行X线及MRI扫描,于术后4 周及12周行螺旋CT扫描,

  1. Local transplantation of ex vivo expanded bone marrow-derived CD34-positive cells accelerates fracture healing.

    Science.gov (United States)

    Kawakami, Yohei; Ii, Masaaki; Alev, Cantas; Kawamoto, Atsuhiko; Matsumoto, Tomoyuki; Kuroda, Ryosuke; Shoji, Taro; Fukui, Tomoaki; Masuda, Haruchika; Akimaru, Hiroshi; Mifune, Yutaka; Kuroda, Tomoya; Horii, Miki; Yokoyama, Ayumi; Kurosaka, Masahiro; Asahara, Takayuki

    2012-01-01

    Transplantation of bone marrow (BM) CD34(+) cells, an endothelial/hematopoietic progenitor-enriched cell population, has shown therapeutic efficiency in the treatment of ischemic diseases enhancing neovascularization. However, the number of CD34(+) cells obtained from bone marrow is not sufficient for routine clinical application. To overcome this issue, we developed a more efficient and clinically applicable CD34(+) cell expansion method. Seven-day ex vivo expansion culture of BM CD34(+) cells with a cocktail of five growth factors containing VEGF, SCF, IL-6, Flt-3 ligand, and TPO resulted in reproducible more than 20-fold increase in cell number. The favorable effect of the local transplantation of culture expanded (cEx)-BM CD34(+) cells on rat unhealing fractures was equivalent or higher than that of nonexpanded (fresh) BM CD34(+) cells exhibiting sufficient therapeutic outcome with frequent vasculogenic/osteogenic differentiation of transplanted cEx-BM CD34(+) cells and fresh BM CD34(+) cells as well as intrinsic enhancement of angiogenesis/osteogenesis at the treated fracture sites. Specifically, cEx-BM CD34(+) cell treatment demonstrated the best blood flow recovery at fracture sites compared with the nonexpanded BM CD34(+) cells. In vitro, cEx-BM CD34(+) cells showed higher colony/tube-forming capacity than nonexpanded BM CD34(+) cells. Both cells demonstrated differentiation potential into osteoblasts. Since fresh BM CD34(+) cells can be easily collected from fracture sites at the time of primary operation and stored for future use, autologous cEx-BM CD34(+) cell transplantation would be not only a simple but also a promising therapeutic strategy for unhealing fractures in the field of orthopedic trauma surgery.

  2. Development of an Injectable Salmon Fibrinogen-Thrombin Matrix to Enhance Healing of Compound Fractures of Extremities

    Science.gov (United States)

    2012-09-01

    protein for tooth enamel . Teeth and bones are related structures but have distinct components and cellular components Surgical results- animal...A fibrin adhesive seal for the repair of osteochondral fracture fragments. Clin Orthop Relat Res, 1984(182): p. 258-63. 33. Kim, S.S. and B.S. Kim...needle, and held in place while the needle was 158 retracted. The catheter was secured in place using tissue adhesive and transparent adhesive 159

  3. A Concert between Biology and Biomechanics: The Influence of the Mechanical Environment on Bone Healing

    Science.gov (United States)

    Glatt, Vaida; Evans, Christopher H.; Tetsworth, Kevin

    2017-01-01

    In order to achieve consistent and predictable fracture healing, a broad spectrum of growth factors are required to interact with one another in a highly organized response. Critically important, the mechanical environment around the fracture site will significantly influence the way bone heals, or if it heals at all. The role of the various biological factors, the timing, and spatial relationship of their introduction, and how the mechanical environment orchestrates this activity, are all crucial aspects to consider. This review will synthesize decades of work and the acquired knowledge that has been used to develop new treatments and technologies for the regeneration and healing of bone. Moreover, it will discuss the current state of the art in experimental and clinical studies concerning the application of these mechano-biological principles to enhance bone healing, by controlling the mechanical environment under which bone regeneration takes place. This includes everything from the basic principles of fracture healing, to the influence of mechanical forces on bone regeneration, and how this knowledge has influenced current clinical practice. Finally, it will examine the efforts now being made for the integration of this research together with the findings of complementary studies in biology, tissue engineering, and regenerative medicine. By bringing together these diverse disciplines in a cohesive manner, the potential exists to enhance fracture healing and ultimately improve clinical outcomes. PMID:28174539

  4. Relationship between surgical time and postoperative complications in senile patients with hip fractures

    Institute of Scientific and Technical Information of China (English)

    MA Ren-shi; GU Gui-shan; WANG Cheng-xue; ZHU Dong; ZHANG Xi-zheng

    2010-01-01

    Objective:To elucidate the relationship between surgical time and postoperative complications in senile patients with hip fractures, and try to find out other factors which are related to these complications.Methods: Sixty-two patients, 28 males aged from 65 to 72 years with a mean age of 76.3 years and 34 females aged from 65 to 95 years with a mean age of 78.1 years, who had undergone orthopedic surgery because of hip fractures,were enrolled in a retrospective cohort study. The surgical time and pattern, the type of fracture, preoperative comorbidities, American Society of Anesthesiologists (ASA) score and the volume of blood transfusion during operation were obtained from these patients who were followed up by telephone calls for postoperative complications.All the patients were followed up at least for 1 year and were divided into subgroups according to their clinical characteristics and the results were analyzed by the Statistical Analysis System software.Results:There was no significant difference in the morbidity of postoperative eomplications with the gender,age,surgical time and pattern,or ASA score. There was significant difference in the morbidity of postoperative complications related to preoperative comorbidities and the volume of blood transfusion. There was a significant causality between preoperative comorbidities and postoperative complications. The morbidity of postoperative complications was 1.651 times higher in patients with preoperative comorbidities than those without.Conclusions:There is no relationship between the surgical time and postoperative complications in senile patients who received surgery for hip fracture within 1 year.No correlation is found between the postoperative complications and gender,age,type of fracture, surgical pattern,ASA score and the volume of blood transfusion. Preoperative comorbidities are an independent predictor for postoperative complications.

  5. Dose-effect relationships in total body irradiation on the healing of cutaneous wounds

    Institute of Scientific and Technical Information of China (English)

    冉新泽; 程天民; 林远; 屈纪富; 刘都户; 艾国平; 阎国和; 王文昌; 许汝福

    2003-01-01

    ObjectiveTo study the effects of dosages of total body irradiation on the healing process of cutaneous wounds and to observe the changes of wound area at different periods after injury.star rats. The single dosage varied from 1 to 8 Gy. Within 1 h after irradiation, two whole thickness circular cutaneduced on the back of the animals (combined injury groups). Same wounds were produced on rats with no irradiation (single wound group). Wound healing was observed at different points after injury. ResultsAfter total body irradiation with the dose of 1,2,3,4,5,6, 7 or 8 Gy, the wound healing was obviously retarded as the dosages increased. The wound area remained was larger in the large dosage groups than in the small dosage groups. Seven days after injury, there was 33.5% wound surface left unhealed in the single wound group, whereas in the combined injury groups, 35.4%, 38.1%, 41.6%, 48.8%, 53.9%, 63.7%, 69.2% and 73.9% of the wound surfaces remained unhealed, respectively. Statistical analysis showed marked correlations between the varioustimes after total body irradiation and various dosages to the percentage of unhealed wound surface. Nine dose-effect relation formulae were deduced according to the statistical results.ConclusionsIn soft tissue trauma combined with radiation injury, the delay of wound healingis related to the dose of radiation inflicted. It is also related to the time between injury and time of observation.

  6. Short-Term Relationship between Hip Fracture and Weather Conditions in Two Spanish Health Areas with Different Climates

    Directory of Open Access Journals (Sweden)

    José María Tenías

    2015-01-01

    Full Text Available Objective. To evaluate differences in the short-term relationship between weather conditions and the incidence of hip fracture in people aged 65 and over among two regions of Spain. Methods. Hip fracture incidence was calculated for the years 2000–2008 for residents of Health Area 14 in Valencian Community (Mediterranean climate and the “Mancha Centro” Health Area in Castilla-La Mancha (inland climate, Spain. The relationship between hip fracture incidence and weather was analyzed with a case-crossover design and explored in subgroups defined by sex, age, and fracture type. Results. In the inland area, a positive and significant tendency for hip fracture incidence was observed (annual increase: 1.5% whereas in the Mediterranean area a seasonal increase of 9% was noted in autumn and winter with respect to spring. Weather conditions, especially wind, were significantly associated with hip fracture incidence: days with more frequent windy periods and/or a greater wind velocity were associated with an increase in hip fracture incidence of 51% in the Mediterranean area and 44% in the inland area. Conclusions. Hip fracture incidence exhibits seasonal changes that differ between the Mediterranean and inland areas. The short-term relationship with climate, although similar in both areas, may partly explain these seasonal changes.

  7. Bone healing in 2016

    Science.gov (United States)

    Buza, John A.; Einhorn, Thomas

    2016-01-01

    Summary Delayed fracture healing and nonunion occurs in up to 5–10% of all fractures, and can present a challenging clinical scenario for the treating physician. Methods for the enhancement of skeletal repair may benefit patients that are at risk of, or have experienced, delayed healing or nonunion. These methods can be categorized into either physical stimulation therapies or biological therapies. Physical stimulation therapies include electrical stimulation, low-intensity pulsed ultrasonography, or extracorporeal shock wave therapy. Biological therapies can be further classified into local or systemic therapy based on the method of delivery. Local methods include autologous bone marrow, autologous bone graft, fibroblast growth factor-2, platelet-rich plasma, platelet-derived growth factor, and bone morphogenetic proteins. Systemic therapies include parathyroid hormone and bisphosphonates. This article reviews the current applications and supporting evidence for the use of these therapies in the enhancement of fracture healing. PMID:27920804

  8. 失神经对大鼠胫骨骨折愈合影响作用的实验研究%Experimental Study of Denervation of Rat Tibial Fracture Healing Effect

    Institute of Scientific and Technical Information of China (English)

    王永红; 汪玉良; 吴卓; 康学文; 康鑫

    2015-01-01

    目的:通过观察失神经后大鼠胫骨骨折的愈合情况,探讨中枢神经系统影响失神经骨折愈合的作用机制。方法将64只 SD 成熟雌性大鼠随机分为失神经骨折组、单纯骨折组,每组各32只。分别于术后第7、14、21、28天进行 BBB 评分,观察骨折愈合情况,并行左下肢骨折部位 X 线检查、胫骨湿重称量、骨痂体积测量,进行相关统计学分析。结果 BBB 行为学评分提示两组大鼠在术后各时间点具有统计学意义(P <0.05)。通过比较失神经骨折组与单纯骨折组 BBB 评分结果,提示在术后各时间点,失神经骨折组大鼠运动功能恢复速度明显减慢。X 线片提示失神经骨折组大鼠骨折处有大量骨痂生成,且愈合速度明显加快。在术后7天,两组大鼠胫骨湿重称量、骨痂体积测量则无统计学意义(P >0.05),而在术后14至28天,失神经骨折组与单纯骨折组相比,胫骨湿重称量、骨痂体积测量分别具有统计学意义(P <0.05),提示在失神经骨折中晚期会生成过量骨痂。结论中枢神经系统在骨折愈合中起重要的调节作用,完整的神经支配是骨折愈合的必要条件。%Objective By observing the healing after denervation of rat tibial fractures to investigate the mechanism of the central nervous system denervation affect fracture healing.Methods The 64 mature female SD rats were randomly divided into 2 groups including denervation fractures and fracture group,32 in each group.7,14,21 and 28 days after surgery,re-spectively,to assess the BBB score,fracture healing was observed,and in the left lower limb fracture site X-ray examination, tibia wet weighing callus volume measurement,the related statistical analysis was carried.Results The BBB behavioral scores showed two groups of rats at various time points after surgery have statistically significant (P 0.05),and in 14 to 28 days after surgery

  9. Open or closed repositioning of mandibular fractures: is there a difference in healing outcome? A systematic review

    DEFF Research Database (Denmark)

    Andreasen, Jens Ove; Storgård Jensen, Simon; Kofod, Thomas

    2008-01-01

    The clinical outcome of closed vs open reduction and rigid fixation was compared based on a systematic review of the literature. Ten non-randomized retrospective studies were found. In six of these ten studies, the complication rate was significantly increased when open reduction and plating...... or wires. Nerve injuries were slightly increased when open reduction was found (although not significant). With regard to occlusal disturbances, no difference was found in the open and closed reduction group. Concerning overall complication problems, six of seven studies showed more problems after open...... in case of more complicated fractures cannot be excluded, which might explain the differences found between the two procedures. Prospective, randomized clinical trials are needed to illuminate this problem....

  10. A constitutive-relationship model for film flow on rough fracture surfaces

    Science.gov (United States)

    Liu, H. H.

    Film flow on fracture surfaces may be an important mechanism for fast flow in unsaturated fractured rocks. Incorporating this mechanism into a numerical model requires knowledge of constitutive relationships for film flow. Based on fractal concepts and a conceptual argument of Tokunaga et al. that water films could be treated as analogues to water in unsaturated porous media, a simple constitutive-relationship model has been developed. The validity of the model is supported by excellent agreements between calculation results and experimental observations for two different fracture surfaces. L'écoulement en film sur les surfaces de fracture peut être un mécanisme important pour l'écoulement rapide dans les roches fracturées non saturées. L'incorporation de ce mécanisme dans un modèle numérique nécessite la connaissance des relations fondamentales pour l'écoulement en film. Basé sur des concepts fractals et sur un argument conceptuel de Tokunaga et al. selon lequel des films d'eau peuvent être considérés comme des analogues de l'eau en milieu poreux non saturé, un modèle simple des relations fondamentales a été développé. La validité de ce modèle est confirmée grâce à une excellente concordance entre les résultats du calcul et les observations expérimentales pour deux surfaces différentes de fractures. El flujo pelicular en la superficie de las fracturas puede ser un mecanismo importante para el flujo rápido en rocas fracturadas no saturadas. Incorporarlo en un modelo numérico requiere conocer las relaciones constitutivas del flujo pelicular. Se ha desarrollado un modelo de una relación constitutiva sencilla partiendo de conceptos fractales y de un argumento conceptual de Tokunaga et al., según el cual las películas de agua pueden ser tratadas como análogos del agua en medios porosos no saturados. La validez del modelo es corroborada por los excelentes ajustes entre los resultados numéricos y las observaciones experimentales en dos

  11. The Relationship Between Inflammation and Impaired Wound Healing in a Diabetic Rat Burn Model.

    Science.gov (United States)

    Tian, Ming; Qing, Chun; Niu, Yiwen; Dong, Jiaoyun; Cao, Xiaozan; Song, Fei; Ji, Xiaoyun; Lu, Shuliang

    2016-01-01

    Inflammation, initiated by polymorphonuclear neutrophil (PMNs) infiltration, is the first step in wound healing. The aim of this study is to investigate the function of neutrophils in a diabetes-impaired wound healing model and to explore the underlying mechanisms leading to neutrophil dysfunction. Superficial second-degree burns were created in the streptozotocin (STZ)-induced diabetic rat model, and the changes in the levels of advanced glycation end products (AGE), receptor of AGE (RAGE), inflammatory cytokines and oxidative markers, as well as cell apoptosis were determined. The effects of AGE on isolated PMNs were also determined in vitro. We found that deposition of AGE in diabetic rat skin activated the neutrophils before injury. However, the dense inflammatory band failed to form in the diabetic rats after injury. Compared with the controls, enhanced expression of RAGE and accelerated cell apoptosis were observed in the burned skin of diabetic rats. The altered expression pattern of inflammatory cytokines (tumor necrosis factor-alpha and interleukin-8) and oxidative markers (glutathione peroxidase, myeloperoxidase, hydrogen peroxide, and malondialdehyde) between burned skin of diabetic and control rats revealed delayed neutrophil chemotaxis and respiratory burst. Furthermore, the results in vitro showed that exposure to AGE inhibited the viability of PMNs, promoted RAGE production and cell apoptosis, and prevented the migration of PMNs, consistent with the findings in vivo. Besides, AGE-treated neutrophils showed increased secretion of inflammatory cytokines and increased oxidative stress. Combined, our results suggest that an interaction between AGE and its receptors inhibits neutrophil viability and function in the diabetic rat burn model.

  12. Relationship between mandibular angle fracture and state of eruption of mandibular third molar: A digital radiographic study

    Directory of Open Access Journals (Sweden)

    Mahesh Kumar Talkad Subbaiah

    2015-01-01

    Full Text Available Objectives: The purpose of this study was to assess the relationship between mandibular angle fracture and the status of eruption of the mandibular third molars. Materials and Methods: The sample consisted of 50 mandibular angle fracture cases with or without the presence of mandibular third molars, inclusive of both genders in the age group 18 years and above. The mandibular angle fractures were assessed by taking an orthopantomograph for each case following strict radiation protection protocol after an informed consent was obtained. The captured image was assessed and traced for the presence of mandibular angle fracture, angulation, and status of mandibular third molar by using Windows Trophy DICOM and Master View 3.0 software. Pell and Gregory′s and Winter′s classifications were followed. Results: We observed the following: Increased incidence of angle fractures in the presence of mandibular third molar, male predominance, the mean average age being 29 years, and the most common cause of angle fractures was road traffic accident; the fractures were observed more on the left side. In the total sample, mandibular third molar was present in 90% of the cases with angle fracture; of this, 73% of the teeth were impacted. Increased incidence of mandibular angle fracture was observed in position A, class II, and mesioangular impaction of third molar, which were statistically significant. Conclusion: The presence of mandibular third molar was in strong association with mandibular angle fracture and there was an increased incidence of position A, class II, and mesioangular impaction, when compared with other positions. This study concludes that there is a direct relationship between the presence and status of impacted third molars with increased risk of mandibular angle fracture.

  13. Fidelity to the healing relationship: a medical student's challenge to contemporary bioethics and prescription for medical practice.

    Science.gov (United States)

    Corcoran, Blake C; Brandt, Lea; Fleming, David A; Gu, Chris N

    2016-04-01

    As a medical  student, I observed that different physicians had strikingly different attitudes and approaches when caring for patients. The care of one patient in particular continues to challenge my understanding of illness and moral responsibility in the practice of medicine. In this paper, I illustrate the care of this patient in order to evaluate the dominant ethics I was taught in medical school, in theory and in practice, and argue neither principlism nor the ethics of care fully captures the moral responsibility of physicians. Emphasising fidelity to the healing relationship, a core principle derived from Pellegrino's virtue theory, I conclude that this approach to clinical ethics fully explains physician responsibility. Pellegrino deconstructs the practice of medicine to clarify the moral event within the clinical encounter and offers a sufficiently useful and justified approach to patient care.

  14. Pseudoarthrosis in atypical femoral fracture: case report.

    Science.gov (United States)

    Giannotti, S; Bottai, V; Dell'Osso, G; De Paola, G; Ghilardi, M; Guido, G

    2013-11-01

    Atypical femoral fractures can be subsequent to a long-term biphosphonates treatment; they have a high frequency of delayed healing. The authors describe a femoral pseudoarthrosis of an atypical fracture treated with intramedullary nailing in a female after prolonged alendronate therapy. Atypical femoral fractures can be subsequent to a long-term biphosphonates treatment even if, in the literature, there is no clarity on the exact pathogenetic mechanism. The Task Force of the American Society for Bone and Mineral Research described the major and minor features to define atypical fractures and recommends that all the five major features must be present while minor features are not necessary. Another controversial aspect regarding the atypical femoral fractures is the higher frequency of the delayed healing that can be probably related to a suppressed bone turnover caused by a prolonged period of bisphosphonates treatment. This concept could be corroborated by the Spet Tc exam. In the case of a pseudoarthrosis, there is not a standardization of the treatment. In this report, the authors describe a femoral pseudoarthrosis of an atypical fracture treated with intramedullary nailing in a female after prolonged alendronate therapy; the patient was studied with clinical, bioumoral end SPECT-Tc exam of both femurs. Many studies show the relationship between bisphosphonates and the presence of atypical fractures. These fractures should be monitored more closely due to the risk of nonunion and they require considering an initial treatment with pharmacological augmentation to reduce the complications for the patient and the health care costs.

  15. 促进跟骨骨折内固定术后切口愈合的护理对策%Nursing Strategy of Promoting Incision Healing After Internal Fixation of Calcaneal Fractures

    Institute of Scientific and Technical Information of China (English)

    吴惠冰; 杜雪莲

    2014-01-01

    Objective To investigate nursing strategy of promoting incision healing after internal fixation of calcaneal fractures. Methods 121 patients with internal fixation of calcaneal fractures were divided into two groups. 60 cases of control group received routine nursing, while 61 cases of observation group received swelling care, pain care and wound care on the basis of routine nursing. The clinical outcomes were compared. Results Among 61 cases of observation group, there were 56 cases of incision healing within 14 days, 4 cases of poor partial involution (healing after one month of treatment) and one case of unhealed incision (caused by allograft rejection). Among 60 cases of control group, there were 39 cases of incision healing within 14 days, 15 cases of poor partial involution (healed after one month of treatment) and 6 cases of necrosis of local skin of incision (healing at 2 months after treatment). Conclusions Nursing intervention can promote the incision healing of calcaneal fractures surgery.%目的:探讨促进跟骨骨折内固定术后切口愈合的护理对策。方法将121例跟骨骨折内固定手术患者分为观察组及对照组,观察组在常规护理基础上,加强肿胀护理、疼痛护理、伤口护理,对照组予常规护理,比较两组的临床效果。结果观察组61例患者有56例切口14天愈合,4例切口局部对合差,经治疗1月内愈合,1例伤口不愈,为异体骨排斥引起;对照组60例患者有39例切口14天愈合,15例患者切口局部对合差,经治疗1月内愈合,6例患者伤口局部皮肤坏死,术后2个月愈合。结论护理干预可以促进跟骨骨折术后切口的愈合。

  16. The Effects of One Chinese Herbal Medicine on Fracture Healing of Rabbits%一剂复方中药对家兔骨骼愈合的影响

    Institute of Scientific and Technical Information of China (English)

    曲伟杰; 李进军; 王生奎

    2011-01-01

    The pathways of Chinese herbal medicine in fracture healing are not very well understood. Therefore, the objective of the present study was to evaluate the effects of one compound Chinese herbal medicine on rabbits radius fracture healing using indexes(such as the serum Ca. P, serum ALP, and X-ray of bone fracture). 48 healthy mature rabbits were selected to build standard defect models, and randomly divided into experimental groups and control groups. The control rabbits were given standard diet. Experimental rabbits were fed with standard diet plus Chinese herbal medicine (2. 5 g/kg) every day. The detection was performed on the 2,4,6 and 8 weeks after operation. The results of the study showed that the level of serum Ca, P, the activity of AKP and X-ray appearances for taking Chinese herbal medicine after fracture were significantly higher than that of the control. In conclusion, composite Chinese herbs might shorten the time to union, improve the quality of fracture healing and be beneficial to the fracture healing.%复方中药对骨折愈合的作用机制目前尚不明确,本试验通过观察复方中药对家兔桡骨骨折后血清钙、磷、碱性磷酸酶和X线影像学等指标的影响,分析该中药促骨愈合的效能及其可能作用机理.试验选用48只成年家兔,制成骨缺损标准模型,随机分为试验组和空白对照组,试验组每日在饲料中添加复方中药2.5 g/kg饲喂,对照组给予普通饲料.分别于术后2、4、6、8周进行生化指标和X线影像学检测.试验结果表明,试验组血清钙、血清磷、血清碱性磷酸酶及X线片评分骨折后明显高于对照组.该复方中药能缩短骨折愈合过程所需时间,提高骨折愈合质量,有利于骨折愈合.

  17. The relationship between suture number and the healing process of end-to-end arterial anastomosis

    Directory of Open Access Journals (Sweden)

    Winston B Yoshida

    1997-06-01

    Full Text Available In spite of the grate experience accumulated in vascular repairing, the ideal number of sutures for vascular anastomosis remains controversial. It is generally thought that the more stitches applied in a vascular anastomosis, the lesser resistant the anastomosis will be. The purpose of this study was to test this hypothesis in 20 rabbits, in which both carotid arteries were cross sectioned and repaired by end-to-end anastomosis with 8 interrupted sutures in one side (G1 and 16 in the other side (G2. After 3 and 15 days, the animals were randomly allocated for tensile strength, hydroxyproline determination (7 animals and for histologic analysis of the anastomosis (3 animals. Conventional staining procedures (hematoxylin-eosin and Masson methods and the picrosirius red polarization (PSP technique for collagen type determination were used. From 3 to 15 days, the tensile strength increased in both groups, from 265.0±-44.4g to 391.2±-49.0g in G1 and from 310.0±-71.5g to 348.7±-84.0g in G2 (p<0.005, with no statistical difference between the groups in each period of study. The hydroxyproline content, expressed as hydroxyproline/protein ratio, varied from 0.04±-0.01 to 0.05±-0.02 in G1 and from 0.05±-0.01 to 0.05±-0.02 in G2, with no significant difference between periods and groups. The histology showed similar inflammatory and reparative aspects in both groups. In both groups and periods the PSP technique demonstrated predominantly type I collagen in relation to type III collagen in the anastomosis. We concluded that even doubling the number of stitches, the healing process and strength did not change in the arterial anastomosis.

  18. Microstructure and its relationship to fracture in portland cement mortar and concrete

    Science.gov (United States)

    Abell, Anne Bernadine

    This research explores the relationship between the geometry of crack propagation and mechanical properties of mortar and concrete. The crack deflection and branching are measured using several microscopy techniques along with image analysis of crack profiles intruded by a low melting-point alloy. The toughness measured by mechanical testing, the fracture surface geometry, phases and elastic properties identified by image analysis and microscopy, along with the crack branching relationships are used to predict the increase in the toughness of these materials with respect to the flat-crack toughness using a micromechanical model. The effect of the model parameters, microscopy techniques, material elastic properties, void modeling and branching ratio were investigated. The parametric analysis and modeling conditions determine a nearly uniform flat-crack toughness for the cement matrix of the mortar samples and a higher flat-wrack toughness for the cement matrix of the concrete samples. The trend toward a single toughness value may be an indication that there is a single material parameter to describe the fracture energy of these materials.

  19. Study of the impact of PDLLA in fracture healing%PDLLA可吸收材料髓内固定对骨折愈合的影响

    Institute of Scientific and Technical Information of China (English)

    凌卓彦; 史高龙; 陈礼; 董启榕

    2015-01-01

    Objective To compare the different effect of PDLLA absorbable materials and traditional metal fixation products for post-traumatic bone healing and osteogenesis/osteoclast.Methods The project will establish an open osteotomy model of SD rats using traditional metal internal fixation products (Kirschner) and PDLLA absorbable intramedullary rod fixation.We compared the osteoblasts/osteoclasts effects of the two materials by dynamic monitoring of relevant indicators of bone repair in wound healing process.Furthermore, wehaveanalyzed the signaling pathways and transcription factor expression levels of osteoblast/osteoclast differentiation and maturation in healing process.We thoroughly studied the differenceof the cellular and molecular mechanisms in the treatment of traumatic fractures by PDLLA intramedullary rod fixation and traditional metal products.We measured the soluble receptor activateor of nuclear factors-κB ligand (sRANKL), osteoprotegerin (OPG), RANKL, OPG by the enzyme linked immunosorbent assay (ELISA) to evaluate the fracture healing.We compared the osteoblasts/osteoclasts effects of the two materials by X-ray and MicroCT.We observed the protein of Wnt OPG and RANKL by histology method.Compared the expression of mRNA of Wnt OPG and RANKL by real-time quantitative polymerase chain reaction (Real-time PCR).Results At 4 and 6 weeks after surgery, compared to that of metal intramedullary fixation products, after using the PDLLA absorbable material for intramedullary fixation, the growth of trabecula in callus was significantly promoted [4 W: (0.522 ± 0.06) 1/mm;6 W: (0.709 ±0.06) 1/mm];The serum concentrations of sRANKL [4 W: (132.66 ± 2.87) ng/L;6 W: (131.08 ±2.09) ng/L], OPG [4W: (42.68 ± 3.99) ng/L;6 W: (44.88 ± 3.90) ng/L], and the ratio of OPG/sRANKL (4 W:0.34 ±0.06;6W:0.34 ±0.08) were significantly increased;The serum concentrations of TRACP-5b[4 W:(86.48 ±5.11) ng/L;6 W:(90.05 ±5.13) ng/L]was decreased(P <0.05).At 4 and 6 weeks after

  20. Ultrasound stimulation of maxillofacial bone healing

    NARCIS (Netherlands)

    Schortinghuis, J; Stegenga, B; Raghoebar, GM; de Bont, LGM

    2003-01-01

    A substantial part of the maxillofacial surgery practice deals with maxillofacial bone healing. In the past decades, low-intensity ultrasound treatment has been shown to reduce the healing time of fresh fractures of the extremities up to 38%, and to heal delayed and non-unions up to 90% and 83%, res

  1. The Relationship Between DP, Fracture Degree and Mechanical Strength of Cellulose Iβ in Insulation Paper by Molecular Dynamic Simulations

    Science.gov (United States)

    Wang, You-Yuan; Yang, Tao; Tian, Miao; Liao, Rui-Jin

    2013-09-01

    The degree of polymerization (DP) has been regarded as an important symbol of mechanical strength, reflecting the aging condition of transformer insulation paper. In this article, a new concept called fracture degree is proposed on the basis of DP. First, nine cellulose Iβ crystal models with different fracture degrees were built. Then relevant mechanical parameters and hydrogen bond numbers were calculated by molecular dynamics (MD) simulation. Results showed that during the aging process of insulation paper with fracture of cellulose chain, the elastic constant C33 produces appreciable impact on the Young's modulus (E). With the decrease of DP and increase of fracture degree, the Young's modulus step decreases. To the 50% and 100% fracture degree models respectively, the relationship between their different degrees of polymerization and Young's modulus is subjected to similar exponential distributions. With the increase of the fracture degree, the average hydrogen bond number drops, and the change rules apply to the Young's modulus. Since hydrogen bond is the main factor of mechanical strength, it can be inferred that the fracture degree influences mechanical strength seriously.

  2. On the Relationship between Stress and Elastic Strain for Porous and Fractured Rock

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Hui-Hai; Rutqvist, Jonny; Berryman, James G.

    2008-02-25

    Modeling the mechanical deformations of porous and fractured rocks requires a stress-strain relationship. Experience with inherently heterogeneous earth materials suggests that different varieties of Hook's law should be applied within regions of the rock having significantly different stress-strain behavior, e.g., such as solid phase and various void geometries. We apply this idea by dividing a rock body conceptually into two distinct parts. The natural strain (volume change divided by rock volume at the current stress state), rather than the engineering strain (volume change divided by the unstressed rock volume), should be used in Hooke's law for accurate modeling of the elastic deformation of that part of the pore volume subject to a relatively large degree of relative deformation (i.e., cracks or fractures). This approach permits the derivation of constitutive relations between stress and a variety of mechanical and/or hydraulic rock properties. We show that the theoretical predictions of this method are generally consistent with empirical expressions (from field data) and also laboratory rock experimental data.

  3. Healing Childhood Trauma Worldwide

    Science.gov (United States)

    Kuban, Caelan

    2012-01-01

    Millions of the world's children are exposed to traumatic events and relationships every day. Whatever the cause, this overwhelming stress produces a host of unsettling symptoms and reactions. The author highlights six practical principles that undergird healing interventions.

  4. 丹参和内固定对胫骨远端骨折愈合的影响研究%Study on the Effect of Salvia Miltiorrhiza and Internal Fixation on the Healing of Distal Tibial Fractures

    Institute of Scientific and Technical Information of China (English)

    董晓强; 王海涛

    2016-01-01

    Objective To discuss the effect of different internal fixation treatment combined with Salvia miltiorrhiza for distal tibial fractures and defining the value of Salvia miltiorrhiza for fracture healing.Methods A retrospective analysis of therapeutic efficacy was made in Department of orthopedics of Chenggang Steel Hospital where there were 226 cases of emergency patients with internal fixation of distal tibial fractures according to the use of Salvia miltiorrhiza. They were divided into the Salvia miltiorrhiza group 114 cases (Salvia miltiorrhiza and pressure plate sub group, Salvia miltiorrhiza and LCP group, Salvia miltiorrhiza and intramedullary nail group) and the internal fixation group 112 cases(compression ifxation group, locking compression plate and intramedullary fixation sub group), in 1 week, 2 weeks, 4 weeks and 8 weeks after the treatment, comparison of callus formation, the postoperative hospitalization time and fracture healing made among groups. ResultsAt the same time after 2 weeks, the callus score of Salvia miltiorrhiza group was significantly better than the internal fixation group, and fracture healing time, postoperative hospitalization time were signiifcantly lower than those of the internal fixation group. The indicators of salvia miltiorrhiza and locking compression plate group were better than other groups,P<0.05, so the difference was significant. Conclusion Salvia miltiorrhiza combined with internal ifxation can signiifcantly improve fracture healing, and Salvia miltiorrhiza combined with locking pressurized plate internal fixation can be the best choice of tibial fractures treatment. The treatment effect is remarkable and fast healing.%目的:探讨丹参结合不同内固定方案治疗胫骨远端骨折的效果,明确丹参对于骨折愈合的价值。方法回顾性分析承钢医院骨科226例胫骨远端骨折患者急诊内固定手术的治疗效果,根据丹参使用分为丹参组114例(丹参与加压板亚组、

  5. Radon in a fractured bedrock aquifer: Relationships with rock type and distribution of parent radionuclides

    Energy Technology Data Exchange (ETDEWEB)

    Folger, P.F.; Wanty, R.B.; Day, W.; Frishman, D.; Taylor, T. (Geological Survey, Denver, CO (United States). Denver Federal Center); Poeter, E. (Colorado School of Mines, Golden, CO (United States))

    1992-01-01

    Ground-water samples collected from 35 domestic water wells in the Elk Creek drainage 30 miles southwest of Denver, Colorado, show a strong relationship between dissolved Rn-222 concentration and host-rock lithology. Wells completed in Precambrian Pikes Peak Granite (Ypp) average 11,000 pCi/L, whereas wells completed in Precambrian migmatitic rocks (Xm) average 4,000 pCi/L. Geophysical logs of three boreholes completed in the same rock type (Ypp) show significant differences in natural gamma traces and correspondingly different radon concentrations. One well shows a monotonous gamma response with depth, averaging 500 counts per second (cps); water from this well contains 5,300 pCi/L Rn-222. Water from the second well contains 11,000 pCi/L and the third well contain over 20,000 pCi/L. If Rn-222 parent radionuclides are homogeneously distributed along fracture walls, then Rn-222 concentration should decrease with an increasing water-volume-to-rock surface-area ratio. An inverse relationship between transmissivity and Rn-222 concentration is not observed for these 3 wells. The 2 wells with 5,300 pCi/L and 20,000 pCi/L Rn-222 in water have transmissivities of 26 and 75 gallons per day per foot (gpd/ft), respectively, whereas transmissivity for the well with 11,000 pCi/L is 195 gpd/ft. Single-well pumping tests on 29 other wells belie a systematic correlation between transmissivity and Rn-222 concentration, suggesting that local heterogeneous accumulations of Rn-222 parent radionuclides on fracture walls may strongly affect Rn-222 concentration in these wells.

  6. Assessment of bone healing on tibial fractures treated with wire osteosynthesis associated or not with infrared laser light and biphasic ceramic bone graft (HATCP) and guided bone regeneration (GBR): Raman spectroscopy study

    Science.gov (United States)

    Bastos de Carvalho, Fabíola; Aciole, Gilberth Tadeu S.; Aciole, Jouber Mateus S.; Silveira, Landulfo, Jr.; Nunes dos Santos, Jean; Pinheiro, Antônio L. B.

    2011-03-01

    The aim of this study was to evaluate, through Raman spectroscopy, the repair of complete tibial fracture in rabbits fixed with wire osteosynthesis - WO, treated or not with infrared laser light (λ 780nm, 50mW, CW) associated or not to the use of HATCP and GBR. Surgical fractures were created under general anesthesia (Ketamine 0.4ml/Kg IP and Xilazine 0.2ml/Kg IP), on the tibia of 15 rabbits that were divided into 5 groups and maintained on individual cages, at day/night cycle, fed with solid laboratory pelted diet and had water ad libidum. On groups II, III, IV and V the fracture was fixed with WO. Animals of groups III and V were grafted with hydroxyapatite + GBR technique. Animals of groups IV and V were irradiated at every other day during two weeks (16J/cm2, 4 x 4J/cm2). Observation time was that of 30 days. After animal death the specimens were kept in liquid nitrogen for further analysis by Raman spectroscopy. Raman spectroscopy showed significant differences between groups (p<0.001). It is concluded that IR laser light was able to accelerate fracture healing and the association with HATCP and GBR resulted on increased deposition of calcium hydroxyapatite.

  7. Application of platelet derived growth factor-BB and diabetic wound healing: the relationship with oxidative events.

    Science.gov (United States)

    Gökşen, Sibel; Balabanlı, Barbaros; Coşkun-Cevher, Şule

    2017-05-01

    The reasons that cause delay in wound healing in diabetes are a decrease in the level of growth factors secretion, an increase in the destruction of growth factors and in oxidative stress. Platelet derived growth factor (PDGF) is one of the important growth factors that play a role in all phases of wound healing. This study investigates time-dependent effects of topically PDGF-BB administration on oxidative events on the healing of dorsolateral-excisional wounds in diabetic rats. Forty-two female Wistar-albino rats with streptozotocin-induced diabetes were divided into four groups: control group, untreated group, chitosan-treated group, chitosan + PDGF-BB-treated group. Two identical full-thickness excisional skin wounds were made under anaesthesia in all rats except for the control group. In the PDGF-BB-treated and chitosan-treated groups, the wounds were treated topically PDGF-BB (7 ng/mL, single daily dose) and blank chitosan gel (equal amount) after wounding, respectively. After these administrations, on day 3 and day 7 of wound healing, rats were sacrificed. Thiobarbituric acid reactive substances, glutathione, nitric oxide, ascorbic acid levels, and superoxide dismutase activity in wound tissues were spectrophotometrically measured. PDGF-BB administration significantly increased TBARS levels and non-enzymatic antioxidant levels in early phase of diabetic wound healing. PDGF-BB dramatically reduced NOx levels on day 3 and sharply increased NOx levels on day 7 of wound healing. Consequently, PDGF-BB administration can be effective on oxidative balance in the early phase of diabetic wound healing.

  8. The Waywardness of Knee Joint Affect Fracture Healing(annexal three Example Clinical Analysis)%膝关节不稳对骨折愈合的影响(附3例临床分析)

    Institute of Scientific and Technical Information of China (English)

    黄枫; 曾志奎; 黄学员; 曾展鹏

    2011-01-01

    Objective: To investigate the waywardness of knee joint affect fracture Healing. Methods: To review our hospital adduct three patients who because of fail to make a definite diagnosis of the Cruciate ligaments of knee joint injuries,which induce the homonymy Fracture of shaft of femur postoperative disunion. Author from the biomechanics point of view to analyze,cruciate ligament is very important to the steady of knee joint,conversely after the injuries of knee joint to mean a certain degree loss of physiological move-ment,as well as load conduction disturbance Followed by,which lead to the waywardness of knee joint. The waywardness of knee joint cause the stress of broken ends of fractured bone modify,which will bring what influence to fracture healing. Results: If we do not repair the injured cruciate ligament in time.when the patient who is postoperative of Fracture of shaft of femur is doing contineous passive motion or contineous passive motion working, there will be one shearing and revolving stress transmit to broken ends of fractured bone, meanwhile Vertical compressive stress of legs is hard to transmit to broken ends of fractured bone.which is likely to induce Fracture of shaft of femur to defer union even disunion. Conclusion: The waywardness of knee joint cause the stress of broken ends of fractured bone in homonymy limbs modify,which is likely to induce fracture to defer union even disunion.%目的:探讨膝关节不稳对骨折愈合的影响.方法:回顾性分析我院收治3例患者因早期未能准确诊治膝关节交叉韧带损伤,而导致同侧股骨干骨折术后不愈合的临床资料.我们从生物力学角度分析,交叉韧带对膝关节生理性制导及稳定作用,反之损伤后膝关节的生理运动一定程度的丧失,以及随之而来的载荷传导紊乱,从而导致膝关节不稳.膝关节不稳所引起骨折端应力改变,其对骨折愈合将产生怎样的影响.结果:如未能及时修复交叉韧带在患者

  9. The relationship between dietary protein consumption and risk of fracture: a subgroup and dose-response meta-analysis of prospective cohort studies.

    Science.gov (United States)

    Wu, Ai-Min; Sun, Xiao-Lei; Lv, Qing-Bo; Zhou, Yong; Xia, Dong-Dong; Xu, Hua-Zi; Huang, Qi-Shan; Chi, Yong-Long

    2015-03-16

    It is still debate of the relationship between the dietary protein consumption and risk of fracture. We searched Medline and Embase to assess the effects of dietary protein consumption on risk of fracture. Twelve prospective cohort studies with 407,104 participants were included, higher total protein consumption may be decrease 11% risk of hip fractures, with adj. RR of 0.89 (0.82, 0.97), no significant difference was found for total protein and risk of all fractures and limb fracture; for animal protein consumption and risk of all fractures and hip fracture, with adj.RR of 0.79 (032, 1.96) and 1.04 (0.70, 1.54); for vegetable protein consumption and risk of all fractures, hip fracture and limb fractures with adj.RR of 0.77 (0.52, 1.12), 1.00 (0.53, 1.91), and 0.94 (0.40, 2.22), the subgroup of vegetable protein consumption and risk of all fractures of postmenopausal women with adj.RR of 0.78(0.52,1.16). Dose-response meta-analysis the relationship of total/animal/vegetable protein and hip fracture was consistent to the results of forest plot, the line of total protein and hip fracture was below the Y = 1.0 line. This meta-analysis showed that total dietary protein consumption may be decrease the risk of hip fracture, but not for animal or vegetable protein.

  10. [Relationship between CD4(+) T lymphocyte cell count and the prognosis (including the healing of the incision wound) of HIV/AIDS patients who had undergone surgical operation].

    Science.gov (United States)

    Yang, Di; Zhao, Hongxin; Gao, Guiju; Wei, Kai; Zhang, Li; Han, Ning; Xiao, Jiang; Li, Xin; Wang, Fang; Liang, Hongyuan; Zhang, Wei; Wu, Liang

    2014-12-01

    To explore the relationship between CD4(+) T lymphocyte cell count and prognosis as well as healing of the surgical incision in HIV/AIDS patients who had received operation. Data were collected and analysed retrospectively from 234 HIV/AIDS patients hospitalized at the Beijing Ditan hospital who underwent operation between January 2008 and December 2012. Following factors were taken into consideration that including:age, gender, time and where that anti-HIV(+) was diagnosed, CD4(+)T lymphocyte cell count at the time of operation, part of the body that being operated, typology of incision, different levels of healing on the surgical incision, infection at the incision site, post-operative complications and the prognosis, etc. Wilcoxon rank sum test, χ(2) test, Kruskal-Wallis H test and Spearman rank correlation were used for statistical analysis to compare the different levels on healing of the incision in relation to the different CD4(+)T lymphocyte cell counts. Rates of level A healing under different CD4(+)T cell counts were also compared. 1) Among the 234 patients including 125 males and 109 females, the average age was 36.17±11.56 years old. Time after discovery of anti-HIV(+)was between 0 and 204 months. The medium CD4(+)T cell count was 388.5 cell/µl; 23.93% of the patients having CD4(+)T lymphocyte cell counts as different organs affected at the time of operation, due to 48 different kinds of illness. 21.37% of the operations belonged to class I incision, 49.57% was class II incision and 29.06% was class III incision. 86.32% of the incisions resulted in level A healing, 12.51% resulted in level B and 1.71% in level C. 4.27% of the patients developed post-operative complications. Differences between level A healing and level B or C healing in terms of CD4(+)T lymphocyte cell count were not significant (P > 0.05). There was no statistically significant difference on the CD4(+) T lymphocyte count in patients with or without postoperative complications

  11. Relationship between bone mineral density changes and fracture risk reduction in patients treated with strontium ranelate

    DEFF Research Database (Denmark)

    Bruyere, Olivier; Roux, Christian; Detilleux, Johann;

    2007-01-01

    Of Peripheral OSteoporosis study were evaluated. OUTCOME MEASURES: The outcome measures included BMD at the lumbar spine, femoral neck, and total proximal femur assessed at baseline and after a follow-up of 1 and 3 yr; semiquantitative visual assessment of vertebral fractures; and nonvertebral fractures based...... on written documentation. RESULTS: After 3 yr of strontium ranelate treatment, each percentage point increase in femoral neck and total proximal femur BMD was associated with a 3% (95% adjusted confidence interval, 1-5%) and 2% (1-4%) reduction in risk of a new vertebral fracture, respectively. The 3-yr...

  12. Reduced transverse spinal area secondary to burst fractures: is there a relationship to neurologic injury?

    Science.gov (United States)

    Rasmussen, P A; Rabin, M H; Mann, D C; Perl, J R; Lorenz, M A; Vrbos, L A

    1994-12-01

    A retrospective case-control study was undertaken to determine the best technique to measure neural canal encroachment at each lumbar level following burst fracture and its relationship to the presence of neurologic deficit. Only patients with postinjury CT scans demonstrating a disrupted posterior body with a retropulsed bone fragment were included. Patients were divided into groups based on the level of bony injury (T12-L5) and neurologic status. Neurologic injury was classified as follows: normal (N), root (R), or cauda equina/conus/paraplegic/paraparetic (C/P). The mean transverse spinal area (TSA, cm2), spinal canal percentage patency (PP), and midsagittal diameter (MSD) were determined for each neurologic group and lumbar level. A "calculated" TSA, based on midsagittal and anterior-posterior diameters, was also derived for each patient. The data were compared level by level and correlated with the patient's neurologic status. At L1, the critical TSA was 1.0 cm2. All patients with TSAs less than this were paraplegic. At both T12 and L1, TSAs in the range of 1.0-1.25 cm2 were observed in both normal and neurologically impaired patients. A critically significant TSA was not established for levels T12, L2, L3, L4, or L5; however, the data indicated that a smaller TSA can be tolerated at successively caudal levels without neurologic deficit. No meaningful correlation between root injury and TSA was observed. The data also indicated that measurement of TSA is a more accurate method for evaluating neural canal encroachment than PP or MSD. The "calculated" TSA is a simple, objective method for obtaining this information without the aid of a computer. This study suggests that absolute TSA should be utilized in future studies evaluating decompressive treatment of thoracolumbar pathology.

  13. Toe and Metatarsal Fractures (Broken Toes)

    Science.gov (United States)

    ... rest is the only treatment needed to promote healing of a stress or traumatic fracture of a metatarsal bone. Avoid the offending activity. Because stress fractures result from repetitive stress, it ...

  14. Relationship of erosive gastritis to the acid secreting area and intestinal metaplasia, and the healing effect of pirenzepine.

    Science.gov (United States)

    Tatsuta, M; Iishi, H; Okuda, S

    1987-01-01

    The extent of acid secreting areas and the distribution of intestinal metaplasia in patients with erosive gastritis, and the healing effects of pirenzepine were examined. Studies were done with the endoscopic Congo red-methylene blue test developed in our hospital. Compared with control patients with no gastroduodenal disease, erosive gastritis was associated significantly more frequently with large acid secreting areas, but little or no intestinal metaplasia was detected in the stomach. A double blind trial was carried out, using 100 mg pirenzepine tablets or placebo for three months in 43 patients with erosive gastritis. Endoscopically, complete healing was significantly more frequent in the pirenzepine treated groups three months after the start of the treatment, as compared with the placebo treated group (p less than 0.05). PMID:3297938

  15. The Relationship between Antioxidants and Wound Healing%抗氧化剂与创伤修复的关系

    Institute of Scientific and Technical Information of China (English)

    贾志刚

    2011-01-01

    Wound healing is a complex process,in which oxidative stress is an important impact factor.When free radicals are nmssively generated or have the elimination decreased, oxidative stress occurs, leading to wound healing difficulty or delay.Based on their working links, anti-oxidants are divided into four groups, namely, inhibiting the generation of superoxide anion, promoting the conversion of superoxide anion to hydrogen peroxide, enhancing hydrogen peroxide's metabolism, and eliminating already generated free radical.Researchers suggest that the application of anti-oxidants will alleviate oxidative stress and accelerate wound healing.%创伤修复是一个复杂过程,氧化应激是其重要影响因素之一,当自由基产生过多或清除能力下降时,导致氧化应激,造成创面愈合困难或延迟.根据抗氧化剂作用环节的不同,可以分为:抑制超氧阴离子的产生、促进超氧阴离子向过氧化氢转化、促进过氧化氢代谢、清除已生成的自由基四种类型的抗氧化剂.这些抗氧化剂都有减轻氧化应激,促进创伤修复的作用.

  16. Effect of different hemostasis methods on operative incision healing of calcaneal fracture%不同止血方法对跟骨骨折手术切口愈合的影响

    Institute of Scientific and Technical Information of China (English)

    代灿; 苟景跃; 邓子龙; 张晓星

    2016-01-01

    目的:观察和对比分析电凝止血、钳夹止血及压迫止血对跟骨骨折手术切口愈合的影响。方法收集2012年12月~2015年12月收治的60例66足跟骨骨折患者临床资料,其中男性48例,女性12例;年龄18~59岁,平均36.6岁。均经跟骨外侧L形切口行切开复位钛板内固定术,术中止血方法分别采用电凝止血、钳夹止血及压迫止血。记录三组患者年龄、骨折分型、伤后至手术时间、手术时间、切口干燥时间、切口愈合时间、切口并发症发生率及足部功能Maryland评分等,并进行统计学分析。结果在切口干燥时间、切口愈合时间及切口并发症等方面钳夹止血组显著优于电凝止血组和压迫止血组(P<0.05),而电凝止血组和压迫止血组之间无显著性差异(P>0.05),三组足部功能Maryland评分无显著性差异(P>0.05)。结论跟骨骨折术中行钳夹止血可明显降低切口并发症的发生率。%Objective To observe and compare the effects of electrocoagulation hemostasis, forceps hemo-stasis and compression hemostasis on the operative incision healing in calcaneal fracture patients.Methods From Dec.2012 to Dec.2015,60 patients with calcaneal fracture were treated.Among them 48 were male and 12 were fe-male ranged from 18 to 59 years(average,36.6 years).All cases (66 calcaneal fractures) were treated by open re-duction and internal fixation through L-type calcaneal lateral incision.Intra-operative hemostasis methods included the electrocoagulation hemostasis, forceps hemostasis and compression hemostasis. Indexes such as age, fracture classification,time from injury to operation,operation time,drying time and healing time of the incision,incidence of incision-related complications and Maryland foot function score among the 3 groups were recorded and statistically analyzed.Results The forceps hemostasis group was significantly better than the electrocoagulation

  17. Effect of He-Ne Laser and CO2 Laser on Bone Fracture Healing%He-Ne激光与扩束CO2激光照射对骨折愈合的影响

    Institute of Scientific and Technical Information of China (English)

    崔建胜; 章萍

    2011-01-01

    目的 比较相同剂量的He-Ne激光与CO激光照射对骨折的疗效.方法 36只健康雄性兔制成骨折模型,随机分为三组,每组12只.He-Ne激光组:He-Ne激光扩束照射骨折区;CO激光组:CO激光扩束照射骨折组;对照组:常规治疗.通过X片,观察骨折愈合情况,测定骨痂中钙和胶原含量及生物力学抗扭性能,比较三组的疗效.结果 (1)骨折愈合效果:两激光组均优于对照组(P激光组优于He-Ne激光组(P激光组好于He-Ne激光组(P)和瞬间扭矩(T)均高于对照组(P激光组T高于He-Ne激光组.结论 He-Ne激光与CO激光照射对骨折愈合均有促进作用,且CO激光更好于He-Ne激光.%Objective To obsere and compare the discrepancy of curative effect of He-Ne laser and CO2 laser irradiation under the same dosage.Methods The bone fracture pattern was made to 36 healthy male rabbits, who were randomly divided into 3 groups ( each 12) : He-Ne laser group: expanding a bunch of the He-Ne laser project light upon the bone fracture zone, CO2 laser group: expanding a bunch of the CO2 laser irradiation, and matched control group:the routine cures.The different therapy impact was observed on the bone fracture healing.Observed X-ray, detected the contents of collagen and calcium in the callus, and measured the biomechanics anti-torsion strength to evaluate curative effect.Results ( 1 ) Fracture healing effect: the two laser groups were better than the control group (P <0.05 or <0.01 ), and 25 days after treatment, CO2 laser group was better than He-Ne laser group ( P < 0.04 ).(2) Collagen and calcium content: two laser groups were higher than control group (P < 0.05), and CO2 laser group was better than He-Ne laser group ( P < 0.05 ).(3) Biomechanics anti-torsion strength: the minimum torque ( T8°) and instantaneous torque (Tmax) of both laser groups were higher than that of control group (P <0.01 ), and the Tmax of CO2 laser group was higher than that of He-Ne laser group

  18. 接骨木总苷片促进骨折愈合与抗炎作用研究Ⅰ%Study on Effects of Sambucus williamsii Total Glycosides Tablets on Fracture Healing and Inflammation: Part Ⅰ

    Institute of Scientific and Technical Information of China (English)

    杨炳友; 何娅雯; 朱晓清; 韩华; 杨柳; 王秋红; 匡海学

    2014-01-01

    目的:研究接骨木总苷片促进骨折愈合与抗炎作用.方法:复制兔骨折模型.60只新西兰大白兔随机均分为正常对照(等容生理盐水)组、模型(等容生理盐水)组、跌打丸(0.28 g/kg)组与接骨木总苷片高、中、低剂量(0.22、0.11、0.06 g/kg)组,以药物加入饲料给药,连续36 d.骨密度仪测定骨密度(BMD)、骨矿含量(BMC)、骨痂面积(Area),通过X光片观察兔骨折愈合程度.采用小鼠耳肿胀和大鼠足肿胀模型观察其抗炎作用,热板法观察其镇痛作用.结果:高、中、低剂量接骨木总苷片可增加模型大白兔BMD、BMC,使模型大白兔骨折断端接近消失,骨膜反应密度加深,骨痂量增多、增深;中剂量组接骨木总苷片可增加模型大白兔Area.高、中、低剂量接骨木总苷片可减轻模型小鼠耳肿胀度,降低模型大鼠足肿胀率,提高1h内模型小鼠痛阈值.结论:接骨木总苷片有较好的抵抗急性炎症和镇痛的作用,并能促进骨折愈合.%OBJECTIVE:To study the effects of Sambucus williamsii total glycosides tablets on fracture healing and inflammation.METHODS:Rabbit fracture model was induced.50 New Zealand white rabbits were randomly divided into normal control group (constant volume of normal saline),model group (constant volume of normal saline),Dieda pills group (0.28 g/kg),S.williamsii total glycosides tablets high-dose,medium-dose and low-dose groups(0.22,0.11,0.06 g/kg).They were given medicine via feedingstuff for consecutive 36 d.The bone mineral density (BMD),bone mineral content (BMC) and callus area (Area) were determined by dual energy X-ray absorptioumetry (DXA).The degree of fracture healing was observed by X-ray film.Anti-inflammatory effects were observed by mice ear swelling and rat foot swelling experiments; analgesic action was observed by hot plate method.RESULTS:High-dose,medium-dose and low-dose of S.williamsii total glycosides tablets could increase BMD and BMC in model group

  19. 掌侧入路与背侧入路对腕舟骨骨折愈合率的影响%Effect of volar approach versus dorsal approach on the healing rate of scaphoid bone fractures

    Institute of Scientific and Technical Information of China (English)

    喻永新; 尚如国

    2014-01-01

    目的:探讨掌侧入路与背侧入路对腕舟骨骨折愈合率的影响。方法:中文数据库以“腕舟骨骨折”与“掌侧入路”和“背侧入路”的布尔逻辑搭配结果作为检索词,英文数据库以“scaphoid fractures”与“dorsal”、“volar”及“palmar”的布尔逻辑搭配结果作为检索词。用计算机检索中国知网、万方学术期刊数据库、维普中文期刊数据库、中国生物医学文献服务系统、中国生物医学期刊网引文数据库、Pubmed及Sciencedirect数据库建库至2013年11月收录的所有相关文献。利用Revman5.2统计软件进行统计分析。结果:共纳入9篇文献,涉及435例患者,其中随机对照实验2篇,非随机对照实验7篇;中文文献4篇,外文文献5篇。漏斗图显示文献不存在发表偏倚。掌侧入路组与背侧入路组总的骨折愈合率比较,差异无统计学意义[Z=149,P=0.140;OR=0.420,95%CI(0.140,1.310)];掌侧入路组术后6~8个月的骨折愈合率优于背侧入路组[Z=2.840,P=0.004;OR=6.930,95%CI(1.820,26.320)]。掌侧入路组与背侧入路组术后并发症发生率比较,差异无统计学意义[Z=0.590,P=0.560;OR=0.760,95%CI(0.310,1.890)]。掌侧入路组与背侧入路组术后腕部活动功能比较,差异无统计学意义[Z=0.990,P=0.320;OR=1.900,95%CI(-1.840,5.840)]。结论:掌侧入路与背侧入路治疗腕舟骨骨折对骨折愈合率的影响没有差异,但经掌侧入路固定的患者骨折愈合更快。%Objective:To explore the effect of volar approach versus dorsal approach on the healing rate of scaphoid bone fractures. Methods:The Boolean logical combination of Scaphoid fractures,Dorsal,Volar and Palmar were used as index terms.All the literatures of controlled trial included from database establishing to November 2013 were retrieved from

  20. Subduction of the Tehuantepec oceanic fracture zone and the relationship with a seismic gap in southern Mexico

    Science.gov (United States)

    Constantin Manea, Vlad; Manea, Marina; Taras, Gerya; Valenzuela, Raul W.

    2016-04-01

    It is accepted that key constraints on the size and recurrence time of large subduction earthquakes originate from the degree of locking between the subducting and overriding plates. Since the interseismic locking degree is influenced by the rheological properties of crustal and mantle rocks, any variations along strike will result in significant changes in seismic behavior due to a change in frictional stability. Additionally, recent seismic studies show that the subduction of hydrothermally altered oceanic fracture zones induces strong pore-fluid pressure variations that control the degree of interseismic locking. The Mexico Subduction Zone (MSZ) is characterized by major along-strike changes in subduction geometry, as well as important structural variations of the incoming oceanic plate. One of the main tectonic features of the Cocos plate is the Tehuantepec fracture zone (FZ) that is currently subducting beneath southern Mexico. The analysis of seismicity revealed that the area around where Tehuantepec fracture zone is currently subducting is conspicuously quiet and considered a seismic gap. Here, no significant quake (Ms ≥ 7.0) has occurred in more than 100 years, and the origin of Tehuantepec Seismic Gap (TSG) has not been elucidated yet. Based on the dimensions of the Tehuantepec gap (125 km length and 80 km width), an earthquake of Mw = 8.0 may be possible. This study aims to shed some light on the relationship between the TSG with the subduction of Tehuantepec oceanic fracture zone. Previous studies show that the uppermost oceanic lithosphere beneath the Tehuantepec FZ is partially serpentinized due to seawater infiltrations along faults. Using high-resolution three-dimensional coupled petrological-thermomechanical numerical simulations specifically tailored for the subduction of the Tehuantepec FZ at MSZ we show that the weakened serpentinized fracture zone is partially scraped out in the forearc region because of its low strength and positive buoyancy

  1. Relationship between microstructure and fracture types in a UNS S32205 duplex stainless steel

    Directory of Open Access Journals (Sweden)

    Maria Victoria Biezma

    2013-01-01

    Full Text Available Duplex stainless steels are susceptible to the formation of sigma phase at high temperature which could potentially be responsible for catastrophic service failure of components. Thermal treatments were applied to duplex stainless steels in order to promote the precipitation of different fractions of sigma phase into a ferrite-austenite microstructure. Quantitative image analysis was employed to characterize the microstructure and Charpy impact tests were used in order to evaluate the mechanical degradation caused by sigma phase presence. The fracture morphology of the Charpy test specimens were thoroughly observed in SEM, looking for a correlation between the microstructure and the fracture types in UNS S32205 duplex stainless steel. The main conclusion is the strong embrittlement effect of sigma phase since it is possible to observe a transition from transgranular fracture to intergranular fracture as increases the percentage of sigma phase. Thus, the mixed modes of fracture are predominant in the present study with high dependence on sigma phase percentages obtained by different thermal treatments.

  2. Our Pathway toward Healing Racism

    Science.gov (United States)

    Honour, Robert

    2013-01-01

    In this article, Robert Honour, Training and Staff Development Manager, at the Fairfax, Virginia, Department of Family Services (DFS), reports on the outcome of "Healing Racism" training at his organization. Participants in "Healing Racism Institutes" are transforming relationships and creating an organizational culture that…

  3. Healed microcrack orientations in granite from Illinois borehole UPH-3 and their relationship to the rock's stress history

    Science.gov (United States)

    Kowallis, Bart J.; Wang, Herbert F.; Jang, Bo-An

    1987-04-01

    Oriented granite cores from the Illinois borehole UPH-3 contain planes of secondary fluid inclusions, which represent healed microcracks. They record the orientation of a paleostress field, with the maximum stress in the horizontal plane oriented to the NNW about 90° from the present stress field orientation. These bubble planes probably formed while the granite was still quite warm (> 400° C) during initial cooling, uplift, and unroofing of the granite prior to deposition of younger overlying Cambrian sediments. The bubble planes have a much more uniform orientation than the open microcracks, which formed by stress-relief when the core was removed from the borehole.

  4. Dual-energy X-ray absorptiometry assessment of postmenopausal women with vertebral fragility fracture and its relationship with serum bone turnover and bone metabolism indexes

    Institute of Scientific and Technical Information of China (English)

    Wei Li

    2016-01-01

    Objective:To study the relationship between dual-energy X-ray bone mass density measurement results of postmenopausal women with vertebral fragility fracture and the serum bone turnover as well as bone metabolism indexes.Methods:A total of 158 postmenopausal women who received DXA tests in our hospital between April 2012 and December 2015 were selected, were divided into osteoporosis group, osteopenia group and normal bone mass group according to the bone mineral density measurement results, and were divided into no vertebral fracture group, thoracic vertebral fracture group, lumbar vertebral fracture group and thoracolumbar vertebral fracture group according to the thoracolumbar vertebral anterioposterior and lateral film results, and serum was collected to determine bone turnover and bone metabolism indexes.Results: Femoral neck, hip and lumbar vertebra L1-4 bone mineral density of subjects with thoracic vertebral fracture and thoracolumbar vertebral fracture were significantly lower than those of the subjects without vertebral fracture, and femoral neck, hip and lumbar vertebra L1-4 bone mineral density of subjects with lumbar vertebral fracture were not significantly different from those of the subjects without vertebral fracture; serum PINP, ICTP, CTX, TRACP-5b, MMP13, OPG and OPN content of osteoporosis group and osteopenia group were significantly higher than those of normal bone mass group while 25(OH)D, BGP and ON content were significantly lower than those of normal bone mass group; serum PINP, ICTP, CTX, TRACP-5b, MMP13, OPG and OPN content of osteoporosis group were significantly higher than those of osteopenia group while 25(OH)D, BGP and ON content were significantly lower than those of osteopenia group.Conclusions: Dual-energy X-ray bone densitometry has clear prediction value for postmenopausal women with thoracic vertebral fragility fracture and thoracolumbar vertebral fragility fracture, and is closely related to the changes of bone turnover and

  5. Self-healing polymers

    Science.gov (United States)

    Klein, Daniel J. (Inventor)

    2011-01-01

    A three dimensional structure fabricated from a self-healing polymeric material, comprising poly(ester amides) obtained from ethylene glycol, azelaic acid and 1,1-aminoundecanoic acid, wherein polymeric material has a melt index above 2.5 g/10 min. as determined by ASTM D1238 at 190.degree. C. and 2.16kg, impact resistance and ductility sufficient to resist cracking and brittle fracture upon impact by a 9 mm bullet fired at a temperature of about 29.degree. C. at subsonic speed in a range from about 800 feet/sec to about 1000 feet/sec. It has been determined that the important factors necessary for self-healing behavior of polymers include sufficient impact strength, control of the degree of crystallinity, low melting point and the ability to instantly melt at impacted area.

  6. Effect of Zoledronic Acid on the Healing of Distal Radial Fracture%唑来膦酸对老年桡骨远端骨折术后疗效观察

    Institute of Scientific and Technical Information of China (English)

    尹自龙; 石磊; 王林; 刘驰; 郑念野; 纪泉; 张华俦; 良元; 薛庆云

    2014-01-01

    ,and a conventional calcium and calcitriol supplement,4 week and 3 month follow-up of fractures heal-ing and postoperative 1 year follow-up of bone mineral density. Results The fracture healing in elderly patients with no obvi-ous effect of zoledronic acid anti osteoporosis medicine after distal radius fracture,callus in A group is more than callus in group B,postoperative bone mineral density increased over one year ago. Conclusion The effect of osteoporosis treatment with zoledronic acid medicine in elderly patients with distal radius fractures is significant,while no obvious negative effect on the healing of the osteoporotic distal radius fracture.

  7. The Experimental Study of the Sound field of Low Intensity Pulsed Ultrasound Promoting Fracture Healing%低强度脉冲超声促进骨愈合的声场研究

    Institute of Scientific and Technical Information of China (English)

    王迪龙; 张冀; 菅喜岐

    2013-01-01

    目的 通过对圆形平面超声换能器近声场的实验测量,研究低强度脉冲超声(low intensity pulsed ultrasound,LIPUS)治疗骨折愈合时,骨组织的厚度和裂缝位置、形状等对近声场的影响,为LIPUS促进骨愈合治疗方案的制定提供理论依据.方法 选取圆形平面超声换能器近声场声轴上的一个声压极大值和极小值端点处作为参考位置,分别对这两个位置上垂直于声轴断面的声压分布进行测试,分析讨论不同功率、骨组织厚度、水体深度、骨折裂缝宽度及其位置,对垂直于声轴断面上的声压分布的影响.结果 近场声压随功率的增大而非线性增大;骨组织厚度在1~5 mm范围时,在声轴上极大值点处的声压随骨组织厚度增厚明显减小,但在极小值点变化较小;声压受骨组织和换能器之间水体的影响较小;随骨折裂缝宽度增大,声压在裂缝处增大.结论 骨组织厚度以及骨折裂缝的位置、形状等对声场分布均有影响,且对近声场内极大值和极小值处的声压影响程度不同;在进行LIPUS促进骨折愈合治疗时,需要根据骨折位置等不同条件设定不同的治疗参数.%Objective To study the effect of the thickness,the shape and location of the bone tissue on the near sound field of the circular plane ultrasonic transducer by experimentally measuring the near sound field,during the fracture healing treated by the low intensity pulsed ultrasound (LIPUS),which can provide theoretical basis for making the treatment plan of the fracture healing promoted by the LIPUS.Methods Select a maximum and minimum point of near field pressure on acoustic axis as the reference positions.Then,respectively obtain the axial pressure distribution of the two positions perpendicular to the cross-section of the acoustic axis.Analyze and discuss the effects of different power,the bone tissue thickness,the depth of water,the width of the fracture crack and the

  8. Relationships between the elastic and fracture properties of boronitrene and molybdenum disulfide and those of graphene

    Science.gov (United States)

    Hess, Peter

    2017-02-01

    A consistent set of 2D elastic and fracture properties of hexagonal boron nitride (h-BN) monolayers (boronitrene) and molybdenum disulfide (MoS2) nanosheets is derived. Reported literature values for Young’s moduli and fracture strengths, based on experiments and DFT calculations, were used to estimate the line or edge energy with a local 2D bond-breaking model. Consistent information was obtained for intrinsic fracture properties. The basic mechanical properties of boronitrene are roughly 25% lower than the corresponding graphene values. This is consistent with the tensile bond force model, and the lower ionic-covalent bonding energy of sp2-hybridized B-N bonds in comparison with sp2-hybridized carbon bonds. While the intrinsic stiffness and strength of MoS2 correlate with the strength of its constituent chemical bonds, DFT calculations of the line or edge energy scale with roughly two times the Mo-S bonding energy, whereas the 2D bond-breaking model yields a correlation similar to that found for h-BN. Additional failure properties such as the fracture toughness and strain energy release rate were determined. Together with the intrinsic strengths a Griffith plot of the effective strength of defective h-BN and MoS2 versus the square root of half the defect size of single defects such as (multi)vacancies and micro-cracks exhibits a slope similar to that of the graphene plot.

  9. Measurement of ulnar variance and radial inclination on X-rays of healed distal radius fractures. With the axis of the distal radius or ulna?

    Science.gov (United States)

    Thuysbaert, Gilles; Ringburg, Akkie; Petronilia, Steven; Vanden Berghe, Alex; Hollevoet, Nadine

    2015-06-01

    Ulnar variance and radial inclination are radiological parameters frequently used to evaluate displacement of distal radius fractures. In most studies measurements are based on the long central axis of the distal radius, although the axis of the distal ulna can also be used. The purpose of this study was to determine which axis is more reliable. Four observers performed measurements on standard anteroposterior digital wrist X-rays of 20 patients taken 1 and 2 months after sustaining an extra-articular distal radius fracture. Intraobserver reliability was similar with both methods. No difference was found in interobserver reliability between both methods for ulnar variance, but for radial inclination it was better with the axis through the radius. Measurements on two X-rays of the same wrist taken at a different moment were similar with both methods. It can be concluded that the central axis of the distal radius can remain the basis to determine ulnar variance and radial inclination.

  10. 罂粟碱促进跟骨骨折手术切口愈合的疗效评价%Evaluation of promotive effect on incision healing after the operation of calcaneus fractures by using papaverine

    Institute of Scientific and Technical Information of China (English)

    汤俊君; 张建; 吴克俭; 刘亭茹; 张永刚

    2015-01-01

    Objective To evaluate the promotive effect on incision healing after the operation of calcaneus fractures by using papaverine. Methods From 2010 to 2013, 52 patients with calcaneus fractures were divided into 2 groups according to whether papaverine was used or not after the operation. There were 29 patients ( 33 feet ) in treatment group and 23 patients ( 25 feet ) in control group. All the patients underwent open reduction and internal ifxation with L-type calcaneal lateral incision, and the time of regular drainage lasted for 48 hours after the operation. The clinical data were recorded in all the patients, including gender, age, degree of soft tissue injury, classiifcation of fracture, time from injury to operation, operation time, intraoperative amount of bleeding, drying time and healing time of the incision, length of unhealthy skin and incidence of complications of the incision and function score of the foot at 1 year after the operation. Statistical analysis was performed. Results There were no statistically signiifcant differences in gender, age, degree of soft tissue injury, classiifcation of fracture, time from injury to operation, operation time, intraoperative amount of bleeding and function score of the foot at 1 year after the operation between the 2 groups. In control group, the average time of incision drying was ( 6.2±1.9 ) days and the average time of incision healing was ( 17.8±3.1 ) days. The good ratio of incision health degree was 64.0%. While in treatment group, the average time of incision drying was ( 5.1±1.2 ) days and the average time of incision healing was ( 15.7±2.6 ) days. The good ratio of incision health degree was 84.8%. The differences between the 2 groups were statistically signiifcant ( P<0.0355, 0.0063, 0.0328 ). Conclusions Papaverine can promote incision healing and decrease complications after the operation of calcaneus fractures.%目的:评价跟骨骨折术后使用罂粟碱对手术切口

  11. RELATIONSHIP BETWEEN TIMING OF EMERGENCY PROCEDURES AND LIMB AMPUTATION IN PATIENTS WITH OPEN TIBIA FRACTURE: UNITED STATES, 2003 – 2009

    Science.gov (United States)

    Sears, Erika Davis; Davis, Matthew M.; Chung, Kevin C.

    2012-01-01

    Background We aimed to characterize patterns in the timing of initial emergency procedures for patients with open tibia fracture and examine the relationship between initial procedure timing and in-hospital amputation. Study Design Data were analyzed from the Nationwide Inpatient Sample, 2003–2009. Adult patients were included if they had a primary diagnosis code of open tibia fracture. Patients were excluded for the following: transferred from or to another hospital, an immediate amputation was performed, more than one amputation was performed, no emergency procedure was documented, or treated at a facility that did not perform any amputations. We evaluated the association between timing of the first procedure and the outcome of amputation using multiple logistic regression, controlled for patient risk factors and hospital characteristics. Results Of 7,560 patients included in the analysis, 1.3% (n=99 patients) underwent amputation on hospital day 2 or later. The majority of patients (52.6%) underwent first operative procedure on day 0 or 1. In adjusted analyses, timing of first operative procedure beyond the day of admission is associated with more than three times greater odds of amputation (day 1 OR 3.81, 95% CI 1.80–8.07). Conclusions Delay of first operative procedure beyond the day of admission appears to be associated with a significantly increased probability of amputation in patients with open tibia fracture. All practitioners involved in the management of patients with open tibia fracture should seek a solution for any barrier, other than medical stability of the patient, of achieving early operative intervention. PMID:22842411

  12. Relationship between spinal osteoarthritis and vertebral fractures in men older than 50 years: data from the Camargo Cohort Study.

    Science.gov (United States)

    Pariente, Emilio; Olmos, José M; Landeras, Rosa; Nan, Daniel; González-Macías, Jesús; Hernández, José Luis

    2017-01-01

    Spinal osteoarthritis has been suggested as a risk factor for vertebral fractures. However, results are conflicting: most of the data are focused on the lumbar region, and referred to postmenopausal women, whereas data for men are scarce. The aim of this study is to assess the relationship between spinal osteoarthritis and vertebral fractures in men over 50 years of age. We conducted a cross-sectional study, nested in a prospective population-based cohort, including 507 community-dwelling men, 93 of them with at least one vertebral fracture. Vertebral fractures, osteophytosis, and disc space narrowing (DSN) were assessed by lateral thoracic and lumbar radiographs. Anthropometric, clinical, and densitometric variables were also analyzed. A multiple logistic regression model was performed. Eighty-five percent of vertebral fractures were located at the thoracic spine. Osteophytosis and DSN showed a bimodal distribution, with major frequency peaks at mid- and distal lumbar spine. The three distributions overlapped around the T9 vertebra. We did not find any relationship between lumbar osteoarthritis and vertebral fractures. Nevertheless, thoracic osteophytosis (OR, 1.84; 95 % CI, 1.05-3.17; p = 0.03) and DSN (OR, 2.52; 95 % CI, 1.43-4.46; p = 0.001) were found to be independently associated with prevalent vertebral fractures, after adjusting for confounders. Our results suggest a positive relationship between radiologic osteoarthritic changes at the thoracic spine and prevalent vertebral fractures in men more than 50 years of age. Osteoarthritis may act as a local risk factor, in addition to other mechanical factors, resulting in a greater propensity to fracture, especially at the mid-thoracic region.

  13. Healing the nations

    Directory of Open Access Journals (Sweden)

    Karl Dortzbach

    2004-10-01

    Full Text Available This article gives the motivations, methodology and some results of a study done in Christian healing interventions in African contexts of� stress and violence. Healing in community has been viewed through the prism of �shalom�. Shalom occurs when people who are in a� right� relationship with God� and� each other enjoy and share together the resources of the earth� in ways� that� show Christ� is Lord of all creation. Charts are given showing� the various kinds of community needs, ways to intervene, and some indications of ways to evaluate the interventions.

  14. 2型糖尿病大鼠骨折愈合障碍与体内晚期糖基化终末产物的变化%Impaired fracture healing and change of advanced glycation end products in vivo in type 2 diabetes rats

    Institute of Scientific and Technical Information of China (English)

    刘振东; 刘亚江; 高敏伟; 黄祖发; 廖小军; 石磊

    2014-01-01

    背景:近年来,晚期糖基化终末产物在骨组织领域的作用日益受到重视,而糖代谢紊乱是引起晚期糖基化终末产物增加的主要原因之一。  目的:观察2型糖尿病大鼠体内晚期糖基化终末产物表达的变化,并探讨其与糖尿病骨折愈合障碍的关系。方法:30只SD大鼠随机均分为2组,实验组制备2型糖尿病模型,对照组正常饲养。糖尿病模型制备成功后,所有大鼠建立左胫骨骨折牵引成骨模型,胫骨延长0.3 mm/d,持续14 d。  结果与结论:牵引结束后,X 射线摄片显示实验组糖尿病模型大鼠骨折断端之间牵引骨痂形成较对照组明显减少;骨痂组织学检查表现为微骨柱排列紊乱,初始基质前沿浅染。ELISA 法检测实验组血清和双侧骨痂组织中晚期糖基化终末产物水平较对照组明显升高(P OBJECTIVE:To observe the change of advanced glycation end products expressed in type 2 diabetes rats, and to investigate the relationship between impaired fracture healing and change of advanced glycation end products expression in vivo. METHODS:Thirty Sprague-Dawley rats were randomly and equal y divided into two groups:control group (normal feeding) and experimental group (high fat and sucrosum diet feeding to establish type 2 diabetes model). After diabetes models were established, the model of distraction osteogenesis in the left tibiae of al the rats was produced. Distraction was given 0.3 mm per day and continued for 14 days. RESULTS AND CONCLUSION:After the traction was complete, cal us formation in distraction gap was obviously reduced in experimental group compared with control group by X-ray examination. The array of microcolumn formation was disordered and the area of primary matrix front was catachromasis by histology examination. The enzyme-linked immunosorbent assay results showed that, the level of advanced glycation end products was obviously elevated (P<0

  15. Dynamical effect of fractures combined with brain injury on the bone healing and bone metabolism%骨折合并脑损伤对骨愈合和骨代谢的影响

    Institute of Scientific and Technical Information of China (English)

    周青; 刘进炼; 刘超群; 周耀东; 陈豪

    2015-01-01

    BACKGROUND:Peri-fracture nerve injury can inhibit osteoclast activity and promote early fracture healing. OBJECTIVE:To investigate dynamical y the effects of traumatic brain injury on the bone mineral density, microstructure, biomechanics property and bone metabolism in rat models of fractures. METHODS:Sixty-three male rats were randomly divided into three groups:sham group, simple fracture group and fracture combined with brain injury group. After 3, 6, and 3 months, the animals were sacrificed in batches under anesthesia, and then, the bones and serum specimens were used to detect the bone mineral density, microstructure, biomechanics property, serum cross-linked N-telopeptide of col agen type I and osteocalcin levels. RESULTS AND CONCLUSION:Compared with the simple fracture group, the fracture combined brain injury group had significantly increased bone mineral density of the proximal tibia, bone volume fraction of the cancel ous bone, trabecular thickness, cross-sectional area of tibial cortical bone and total area of the bone marrow, ultimate load and stress of the tibia, serum cross-linked N-telopeptide of col agen type I and osteocalcin levels at 3 and 6 weeks after modeling (P  目的:观察了大鼠肢体骨折合并脑损伤对骨密度、骨微结构、骨生物力学特征和骨代谢影响。  方法:63只大鼠随机分为假手术组、单纯骨折组和脑损伤合并骨折组。在术后3周、6周和3个月分批麻醉处死动物保存骨骼和血清标本,检测骨密度、骨微结构和生物力学性能以及血清Ⅰ型胶原氨基末端肽和骨钙素水平的变化。  结果与结论:与单纯骨折组相比,在造模3周和6周后,脑损伤合并骨折组胫骨近端的骨密度、松质骨微结构骨体积分数、骨小梁厚度、胫骨皮质骨截面总面积和骨髓腔面积、胫骨极限载荷和极限应力、血清原氨基末端肽和骨钙素水平均显著增高(P<0.05),造模后3个月,3组间

  16. Reconsiderações sobre o tempo de consolidação das fraturas na picnodisostose Reconsiderations regarding time of fracture healing in Pycnodysostosis

    Directory of Open Access Journals (Sweden)

    Flávio Dorcilo Rabelo

    2010-01-01

    Full Text Available OBJETIVO: Discutir o que vem sendo descrito na literatura até então a respeito do tempo de consolidação das fraturas na picnodisostose. MÉTODOS: Treze novos casos foram estudados por questão de disponibilidade de prontuários e exames radiográficos, totalizando 44 fraturas englobando pacientes avaliados no período de novembro de 1970 a agosto de 2004, no Hospital Ortopédico de Goiânia. Pesquisa em campo, acompanhamento clínico simultâneo, por novas fraturas, de duas pacientes e avaliação retrospectiva de prontuários foram feitos, com base em se determinar o número de fraturas totais de cada paciente e quais destas tinham viabilidade para esta pesquisa. O grupo de pacientes compõe-se de três mulheres e dois homens com idade média de 51,4 anos. A tíbia foi o osso mais acometido, seguido pelo fêmur. Foram excluídas as fraturas cujo acompanhamento tenha sido feito em outro serviço. RESULTADOS: Das 12 fraturas consideradas plenas para o estudo, nove aconteceram em fêmures (seis no fêmur E e três no fêmur D; uma em tíbia (D; uma em clavícula (D e uma em ulna (E. Dentre as 12 fraturas, oito evoluíram com pseudartrose em um tempo médio de 29,25 meses; três consolidaram bem em uma média de 5,83 meses e um paciente evoluiu com retardo de consolidação em apenas dois meses. CONCLUSÃO: Associadas à pesquisa gênica e estudos micromorfológicos, aguarda-se novos estudos para reconfirmação diagnóstica numa entidade clínica tão rara.OBJECTIVE: To discuss what has been described so far in the literature regarding the time of consolidation of fractures in Pycnodysostosis. MATERIALS AND METHODS: Thirteen new cases were studied, as a matter of the availability of medical records and radiographic examinations, totaling 44 patients in the period from November 1970 to August 2004 in the Hospital Ortopédico de Goiânia. Field research and simultaneous clinical monitoring for new fractures in two patients, and the retrospective

  17. Changes in the ultimate load and static bone histomorphometery parameters during the fracture healing process of denervated rats with tibial fracture%胫骨骨折大鼠失神经支配条件下骨折愈合过程中最大载荷及静态骨计量学参数变化

    Institute of Scientific and Technical Information of China (English)

    苗军; 刘春蓉; 夏群; 张继东; 金鸿宾

    2006-01-01

    背景:临床观察表明,截瘫患者骨折常常愈合加快或在下肢有异位骨化形成,表明周围神经系统对骨折愈合有重要的调节作用.目的:观察一侧下肢失神经胫骨骨折愈合过程中骨计量学参数及骨痂形成和生物力学的变化.设计:自身对照动物实验.单位:天津医院.材料:健康雄性Wistar大鼠36只,6个月龄,平均体质量210 g.方法:实验于2001-03/2004-03在天津医院动物实验中心完成.将大鼠一侧下肢制成失神经胫骨骨折模型,对侧制成正常神经支配骨折模型.骨折后2周、4周麻醉状态下处死大鼠,取双侧胫骨,拍X射线片、测定生物力学强度,制备不脱钙切片,进行骨计量学观察.主要观察指标:①两组大鼠骨折后双侧胫骨和骨痂湿质量比较.②X射线平片计分.③胫骨标本生物力学测试结果.④骨折愈合组织形态学观察.结果:①两组大鼠骨折后双侧胫骨和骨痂湿质量比较:骨折后2,4周失神经组重量远大于正常神经支配组[(0.94±0.15)比(0.76±0.14)g,(1.06±0.26)比(0.81±0.10)g,P<0.05].②X射线平片计分结果:失神经组骨痂形成量明显增多(P<0.01).③胫骨标本三点弯曲生物力学测试结果:骨折后2,4周失神经组骨痂的强度明显低于正常神经支配组[(9.88±8.49)比(16.62±13.38)N,(12.77±7.55)比(20.19±10.60)N,P<0.05].④骨计量学检测结果:静态参数与正常神经支配组比较,失神经组矿化骨小梁宽度明显减小(P<0.05),类骨质宽度增加,破骨细胞指数及骨吸收表面明显增大(P<0.05),成骨细胞指数及骨形成表面两组无差别;动态参数与正常神经支配组比较,失神经组矿化沉积率明显变小(P<0.05),类骨质成熟时间延长(P<0.05).结论:周围神经在骨折愈合早、中期起重要的调节作用,完整的神经支配是骨折愈合所必需的.%BACKGROUND: Clinical observation demonstrates that accelerated fracture healing or lower limb

  18. 鲑鱼降钙素联合恒古骨伤愈合剂治疗腰椎OPF疗效分析%The study on treatment of vertebral osteoporotic fracture by salmon calcitonin and Heng Gu bone healing reagent

    Institute of Scientific and Technical Information of China (English)

    罗德军; 赵宏斌; 周旭; 董锡亮; 李林芝; 王文志; 熊海

    2011-01-01

    Objective To study effects of salmon calcitonin and Heng Gu bone healing reagent on vertebral osteoporotic fracture(OPF).Methods From Nov.2007 to Dec.2009,82 cases of vertebral OPF were treated.These cases were randomly divided into treatment group and control group.The treatment group(42 cascs)were treated with salmon calcitonin and Heng Gu bone healing reagent.The control group(40 cases)received salmon calcitonin only.Pain relief of the 2 groups wag compared.Results Before treatment,the 82 patients were scored 6-9 points by visual analogue scales(VAS)and pain scores of the 2 groups were similar (P>0.05).3 days,5 days,8 days and 15 days after treatment,VAS scores of the 2 groups were significantly different(P0.05).治疗后3、5、8、15 d,2组疼痛VAS评分分别经秩和检验差异有统计学意义(P<0.01).治疗组不但疼痛缓解快,3个月后复查骨矿物密度改善程度亦明显优于对照组.结论 鲑鱼降钙素联合恒古骨伤愈合剂治疗腰椎骨质疏松性骨折具有良好止痛和促进成骨作用,是一种安全、有效的方法.

  19. Influência do componente protéico na consolidação de fraturas: trabalho experimental em ratos Influence of the protein component upon fracture healing: an experimental study in rats

    Directory of Open Access Journals (Sweden)

    Roberto Guarniero

    2003-12-01

    Full Text Available Os autores estudaram a influência da nutrição protéica na consolidação de fraturas em 40 ratos Lewis divididos em 4 grupos de 10. Durante 6 semanas os grupos 1, 2 e 3 receberam respectivamente dietas com 0, 19% e 36% de proteínas. O grupo 4 recebeu dieta sem proteínas durante as 2 primeiras semanas e com 36% de proteínas nas 4 semanas seguintes. Foram realizadas fraturas nas tíbias esquerdas ao final de 2 semanas e após 4 semanas das fraturas os animais foram sacrificados para estudo dos calos ósseos. Para a avaliação dos resultados foram utilizadas medidas clínicas, bioquímicas, radiográficas, densitométricas, e histomorfométricas. Concluiu-se que a dieta hiperprotéica alterou a consolidação óssea produzindo um calo maior e mais resistente, mas não alterou a qualidade em concentração de cálcio e em porcentagem a quantidade de tecido ósseo.The authors investigated the influence of a protein diet on fracture healing in 40 Lewis rats divided into four groups of ten. During 6 weeks, Groups 1, 2 and 3 were fed diets containing, respectively, 0.19% and 36% protein. Group 4 was fed a proteinless diet during the first two weeks and a 36%-protein diet during the next 4 weeks. At two weeks, fractures were performed in the left tibias; all animals were killed 4 weeks later so that the bone calluses could be investigated. Clinical, biochemical, radiographic, densitometry and histomorphometry measurements were performed to evaluate the findings. The conclusion was that the hyperprotein diet altered bone healing by producing a larger, more resistant callus, although it did not change quality as regards calcium levels and the percentage amount of bone tissue.

  20. The effect of PDGFmRNA and IGFmRNA in the platelet concentrated liquid on ulna fracture healing in rabbit%血小板浓缩液中血小板源性生长因子及胰岛素样生长因子对兔尺骨骨折愈合的影响

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Objective By hybridization in situ and biomechanical approach of platelet derived growth fator mRNA(PDGFmRNA) and insulin like growth factor mRNA(IGFmRNA),we discussed the influence of the platelet concentrated liquid on the healing of rabbit ulna fracture.Method We selected 24 New Zealand rabbits,divided them into 4 groups randomly (blank group, serum control group, group with platelet concentrated liquid and group with bone graft and platelet concentrated liquid), and then made the fracture model on the middle of ulna which was fixed by finger armor plate.Before the operation, we drew out 6 ml blood from femoral artery, performed anti coagulation with the Sodium Citrate and centrifugated by low and the followed high speed.We purified the white blood plate and injected it into the fracture position.The rabbits were killed at 1st, 2nd, 4th and 6th week.Qualitative analysis by hybridization in situ of PDGFmRNA and IGFmRNA and biomechanical measurement on the 6th week sample were made.Result Bone callus could be seen on the radius specimen in various degrees when the rabbits were killed at 1st,2nd,4th and 6th week, particularly in the last week.The average maximum destructive load on the fracture tip is higher to the control, and there is significant difference(P< 0.01). Conclusion The local application of platelet concentration on the fracture tip can accelerate its healing.

  1. Effect of Jieguqili chip and simvastatin in promoting fracture Healing: An animal experiment%接骨七厘片、辛伐他汀对促进骨折愈合的动物实验研究

    Institute of Scientific and Technical Information of China (English)

    张勇妹; 丁妍; 郭贵宾; 陈邦元

    2013-01-01

    目的 探讨接骨七厘片和辛伐他汀对促进骨折愈合的机制,并分析联合应用接骨七厘片和辛伐他汀与单独应用接骨七厘片或辛伐他汀对促进骨折愈合的差异.方法 用蒸馏水将接骨七厘片和辛伐他汀片分别溶解,配成一定浓度的溶解液.将实验大鼠随机分成4组,将双侧尺桡骨中1/3段徒手折断,造成闭合性完全性骨折,不给予外固定.术后接骨七厘片组给予接骨七厘片溶液,1次/d,连续28 d;辛伐他汀片组给予辛伐他汀溶液,1次/d,连续28d;联合应用组同时给予接骨七厘片溶液及辛伐他汀溶液,1次/d,连续28d;对照组灌胃给予生理盐水1 mL,1次/d,连续28d.结果 在一般行为表现、X线表现、组织形态学、骨痂干重等方面,接骨七厘片组和(或)辛伐他汀组与联合应用接骨七厘片和辛伐他汀组相比,差异有统计学意义(P<0.05).结论 本实验研究发现接骨七厘片及辛伐他汀在骨折愈合的过程中,均能增加成骨细胞的活性,使成骨细胞大量增生,促进骨痂的形成,提高骨痂的质量,而联合应用接骨七厘片及辛伐他汀比单纯使用接骨七厘片或辛伐他汀片作用更明显,骨折愈合较快.%Objective To analyze the mechanism of Jieguqili chip and simvastatin in promoting fracture healing, and to compare the difference between the combined use of the Jieguqili chip and simvastatin and single use of Jieguqili chip or simvastatin in promoting fracture healing. Methods The Jieguqili chip and simvastatin tablets were dissolved with distilled, dubbed a certain concentration of solvent. Rats were randomly divided into 4 groups, and their bilateral radius and ulna 1/3 of unarmed were broken, which created the closed complete bone fracture. No external fixation was done. After the technique, the 1st group was treated the Jieguqili chip solution, once a day, continually 28 days. The second group was treated with simvastatin solution, once a day

  2. Scaphoid fractures in children

    Directory of Open Access Journals (Sweden)

    Gajdobranski Đorđe

    2014-01-01

    Full Text Available Introduction. Scaphoid fractures are rare in childhood. Diagnosis is very difficult to establish because carpal bones are not fully ossified. In suspected cases comparative or delayed radiography is used, as well as computerized tomography, magnetic resonance imaging, ultrasound and bone scintigraphy. Majority of scaphoid fractures are treated conservatively with good results. In case of delayed fracture healing various types of treatment are available. Objective. To determine the mechanism of injury, clinical healing process, types and outcome of treatment of scaphoid fractures in children. Methods. We retrospectively analyzed patients with traumatic closed fracture of the scaphoid bone over a ten-year period (2002-2011. The outcome of the treatment of “acute” scaphoid fracture was evaluated using the Mayo Wrist Score. Results. There were in total 34 patients, of mean age 13.8 years, with traumatic closed fracture of the scaphoid bone, whose bone growth was not finished yet. Most common injury mechanism was fall on outstretched arm - 76% of patients. During the examined period 31 children with “acute” fracture underwent conservative treatment, with average immobilization period of 51 days. Six patients were lost to follow-up. In the remaining 25 patients, after completed rehabilitation, functional results determined by the Mayo Wrist Score were excellent. Conclusion. Conservative therapy of “acute” scaphoid fractures is an acceptable treatment option for pediatric patients with excellent functional results.

  3. Relationship of changes in total hip bone mineral density to vertebral and nonvertebral fracture risk in women with postmenopausal osteoporosis treated with once-yearly zoledronic acid 5 mg: the HORIZON-Pivotal Fracture Trial (PFT).

    Science.gov (United States)

    Jacques, Richard M; Boonen, Steven; Cosman, Felicia; Reid, Ian R; Bauer, Douglas C; Black, Dennis M; Eastell, Richard

    2012-08-01

    Measurements of change in bone mineral density (BMD) are thought to be weak predictors of treatment effect on the reduction of fracture risk. In this study we report an alternative year-on-year approach for the estimation of treatment effect explained by BMD in which we examine the relationship between fracture risk and the most recent change in BMD. We studied 7736 postmenopausal women (ages 65 to 89 years) who were participants in the Health Outcomes and Reduced Incidence with Zoledronic Acid Once Yearly-Pivotal Fracture Trial (HORIZON-PFT) and were randomized to either intravenous administration of zoledronic acid or placebo. The percentage of treatment effect explained by change in total hip BMD was estimated using the alternative year-on-year approach and the standard approach of looking at change over 3 years. We also studied a subset of 1132 women in whom procollagen type 1 amino-terminal propeptide (PINP) was measured at baseline and 12 months, to estimate the percentage of treatment effect explained by change in PINP. Regardless of the method used, the change in total hip BMD explained a large percentage of the effect of zoledronic acid in reducing new vertebral fracture risk (40%; 95% CI, 30% to 54%; for the 3-year analysis). The treatment effects for nonvertebral fracture were not statistically significant for the year-on-year analysis but 3-year change in BMD explained 61% (95% CI, 24% to 156%) of treatment effect. Change in PINP explained 58% (95% CI, 15% to 222%) of the effect of zoledronic acid in reducing new vertebral fracture risk. We conclude that our estimates of the percentage of treatment effect explained may be higher than in previous studies because of high compliance with zoledronic acid (due to its once-yearly intravenous administration). Previous studies may have underestimated the relationship between BMD change and the effect of treatment on fracture risk. Copyright © 2012 American Society for Bone and Mineral Research.

  4. Healing Architecture

    DEFF Research Database (Denmark)

    Folmer, Mette Blicher; Mullins, Michael; Frandsen, Anne Kathrine

    2012-01-01

    The project examines how architecture and design of space in the intensive unit promotes or hinders interaction between relatives and patients. The primary starting point is the relatives. Relatives’ support and interaction with their loved ones is important in order to promote the patients healing...... process. Therefore knowledge on how space can support interaction is fundamental for the architect, in order to make the best design solutions. Several scientific studies document that the hospital's architecture and design are important for human healing processes, including how the physical environment...... architectural and design solutions in order to improve quality of interaction between relative and patient in the hospital's intensive unit....

  5. Rotation and Displacement Predict Adverse Events in Pediatric Supracondylar Fractures.

    Science.gov (United States)

    Flierl, Michael A; Carry, Patrick M; Scott, Frank; Georgopoulos, Gaia; Hadley-Miller, Nancy

    2015-08-01

    The goal of this study was to identify supracondylar fracture patterns that were predictive of adverse events and poor outcomes. The study consisted of a retrospective review of patients admitted for surgical treatment of a supracondylar humerus fracture between June 2008 and August 2010. Preoperative radiographs were assessed based on appearance (simple vs oblique vs comminuted), coronal plane displacement (angulated, posterior, posteromedial vs posterolateral), and rotation (rotation vs no rotation). Logistic regression models were used to examine the relationship between fracture pattern and clinical outcome parameters in 373 patients who were followed for 4 weeks or more postoperatively. Outcome parameters included postoperative complications (infection, delayed healing, pin migration, revision surgery), need for physical or occupational therapy, need for postoperative intravenous narcotics, and preoperative nerve injury. Rotation and coronal displacement patterns of the fracture segments were significantly associated with postoperative complications, postoperative need for physical or occupational therapy as a result of residual stiffness, and nerve injury (P<.05). Compared with posteriorly displaced fractures, posterolaterally displaced fractures were associated with significantly greater odds of complications (P=.045), need for physical or occupational therapy (P<.001), and nerve injury (P<.001). Additionally, fractures with rotation were associated with significantly greater odds of complications (P<.001), need for physical or occupational therapy (P<.001), and nerve injury (P<.001) compared with fractures without rotation. Rotation and coronal plane displacement were predictive of complications, need for physical or occupational therapy, and nerve injury, and thus should be considered as potential prognostic variables when evaluating the initial injury pattern.

  6. Qualitative and quantitative assessment of relationship between mandibular third molar and angle fracture on North Indian population: A clinico-radiographic study.

    Science.gov (United States)

    Yadav, Suresh; Tyagi, Shallu; Puri, Naveen; Kumar, Prince; Kumar, Puneet

    2013-04-01

    To assess the relationship between impacted mandibular third molar presence and the risk for mandibular angle fracture with the effect of various positions of mandibular third molar and the risk of mandibular angle fracture. In the North Indian territory, a total of 289 patients with mandibular angle fractures were studied and evaluated for the possible relationship with impacted third molar on the basis of clinical and panoramic radiographical findings. Results that confirmed the highest risk for mandibular angle fracture was associated with mesioangular angulations (45.42%) followed by vertical (26.34%), distoangular in sequence and least risk was found with bucco-version angulations (2.67%) according to Winter's classification. Additionally, the highest risk of mandibular angle fracture was reported with partially erupted third molar (47.75%), followed by erupted (23.53%) and unerupted third molar (19.38%). The risk for mandibular angle fracture is not only affected by status of eruption, angulations, position, number of roots present in third molar but also by the distance of mandibular third molar from inferior border of mandible and the percentage of remaining amount of bone at the mandibular angle region.

  7. Ipsilateral combination of Galeazzi and Monteggia fractures in a ten-year-old patient: a case report.

    Science.gov (United States)

    Akalin, Yavuz; Akinci, Orhan; Kayali, Cemil

    2010-01-01

    Galeazzi fractures represent approximately 3 to 6 percent of forearm fractures, whereas Monteggia fractures represent 1 to 2 percent. The combination of these injuries in the same extremity is an exceedingly rare occurrence. We report a case of ipsilateral combination of Galeazzi and Monteggia fractures in a ten-year-old patient. The patient was treated with closed reduction and internal fixation with Kirschner pins. The distal radioulnar and radiocapitellar joint relationships were restored and the fractures healed. The patient proceeded to obtain a satisfactory functional result three years later. Internal fixation is a safe method for such complex forearm fractures in older children and allows post-operative rehabilitation with the advantage of early mobilization.

  8. 鲑鱼降钙素促进老年转子间骨折愈合的疗效观察%Efficacy Observation of Salmon Calcitonin for Femoral Intertrochanteric Fractures Healing in Elderly Patients

    Institute of Scientific and Technical Information of China (English)

    谭美云; 郭杏; 税巍; 王远辉; 张忠杰

    2011-01-01

    目的:观察鲑鱼降钙素促进老年转子问骨折愈合的疗效.方法:将40例老年患者随机分为2组:治疗组20例,肌肉注射鲑鱼降钙素;对照组20例,在相同的部位肌肉注射等量注射用生理盐水.自术后第1天开始,2组均连续用药3个月.用药后的第1、3个月复查X线片,观察骨痂生长情况.治疗前和治疗后3个月检测患者腰椎(L4)骨密度(BMD)及血清钙、磷、碱性磷酸酶等浓度.结果:所有患者均得到随访.术后第1、3个月x线评估发现,治疗组比同时期对照组的骨痂生成量多.治疗后3个月,治疗组腰椎(L4)BMD明显高于对照组(P0.05),治疗组碱性磷酸酶明显高于对照组(P<0.05).治疗组1例出现恶心、呕吐等胃肠道症状,2例出现面颈部潮红.结论:鲑鱼降钙素能显著促进老年转子间骨折的愈合.%OBJECTIVE: To observe the therapeutic efficacy of salmon calcitonin for femoral intertrochanteric fractures healing in elderly patients. METHODS: A total of 40 elderly patients with femoral intertrochanteric fractures were randomly divided into 2 groups. 20 cases in treatment group received intramuscular injection of salmon calcitonin and 20 cases in control group received equal dose of normal saline at the same site. Both groups were given medicine after operation for 3 months. The X-ray plate of 2 groups was examined at 1 and 3 months after treatment to investigate the condition of bony callus. The BMD of the lumbar spine at LA, the concentration of serum calcium, serum phosphorus and alkaline phosphate were measured before treament and 3 months after treatment. RESULTS: All patients were followed up. The X-ray plate showed that the bony callus in treatment group was more abundant than in control group at 1 and 3 months after treatment. 3 months after treatment, the BMD of the lumbar spine at L4 in treatment group was significantly higher than in control group (P<0.05). The concentration of serum calcium in treatment group was

  9. Biomechanics Significance of Femoral Head and Neck of Grafting-bone Group After Femoral Neck Fracture-healing%股骨颈骨折愈合后钉道植骨的生物力学意义

    Institute of Scientific and Technical Information of China (English)

    唐洪涛; 仝允辉; 杨茹萍; 朱太永; 张美超; 赵卫东

    2011-01-01

    Objective To study biomechanical performance of fracture-healing femoral head and neck after the hollow compressionb screws are taken out in ungrafting-bone group, grafting-bone group, normal group, and provide theoretical basis for the treatment of necrosis of the femoral head by bone grafting in the channel of screws. Methods Nine femurs fixed and preserved by formalin were used in this test. They were randomly divided into three groups: normal group, ungrafting-bone group, grafting-bone group. According to inversed-triangle, at the range of physiological load, it tested the defixed bias-value of three group femoral head at different load. The data were collected and analyzed. The three-dimension finite element model of the femoral head and neck was calculated. Nodal solution of stress value and max-offset was calculated at area of femoral head and neck, then the data were compared and analyzed.Results Compared with the mean of load-offset about the femoral head and neck, biomechanical capability of ungrafting-bone group was lowest with regard to other two groups , the influence was very hard, P <0.05. But there was no singnificant difference between normal group and graflng-bone group, P >0.05. Analysis of the three-dimension finite element model showed that the massive stress was concentrated at weight loading region of ungrafting-bone group's femoral head, it was an dangerous chance to lead to femoral head collapse. Conclusion For the treatment of femur neck fractures with cannulated compression screws, bone grafting in the channel of screw should be used to improve biomechanical integrity after fracture healed and cannulated compression screws are taken out. This is of benefit to loading in early stage and to preventing the collapse of femoral head, etc.%目的 探讨股骨颈骨折愈合后取出空心加压螺钉遗留钉道不植骨、植骨及正常的股骨头颈部的生物力学特性,为临床提供实验依据.方法 收集9付股骨标本测量

  10. Displaced patella fractures.

    Science.gov (United States)

    Della Rocca, Gregory J

    2013-10-01

    Displaced patella fractures often result in disruption of the extensor mechanism of the knee. An intact extensor mechanism is a requirement for unassisted gait. Therefore, operative treatment of the displaced patella fracture is generally recommended. The evaluation of the patella fracture patient includes examination of extensor mechanism integrity. Operative management of patella fractures normally includes open reduction with internal fixation, although partial patellectomy is occasionally performed, with advancement of quadriceps tendon or patellar ligament to the fracture bed. Open reduction with internal fixation has historically been performed utilizing anterior tension band wiring, although comminution of the fracture occasionally makes this fixation construct inadequate. Supplementation or replacement of the tension band wire construct with interfragmentary screws, cerclage wire or suture, and/or plate-and-screw constructs may add to the stability of the fixation construct. Arthrosis of the patellofemoral joint is very common after healing of patella fractures, and substantial functional deficits may persist long after fracture healing has occurred. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  11. Humeral cortical thickness in female Bantu - its relationship to the incidence of femoral neck fracture

    Energy Technology Data Exchange (ETDEWEB)

    Bloom, R.A.; Pogrund, H.

    1982-03-01

    Measurements of the humeral cortical thickness demonstrate that generalised osteoporosis in female Bantu commences in the fifth decade and gradually increases until, in the ninth decade, all subjects are osteoporotic. The combined cortical thickness (CCT) of the humerus in young adults is very similar to that found previously in a white London population and the loss of cortex with age is very similar. It is concluded that the known low incidence of femoral neck fracture in Bantu is not due to a lower incidence of generalised osteoporosis but to environmental factors. The chief environmental factor postulated is the greater amount of physical work performed by the Bantu. A more careful mode of walking is suggested as a subsidiary cause.

  12. Prevalence of Sarcopenia and Its Relationship with Sites of Fragility Fractures in Elderly Chinese Men and Women.

    Directory of Open Access Journals (Sweden)

    Wei Hong

    Full Text Available Sarcopenia might be associated with bone fragility in elderly individuals. This study aimed to investigate the prevalence of sarcopenia and its association with fragility fracture sites in elderly Chinese patients.Patients (322 men and 435 women aged 65-94 years and with a history of fragility fractures in the ankle, wrist, vertebrae or hip, and healthy men (n = 1263 and women (n = 1057 aged 65-92 years without a history of fractures were enrolled. Whole-body dual energy X-ray absorptiometry was used to analyze skeletal muscle mass index (SMI, fat mass and bone mineral density. Sarcopenia was defined as SMI less than two standard deviations below the mean of a young reference group.Sarcopenia occurrence varied with fracture location. Sarcopenia was more common in females with vertebral and hip fractures and in men with hip and ankle fractures than in the non-fracture group. Sarcopenia was significantly more prevalent in men with wrist, hip and ankle fractures than in women. SMI was correlated with BMD in different fracture groups. Logistic regression analyses revealed that lower SMI was associated with an increased risk of hip fracture both in men and women and ankle fracture in men.Sarcopenia may be an independent risk factor for hip and ankle fractures in men, and for hip fractures in women.

  13. Study on the Effects of Differrent Compatibility of Traditonal Chinese Medicine on VEGF Expression at Fracture Site and Healing of Early Radius Fracture of Rats%桃仁、木香、黄芪分别与红花配伍对大鼠早期桡骨骨折愈合及VEGF表达的影响

    Institute of Scientific and Technical Information of China (English)

    王轩; 李引刚

    2009-01-01

    Objective:To observe the effect of different compatibility of herbs on VEGF expression at fracture site and thickness of callus of early radius fracture rat models. Methods:256 SD rats were divided into four groups randomly,model group,Semen Persicae and Flos Carthami group,Radix Aucklandiae and Flos Carthami group,Radix Astragali and Flos Carthami group.Left radius fracture rat models were established. Conventional haematoxylin and eosin staining and im-munostaining for bone section were carried out on clays 3,7,10 and 14 after model establishment. Results:On days 7,10 and 14 after model establishment, compared with model group, VEGF positive cells at fracture site and thickness of callus were significantly increased in all the treatment groups;compared with Radix Aucklandiae and Flos Carthami group,VEGF positive cells at fracture site and thickness of callus were significantly decreased in Semen Persicae and Flos Carthami group,Radix Astragali and Flos Carthami group. Conclusions:Radix Aucklandiae and Flos Carthami can increase obvi-ously VEGF expression at fracture site and thickness of callus in the healing of early radius fracture rats.We can get a con-clusion that the therapy of regulating the flow of qi and promoting the circulation of blood is an effective therapy on early extremities closed fracture from this experiment.%目的:观察桃仁、木香、黄芪分别与红花配伍对成年SD大鼠早期桡骨骨折愈合过程中骨痂厚度及VEGF表达的影响,为理气活血法用于四肢闭合性骨折早期临床治疗提供实验支持.方法:256只SD大鼠随机分为模型组、桃仁红花组、木香红花组、黄芪红花组4组,每组各64只,各组大鼠均造成左侧桡骨骨折模型.于造模后第3天、第7天、第10天、第14天,各组大鼠分4次处死,每次每组处死16只,取材进行常规HE染色观察骨痂厚度,VEGF-DAB显色计数观察VEGF阳性细胞数.结果:造模后第3天,各给药组与模型组比较,标本VEGF

  14. Effects of different compatibility of TCM on BMP-2 expression at fracture site and healing of early radius fracture of rats%桃仁、木香、黄芪分别与红花配伍对大鼠早期桡骨骨折愈合过程中BMP-2表达的影响

    Institute of Scientific and Technical Information of China (English)

    王轩; 潘琪; 张慧萍; 李引刚

    2011-01-01

    Carthami group, BMP-2 positive cells at fracture site and thickness of callus were significantly decreased in Semen Persicae and Flos Carthami group, Radix Astragali and Flos Carthami group.Conclusions: Radix Aueklandiae and Flos Carthami can increase obviously BMP-2 expression at fracture site and thickness of callus in the healing of early radius fracture rats. We can get a conclusion that the therapy of regulating the flow of qi and promoting the circulation of blood was an effective therapy on early extremities closed fracture from this experiment.

  15. A follow-up study of the in-practice results of pulsed electromagnetic field therapy in the management of nonunion fractures

    Directory of Open Access Journals (Sweden)

    Murray HB

    2016-12-01

    Full Text Available Hallie B Murray,1 Brian A Pethica1,2 1EBI, LLC (a Zimmer Biomet company, Parsippany, NJ, USA; 2Department of Chemical and Biological Engineering, Princeton University, Princeton, NJ, USA Abstract: During normal fracture repair, healing occurs within a few months. However, for a minority of patients, the processes of bone repair are compromised or interrupted leading to the development of delayed union and nonunion fractures. Noninvasive bone growth stimulators using pulsed electromagnetic field (PEMF technology are currently in widespread use by patients with impaired fracture healing. This article reports the results of a follow-up study of 1,382 patients treated with PEMF stimulation to evaluate success rates and the relationship between average daily use and the clinical outcomes of therapy as reported by their prescribing physicians. The reported overall success rate for the 1,382 patients was 89.6%. The results were analyzed in audited subsets comparing days of treatment time and average daily use of the electrical bone growth stimulator, using several statistical methods. Linear regression analysis indicated a 6-day reduction in time to heal with each additional hour of average daily use. Survival analysis concluded that the median heal time was reduced by 35%–60%, depending on the different fracture characteristics of patients who complied with the recommended daily use of 10 hours per day. A third statistical analysis indicated that patients treated with the PEMF device for 9 hours or more per day had a significant reduction in time to heal, achieving successful fracture repair an average of 76 days earlier than patients treated with the PEMF device for an average of 3 hours or less per day. Overall, these different methods of statistical analysis indicate that PEMF therapy correlates with an acceleration in the healing of nonunion fractures. Keywords: PEMF, pulsed electromagnetic field, dose–response, nonunion, time to heal

  16. Tooth mobility changes subsequent to root fractures

    DEFF Research Database (Denmark)

    Andreasen, Jens Ove; Christensen, Søren Steno Ahrensburg; Tsilingaridis, Georgios

    2012-01-01

    The purpose of this study was to analyze tooth mobility changes in root-fractured permanent teeth and relate this to type of interfragment healing (hard tissue healing (HT), interfragment healing with periodontal ligament (PDL) and nonhealing with interposition of granulation tissue (GT) because...... of pulp necrosis in the coronal fragment. Furthermore, the effect of age, location of the fracture on the root, and observation period on mobility values was analyzed. Mobility values were measured for 44 of 95 previous reported root-fractured permanent incisors. Mobility changes were measured...... after 3 months and 1 year, and a normalization of mobility value was usually found after 5 and 10 years. In 17 cases of PDL healing, generally a higher mobility was found in comparison with root fractures healing with hard tissue, and a consistent decrease in mobility value was found in the course...

  17. Interactions between MSCs and Immune Cells: Implications for Bone Healing

    Directory of Open Access Journals (Sweden)

    Tracy K. Kovach

    2015-01-01

    Full Text Available It is estimated that, of the 7.9 million fractures sustained in the United States each year, 5% to 20% result in delayed or impaired healing requiring therapeutic intervention. Following fracture injury, there is an initial inflammatory response that plays a crucial role in bone healing; however, prolonged inflammation is inhibitory for fracture repair. The precise spatial and temporal impact of immune cells and their cytokines on fracture healing remains obscure. Some cytokines are reported to be proosteogenic while others inhibit bone healing. Cell-based therapy utilizing mesenchymal stromal cells (MSCs is an attractive option for augmenting the fracture repair process. Osteoprogenitor MSCs not only differentiate into bone, but they also exert modulatory effects on immune cells via a variety of mechanisms. In this paper, we review the current literature on both in vitro and in vivo studies on the role of the immune system in fracture repair, the use of MSCs in the enhancement of fracture healing, and interactions between MSCs and immune cells. Insight into this paradigm can provide valuable clues in identifying cellular and noncellular targets that can potentially be modulated to enhance both natural bone healing and bone repair augmented by the exogenous addition of MSCs.

  18. Carbon Dots as Fillers Inducing Healing/Self-Healing and Anticorrosion Properties in Polymers.

    Science.gov (United States)

    Zhu, Cheng; Fu, Yijun; Liu, Changan; Liu, Yang; Hu, Lulu; Liu, Juan; Bello, Igor; Li, Hao; Liu, Naiyun; Guo, Sijie; Huang, Hui; Lifshitz, Yeshayahu; Lee, Shuit-Tong; Kang, Zhenhui

    2017-08-01

    Self-healing is the way by which nature repairs damage and prolongs the life of bio entities. A variety of practical applications require self-healing materials in general and self-healing polymers in particular. Different (complex) methods provide the rebonding of broken bonds, suppressing crack, or local damage propagation. Here, a simple, versatile, and cost-effective methodology is reported for initiating healing in bulk polymers and self-healing and anticorrosion properties in polymer coatings: introduction of carbon dots (CDs), 5 nm sized carbon nanocrystallites, into the polymer matrix forming a composite. The CDs are blended into polymethacrylate, polyurethane, and other common polymers. The healing/self-healing process is initiated by interfacial bonding (covalent, hydrogen, and van der Waals bonding) between the CDs and the polymer matrix and can be optimized by modifying the functional groups which terminate the CDs. The healing properties of the bulk polymer-CD composites are evaluated by comparing the tensile strength of pristine (bulk and coatings) composites to those of fractured composites that are healed and by following the self-healing of scratches intentionally introduced to polymer-CD composite coatings. The composite coatings not only possess self-healing properties but also have superior anticorrosion properties compared to those of the pure polymer coatings. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  19. Bilateral Distal Radius Fracture in Third Trimester of Pregnancy with Accelerated Union: A Rare Case Report

    OpenAIRE

    2015-01-01

    Bilateral distal radius fracture is a rare entity. There is no literature reporting a bilateral distal radius fracture in pregnancy. Fracture healing is influenced by hormones. Hormonal changes of pregnancy will affect the healing of a fracture. A 28-year-old female at 34 wk of pregnancy sustained a bilateral distal radius fracture after a self fall. One side was managed conservatively and open reduction was done for the other side. Both fractures united at four weeks. This case is unique in ...

  20. Multifunctional composites: Healing, heating and electromagnetic integration

    Science.gov (United States)

    Plaisted, Thomas Anthony John

    2007-12-01

    Multifunctional materials, in the context of this research, integrate other functions into materials that foremost have outstanding structural integrity. Details of the integration of electromagnetic, heating, and healing functionalities into fiber-reinforced polymer composites are presented. As a result of fiber/wire integration through textile braiding and weaving, the dielectric constant of a composite may be tuned from negative to positive values. These wires are further leveraged to uniformly heat the composite through resistive heating. A healing functionality is introduced by utilizing a polymer matrix with the ability to heal internal cracking through thermally-reversible covalent bonds based on Diels-Alder cycloaddition. The Double Cleavage Drilled Compression (DCDC) specimen is applied to study the fracture and healing characteristics of the neat polymer. This method allows for quantitative evaluation of incremental crack growth, and ensures that the cracked sample remains in one piece after the test, improving the ability to re-align the fracture surfaces prior to healing. Initially, the fracture strength of PMMA is studied with various DCDC geometries to develop a model of the propagation of a crack within this type of specimen. Applied to the healable polymer (2MEP4F), repeated fracture-healing cycles demonstrate that treatment at temperatures between 85 to 95°C results in full fracture toughness recovery and no dimensional changes due to creep. The fracture toughness after each fracturing and healing cycle has been calculated, using the model, to yield a fracture toughness of about 0.71 MPa·m1/2 for this material at room temperature. Glass and carbon fiber-reinforced composites have been fabricated with the 2MEP4F polymer, and the ability of this polymer to heal microcracks in fiber-reinforced composites is demonstrated. Microcracks have been introduced into the composites by cryogenic cycling in liquid nitrogen, causing a reduction in the storage

  1. Origin and implications of fluid inclusions from filled fractures, Oriskany Sandstone, Allegheny Plateau, Pennsylvania

    Energy Technology Data Exchange (ETDEWEB)

    Basilone, T.; Anderson, T.; Burruss, R.C.

    1984-12-01

    Two cores from the Lower Devonian Oriskany Sandstone underlying the Allegheny Plateau in south-central Somerset County, Pennsylvania, contain fractures that may either be filled with epigenetic minerals or unfilled. The 1 Sipe core, taken from an unproductive well drilled on the crest of an anticlinal structure, is characterized by numerous discontinuous vertical fractures. The 1 Romesburg core, taken from a productive well drilled on the flank of an anticlinal structure, contains numerous fractures that lie parallel with bedding planes. The walls of these fractures consist of smooth slickensided surfaces. Quartz and ferroan-calcite crystals filling fractures contain numerous hydrocarbon-bearing fluid inclusions. The distribution of these fluid inclusions within most minerals allowed a determination to be made regarding the relative times of migration of fluid hydrocarbon phases in the subsurface with respect to the paragenetic sequence of mineralization events. Analysis of fluid inclusions indicates that fractures were opened at 22,000 ft (6700 m) and remained open throughout an extended period of uplift. Furthermore, inclusions contain hydrocarbon-rich fluids that are comparable to reservoir hydrocarbons in the nearby Shamrock field. This relationship implies that hydrocarbons that currently exist in reservoirs were conducted along fractures that were once open. Fractures crosscut diagenetic features, indicating that diagenesis, for the most part, preceded fracture events. Although they differ in origin and orientation, fractures characterizing Oriskany strata were healed by a consistent sequence of epigenetic minerals.

  2. Forearm Fractures in Children

    Science.gov (United States)

    ... secure them in place. Your doctor may recommend surgery if: Casts support and protect broken bones while they heal. Reproduced from Pring M, Chambers H: Pediatric forearm fractures. Orthopaedic Knowledge Online Journal 2007; 5(5). Accessed October 2014. • The bone ...

  3. New results on the relationship between hardness and fracture toughness of WC-Co hardmetal

    CSIR Research Space (South Africa)

    O'Quigley, DGF

    1996-05-01

    Full Text Available Two sets of WC-Co grades were produced, with cobalt content ranging from 3 to 50 wt.%. The mean grain size of the two sets was 2.2 and 6 mu m respectively. The two sets of grades were used to investigate the relationship between hardness...

  4. Relationship between fracturing and porogenesis in a carbonate reservoir: Example from the Middle Turonian Bireno Member in Jebel M'rhila, Central Tunisia

    Science.gov (United States)

    Haj Ali, Hajer; Belghithi, Hanen; Ouali, Jamel Abdennaceur; Touir, Jamel

    2016-09-01

    relationship between fracturing and the reservoir potentiality of dolomites and the dolomitization process. Although the porosity in dolomites is not important enough, its gradual lateral variation with the distance from the fractures reflects the role of the latter in the porogenesis. The field observation and the results of the petrographic and petrophysical analysis show that the fractures must have played a substantial role in conducting the meteoric waters from the emerged platform surface to its base and laterally, resulting in a cementing dolomitization and a solution-related porogenesis. Therefore, it seems that if the dolomitic Bireno Member is rather a good potential reservoir due to the associated fractures networks.

  5. Dose-Effect Relationships for Femoral Fractures After Multimodality Limb-Sparing Therapy of Soft-Tissue Sarcomas of the Proximal Lower Extremity

    Energy Technology Data Exchange (ETDEWEB)

    Pak, Daniel; Vineberg, Karen A. [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States); Griffith, Kent A. [Biostatistics Unit, Comprehensive Cancer Center, University of Michigan, Ann Arbor, MI (United States); Sabolch, Aaron [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States); Chugh, Rashmi [Department of Internal Medicine, Division of Hematology/Oncology, University of Michigan, Ann Arbor, MI (United States); Ben-Josef, Edgar [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States); Biermann, Janet Sybil [Department of Orthopedic Surgery, University of Michigan, Ann Arbor, MI (United States); Feng, Mary, E-mail: maryfeng@umich.edu [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States)

    2012-07-15

    Purpose: We investigated the clinical and dosimetric predictors for radiation-associated femoral fractures in patients with proximal lower extremity soft tissue sarcomas (STS). Methods and Materials: We examined 131 patients with proximal lower extremity STS who received limb-sparing surgery and external-beam radiation therapy between 1985 and 2006. Five (4%) patients sustained pathologic femoral fractures. Dosimetric analysis was limited to 4 fracture patients with full three-dimensional dose information, who were compared with 59 nonfracture patients. The mean doses and volumes of bone (V{sub d}) receiving specified doses ({>=}30 Gy, 45 Gy, 60 Gy) at the femoral body, femoral neck, intertrochanteric region, and subtrochanteric region were compared. Clinical predictive factors were also evaluated. Results: Of 4 fracture patients in our dosimetric series, there were three femoral neck fractures with a mean dose of 57.6 {+-} 8.9 Gy, V30 of 14.5 {+-} 2.3 cc, V45 of 11.8 {+-} 1.1 cc, and V60 of 7.2 {+-} 2.2 cc at the femoral neck compared with 22.9 {+-} 20.8 Gy, 4.8 {+-} 5.6 cc, 2.5 {+-} 3.9 cc, and 0.8 {+-} 2.7 cc, respectively, for nonfracture patients (p < 0.03 for all). The femoral neck fracture rate was higher than at the subtrochanteric region despite lower mean doses at these subregions. All fracture sites received mean doses greater than 40 Gy. Also, with our policy of prophylactic femoral intramedullary nailing for high-risk patients, there was no significant difference in fracture rates between patients with and without periosteal excision. There were no significant differences in age, sex, tumor size, timing of radiation therapy, and use of chemotherapy between fracture and nonfracture patients. Conclusions: These dose-volume toxicity relationships provide RT optimization goals to guide future efforts for reducing pathologic fracture rates. Prophylactic femoral intramedullary nailing may also reduce fracture risk for susceptible patients.

  6. Dating fractures in infants

    Energy Technology Data Exchange (ETDEWEB)

    Halliday, K.E., E-mail: kath.halliday@nuh.nhs.uk [Department of Radiology, Nottingham University Hospitals, Queen' s Medical Centre, Nottingham (United Kingdom); Broderick, N.J.; Somers, J.M. [Department of Radiology, Nottingham University Hospitals, Queen' s Medical Centre, Nottingham (United Kingdom); Hawkes, R. [Department of Radiology, Paul O' Gorman Building, Bristol (United Kingdom)

    2011-11-15

    Aim: To document the timing of the appearance of the radiological features of fracture healing in a group of infants in which the date of injury was known and to assess the degree of interobserver agreement. Materials and methods: Three paediatric radiologists independently assessed 161 images of 37 long bone fractures in 31 patients aged 0-44 months. The following features were assessed: soft-tissue swelling, subperiosteal new bone formation (SPNBF), definition of fracture line, presence or absence of callus, whether callus was well or ill defined, and the presence of endosteal callus. Results: Agreement between observers was only moderate for all discriminators except SPNBF. SPNBF was invariably seen after 11 days but was uncommon before this time even in the very young. In one case SPNBF was seen at 4 days. Conclusion: With the exception of SPNBF, the criteria relied on to date fractures are either not reproducible or are poor discriminators of fracture age.

  7. Relationship between change in femoral neck bone mineral density and hip fracture incidence during treatment with strontium ranelate.

    Science.gov (United States)

    Bruyère, O; Roux, C; Badurski, J; Isaia, G; de Vernejoul, M C; Cannata, J; Ortolani, S; Slosman, D; Detilleux, J; Reginster, J-Y

    2007-12-01

    Strontium ranelate (SR) increases bone mineral density (BMD) in postmenopausal osteoporotic women and reduces vertebral and non-vertebral fracture incidence. Hip fracture reduction has also been observed during 3-year treatment with SR in osteoporotic women at high risk of hip fracture. The objective of this study is to analyse the association between BMD changes and hip fracture incidence during treatment with SR. In this post-hoc analysis, 465 women aged over 74 years with low BMD at the femoral neck (T-score TROPOS). BMD was assessed at the femoral neck at baseline and after a follow-up of 3 years. Hip fractures were reported by study investigators. After adjusting for age, body mass index, femoral neck BMD at baseline and number of prevalent vertebral fractures, we found that for each 1% increase in femoral neck BMD observed after 3 years, the risk to experience a hip fracture after 3 years decreased by 7% (95% CI: 1-14%) (p = 0.04). In patients experiencing a hip fracture over 3 years of treatment with SR, femoral neck BMD increased by (mean [SE]) 3.41 (1.02)% compared to 7.23 (0.81)% in patients without hip fracture (p = 0.02). In this post-hoc analysis of women undergoing 3 years of SR treatment, an increase in femoral neck BMD is associated with a decrease in hip fracture incidence.

  8. Relationship of Shallow Groundwater Quality to Hydraulic Fracturing Activities in Antrim and Kalkaska Counties, MI

    Science.gov (United States)

    Stefansky, J. N.; Robertson, W. M.; Chappaz, A.; Babos, H.; Israel, S.; Groskreutz, L. M.

    2015-12-01

    Hydraulic fracturing (fracking) of oil and natural gas (O&G) wells is a widely applied technology that can increase yields from tight geologic formations. However, it is unclear how fracking may impact shallow groundwater; previous research into its effects has produced conflicting results. Much of the worry over potential impacts to water quality arises from concerns about the produced water. The water produced from O&G formations is often salty, contains toxic dissolved elements, and can be radioactive. If fracking activities cause or increase connectivity between O&G formations and overlying groundwater, there may be risks to aquifers. As one part of a groundwater quality study in Antrim and Kalkaska Counties, MI, samples were collected from the unconfined glacial aquifer (3-300 m thick) and produced water from the underlying Antrim formation, a shallow (180-670 m deep) natural gas producing black shale. Groundwater samples were collected between 200 to 10,000 m distance from producing Antrim gas wells and from a range of screened intervals (15-95 m). Samples were analyzed for major constituents (e.g., Br, Cl), pH, conductivity, and dissolved oxygen (DO). The specific conductance of groundwater samples ranged from 230-1020 μS/cm; DO ranged from 0.4-100% saturation. Preliminary results show a slight inverse correlation between specific conductance and proximity to producing Antrim wells. The observed range of DO saturation in glacial aquifer groundwater appears to be related to both screened depth of the water wells and proximity to Antrim wells. During sampling, some well owners expressed concerns about the effects of fracking on groundwater quality and reported odd smells and tastes in their water after O&G drilling occurred near their homes. The results of this study and reported observations provide evidence to suggest a potential hydrogeological connection between the Antrim formation and the overlying glacial aquifer in some locations; it also raises

  9. Growth hormone does not stimulate early healing in rat tendons

    OpenAIRE

    2012-01-01

    Growth Hormone stimulates bone growth and fracture repair. It acts mainly by increasing the systemic levels of IGF-1. Local treatment with IGF-1 appears to stimulate tendon healing. We therefore hypothesized that systemic treatment with Growth Hormone would also stimulate tendon healing. Rat Achilles tendons were transected and left to heal. 4 groups were studied. Intramuscular injections of botulinum toxin A (Botox) were used to reduce loading in 2 groups. The animals were randomized to twic...

  10. Relationship Between Dislocation Time and Prognosis in Vertical Fractured Posterior Teeth Replantation%纵折后牙黏结再植术中离体时间与愈合方式的关系

    Institute of Scientific and Technical Information of China (English)

    张珂; 盛乾斌; 王淑敏; 俞立英

    2012-01-01

    Objective;To investigate the relationship between dislocation time and prognosis in vertical fractured posterior teeth replantation. Methods; A total of 109 vertical fractured posterior teeth were extracted, treated with root canal therapy and spliced in vitro. The dentists treated root surfaces, adjusted occlusion; then replanted the teeth, sutured and fixed them. Followed up the patients and prognosis was evaluated by clinical examination, radiological examination and chief complaints of the patients. Results; The dislocation time of 109 vertical fractured posterior teeth varied from 25 minutes to 121 minutes. The total success rate was 81.6% (PLH 44.9%; OIH 36.7%). The success rate was 100% [pcriodontal ligament healing (PLH) 50% ; osscointcgration healing (OIH) 50%^] when the dislocation time was less than 30 minutes. The success rate was 89. 48% (PLH 42. 11% ; OIH 47. 37%) when the dislocation time was not less than 60 minutes. Conclusions; There was no correlation between dislocation time and prognosis in vertical fractured posterior teeth replantation.%目的:探讨纵折后牙黏结再植术中离体时间与愈合方式及效果的关系.方法:对109颗纵折后牙行牙拔除术,体外根管治疗后黏结,清除龈上龈下结石、刮除肉芽组织、根面处理、调合、再植、缝合.随访后分别从临床症状、X线片和患者主诉评价治疗效果,分析纵折牙在黏结再植术中不同的再植牙离体时间对愈合方式及效果的影响.结果:109颗牙纵折后黏结再植术中牙离体时间为25 ~121 min;再植成功率81.6%,其中牙周膜愈合率为44.9%,骨性愈合率为36.7%.离体时间<30 min者牙周膜愈合率和骨性愈合率均为50%,离体时间≥60 min者牙周膜愈合率与骨性愈合率分别为42.11%和47.37%.结论:纵折后牙黏结再植术中牙离体时间在25~121 min之间时,其与愈合方式及疗效无显著相关性.

  11. Pedicular stress fracture in the lumbar spine

    Energy Technology Data Exchange (ETDEWEB)

    Chong, V.F.H.; Htoo, M.M. [Singapore General Hospital, Singapore, (Singapore). Department of Diagnostic Radiology

    1997-08-01

    Spondylolisthesis with or without spondylolysis is common in the lumbar spine. Associated fracture in the pedicle (`pediculolysis`) is unusual. The margins of pedicular stress fractures, like spondylolysis, usually appear sclerotic. A patient with a pedicular stress fracture with minimal marginal sclerosis suggesting an injury of recent onset is presented here. There was associated bilateral spondylolysis. The findings in this patient suggest that established pediculolysis probably represents a stress fracture that has failed to heal. (authors). 10 refs., 2 figs.

  12. The prevalence of vitamin D deficiency in patients with vertebral fragility fractures.

    Science.gov (United States)

    Maier, G S; Seeger, J B; Horas, K; Roth, K E; Kurth, A A; Maus, U

    2015-01-01

    Hypovitaminosis D has been identified as a common risk factor for fragility fractures and poor fracture healing. Epidemiological data on vitamin D deficiency have been gathered in various populations, but the association between vertebral fragility fractures and hypovitaminosis D, especially in males, remains unclear. The purpose of this study was to evaluate serum levels of 25-hydroxyvitamin D (25-OH D) in patients presenting with vertebral fragility fractures and to determine whether patients with a vertebral fracture were at greater risk of hypovitaminosis D than a control population. Furthermore, we studied the seasonal variations in the serum vitamin D levels of tested patients in order to clarify the relationship between other known risk factors for osteoporosis and vitamin D levels. We measured the serum 25-OH D levels of 246 patients admitted with vertebral fractures (105 men, 141 female, mean age 69 years, sd 8.5), and in 392 orthopaedic patients with back pain and no fractures (219 men, 173 female, mean age 63 years, sd 11) to evaluate the prevalence of vitamin D insufficiency. Statistical analysis found a significant difference in vitamin D levels between patients with vertebral fragility fracture and the control group (p = 0.036). In addition, there was a significant main effect of the tested variables: obesity (p vitamin D levels and gender (p = 0.34). Vitamin D insufficiency was shown to be a risk factor for vertebral fragility fractures in both men and women.

  13. The relationship between CT-determined mineral content and liability to fracture of normal and metastatic vertebrae. Beziehungen zwischen dem computertomographisch bestimmten Mineralgehalt und dem Frakturverhalten von gesunden und metastatischen Wirbelkoerpern

    Energy Technology Data Exchange (ETDEWEB)

    Crone-Muenzebrock, W.; Spielmann, R.P. (Hamburg Univ. (Germany, F.R.). Abt. fuer Roentgendiagnostik); Meenen, N.M. (Hamburg Univ. (Germany, F.R.). Abt. fuer Unfallchirurgie)

    1989-09-01

    The mineral content of 42 normal and 19 vertebrae with metastases obtained at post mortem was determined by a dual energy method and this was related to their liability to fracture. In the normal vertebrae, this relationship was expressed in the form of a logarithmic function. Amongst vertebrae with osteolytic lesions, liability to fracture increased more rapidly than mineral loss. Vertebrae with osteoblastic metastases showed increased mineral concentration with an increased liability to fracture as compared with normal vertebrae. (orig.).

  14. A unified theory of bone healing and nonunion: BHN theory.

    Science.gov (United States)

    Elliott, D S; Newman, K J H; Forward, D P; Hahn, D M; Ollivere, B; Kojima, K; Handley, R; Rossiter, N D; Wixted, J J; Smith, R M; Moran, C G

    2016-07-01

    This article presents a unified clinical theory that links established facts about the physiology of bone and homeostasis, with those involved in the healing of fractures and the development of nonunion. The key to this theory is the concept that the tissue that forms in and around a fracture should be considered a specific functional entity. This 'bone-healing unit' produces a physiological response to its biological and mechanical environment, which leads to the normal healing of bone. This tissue responds to mechanical forces and functions according to Wolff's law, Perren's strain theory and Frost's concept of the "mechanostat". In response to the local mechanical environment, the bone-healing unit normally changes with time, producing different tissues that can tolerate various levels of strain. The normal result is the formation of bone that bridges the fracture - healing by callus. Nonunion occurs when the bone-healing unit fails either due to mechanical or biological problems or a combination of both. In clinical practice, the majority of nonunions are due to mechanical problems with instability, resulting in too much strain at the fracture site. In most nonunions, there is an intact bone-healing unit. We suggest that this maintains its biological potential to heal, but fails to function due to the mechanical conditions. The theory predicts the healing pattern of multifragmentary fractures and the observed morphological characteristics of different nonunions. It suggests that the majority of nonunions will heal if the correct mechanical environment is produced by surgery, without the need for biological adjuncts such as autologous bone graft. Cite this article: Bone Joint J 2016;98-B:884-91.

  15. Subtrochanteric femur fracture after removal of screws for femoral neck fracture in a child.

    Science.gov (United States)

    Song, Kwang Soon; Lee, Si Wook

    2015-01-01

    Displaced femoral neck fractures are rare in children and are associated with a high rate of complications. Subtrochanteric fractures after cannulated screw fixation of femoral neck fractures in adults are well recognized, and there are several reports on the topic. However, there are no reports on complications related to hardware or subtrochanteric fractures after removal of the screws in the treatment of femoral neck fractures in children. Here we report the case of a 10-year-old boy who sustained a subtrochanteric fracture after the screw removal and healing that followed a femoral neck fracture.

  16. Scaphoid fractures in the athlete.

    Science.gov (United States)

    Winston, Mark J; Weiland, Andrew J

    2017-03-01

    Scaphoid fractures are a common wrist injury, especially in athletes. Clinicians should have a high index of suspicion for a scaphoid fracture in any patient complaining of radial-sided wrist pain after a fall on an outstretched hand. Advanced imaging, including CT and MRI scans, may be useful in diagnosis and classification of fracture patterns. Treatment varies based on the fracture location, stability of the fracture, and predictability of the fracture to heal. Treatment involves either non-operative management with a thumb spica cast or brace, or operative fixation with a headless compression screw, k-wires, or scaphoid-specific plates. Return to play is dependent on many variables, including sport, fracture union, and ability to play with cast.

  17. Fractures system within Qusaiba shale outcrop and its relationship to the lithological properties, Qasim area, Central Saudi Arabia

    Science.gov (United States)

    Ibrahim, Mohamed I. M.; Hariri, Mustafa M.; Abdullatif, Osman M.; Makkawi, Mohammad H.; Elzain, Hussam

    2017-09-01

    The basal Qusaiba hot shale member of Qalibah Formation is considered to be an important source rock in the Paleozoic petroleum system of Saudi Arabia and an exploration target for tight shale as one of the Unconventional resources of petroleum. This work has been carried out to understand the fractures network of Qusaiba shale member in outcrops located to the west of Qusayba' village in Al-Qasim area, Central Saudi Arabia. The main objective of this study is to understand the distribution of natural fractures over different lithological units. Description data sheets were used for the detailed lithological description of Qusaiba shale member on two outcrops. Spot-7 and Landsat ETM+ satellite images were used for lineament mapping and analyses on a regional scale in a GIS environment. Fractures characterization in outcrop-scale was conducted by using linear scanline method. Qusaiba shale member in the study area consists of 5 main lithofacies, divided based on their sedimentary structures and petrographical properties, from base to top in the outcrops, the lithofacies are; fissile shale, very fine-grained micaceous siltstone, bioturbated mudstone, very fine to fine-grained hummocky cross-stratified sandstone, and fine to medium-grained low/high angle cross-stratified sandstone lithofacies. Lineaments interpretation of the Spot-7 and Landsat ETM+ satellite images showed two major directions in the study area; 320° that could be related to Najd fault system and 20° that could be related to the extensional activities which took place after Amar collision. Fractures are much denser in the fissile shale and mudstone lithofacies than sandstones lithofacies, and average spacing is smaller in the fissile shale and mudstone lithofacies than sandstones lithofacies. Lineaments and large-scale fractures are Non-Stratabound fractures and they deal with the area as one big mechanical unit, but small-scale fractures are Stratabound fractures that propose different mechanical

  18. Medicinal plants and bone healing.

    Science.gov (United States)

    Singh, Vibha

    2017-01-01

    Fracture is defined as complete or incomplete separation in the continuity of bone Fracture healing is a complex physiological process that involves the coordinated participation of hematopoietic and immune cells within bone marrow. It conjunction with vascular and skeletal cell precursors it also includes mesenchymal stem cells which are recruited from the circulation and the surrounding tissues. It is estimated that 80% of the population in developing countries still rely on the traditional herbal medicines. Healing is practiced by people from all levels of society, who live and work in intimate relation with their environment. They range from bone setting, treatment of snake bite and mental disorders. Knowledge of Medicinal plants and their identification should be gain with the help of cowherds, hermits, hunters, forest dwellers and those who gather plants of forest for food. Sushruta Samita Sutrasthanam 36 V.10. Herbs can effective in reducing swelling pain and soreness of the fracture and al so speedy recovery of function. In last few decades there has been growing In alternative forms of therapy globally. Herbal medicines are currently in demand and their popularity is increasing.

  19. Influence of oxygen on wound healing.

    Science.gov (United States)

    Yip, Wai Lam

    2015-12-01

    Oxygen has an important role in normal wound healing. This article reviews the evidence concerning the role of oxygen in wound healing and its influence on the different stages of wound healing. The evidence reviewed has demonstrated that improving oxygenation may be helpful in limiting wound infection, although there is a lack of good quality studies on the role of oxygen in the proliferative phase and in reepithelialisation. Overall, the relationship between oxygen and wound healing is complex. Knowledge of this aspect is important as many treatment modalities for refractory wounds are based on these principles.

  20. Clinical analysis of the rap stress stimulator applied for crus fracture after skeletal external fixation

    OpenAIRE

    Zhuang, Ping; Hong, Jiayuan; Chen, Wei; Wu, Jin; Ding, Zhenqi

    2015-01-01

    Introduction Open crus fracture is still difficult in clinical treatment because of the delayed fracture union and high rate of nonunion after the operation. A consensus has been reached that mechanical stress can promote fracture healing. We independently developed a stress stimulator, which can provide longitudinal pressure for the fixed fracture end of the lower legs to promote fracture healing. The purpose of this study is to explore the advantages and clinical effect of the rap stress st...

  1. Effects of Traditional Chinese Medicine Formula for Nourishing Kidney-Essence on Osteogenic Differentiation of Bone Marrow Mesenchymal Stem Cells in Rabbits in Different Phases of Fracture Healing%补肾填精法对兔骨折后不同时相骨髓间充质干细胞成骨分化的影响

    Institute of Scientific and Technical Information of China (English)

    王斌; 罗毅文; 胡年宏

    2013-01-01

    目的 观察补肾填精中药对兔骨折后不同时点骨髓间充质干细胞(bone marrow mesenchymal stem cells,BMSCs)分化为成骨细胞的影响.方法 将20只白兔随机分成4组,即正常对照组、骨折模型组、中药治疗组、西药治疗组.分离培养骨折端BMSCs,取P3代BMSCs并向成骨细胞诱导分化,分别采用碱性磷酸酶(alkaline phosphatase,ALP)试剂盒、骨钙素(osteocalcin,OCN)试剂盒检测ALP活性、OCN水平.结果 随着用药时间的延长,各骨折组ALP活性和OCN水平均逐渐增强.在骨折后第14、21天,中药治疗组ALP活性、OCN水平均高于其他3组.结论 补肾填精法可促进兔骨折后不同时点BMSCs向成骨细胞分化.%Objective To observe the effects of traditional Chinese medicine (TCM) formula for nourishing kidney-essence on the osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) in rabbits in different phases of fracture healing. Methods Twenty white rabbits were divided into normal control group, fracture model group, TCM treatment group, and Western medicine (WM) treatment group. The BMSCs at the fracture ends were isolated and cultured, and the passage 3 cells were collected and then induced to differentiate into osteoblasts. Alkaline phosphatase (ALP) assay kit and osteocalcin (OCN) assay kit were used to measure the ALP activity and OCN level, respectively. Results After fracture, the ALP activity and OCN level increased gradually in the fracture model group, TCM treatment group, and WM treatment group. At 14 and 21 days after fracture, the TCM treatment group had significantly higher ALP activity and OCN level than the other three groups (P<0. 05 or P<0. 01). Conclusion TCM formula for nourishing kidney-essence can promote the osteogenic differentiation of BMSCs in rabbits in different phases of fracture healing.

  2. Effect of treatment delay upon pulp and periodontal healing of traumatic dental injuries -- a review article.

    Science.gov (United States)

    Andreasen, J O; Andreasen, F M; Skeie, A; Hjørting-Hansen, E; Schwartz, O

    2002-06-01

    Based on an analysis of the literature concerning parameters influencing the prognosis of traumatic dental injuries, few studies were found to have examined possible relationships between treatment delay and pulpal and periodontal ligament healing complications. It has been commonly accepted that all injuries should be treated on an emergency basis, for the comfort of the patient and also to reduce wound healing complications. For practical and especially economic reasons, various approaches can be selected to fulfill such a demand, such as acute treatment (i.e. within a few hours), subacute (i.e. within the first 24 h), and delayed (i.e. after the first 24 h). In this survey the consequences of treatment delay on pulpal and periodontal healing have been analyzed for the various dental trauma groups. Applying such a treatment approach to the various types of injuries, the following treatment guidelines can be recommended, based on our present rather limited knowledge of the effect of treatment delay upon wound healing. Crown and crown/root fractures: Subacute or delayed approach. Root fractures: Acute or subacute approach. Alveolar fractures: Acute approach (evidence however questionable). Concussion and subluxation: Subacute approach. Extrusion and lateral luxation: Acute or subacute approach (evidence however questionable). Intrusion: Subacute approach (evidence however questionable). Avulsion: If the tooth is not replanted at the time of injury, acute approach; otherwise subacute. Primary tooth injury: Subacute approach, unless the primary tooth is displaced into the follicle of the permanent tooth or occlusal problems are present; in the latter instances, an acute approach should be chosen. These treatment guidelines are based on very limited evidence from the literature and should be revised as soon as more evidence about the effect of treatment delay becomes available.

  3. Spirituality and healing. Impacts on the Akan of Ghana.

    NARCIS (Netherlands)

    Opoku, J.K.

    2016-01-01

    Spirituality and healing are two distinct realities in form and nature. While healing deals practically with physical bodily disorders, spirituality concerns the sacred and the supernatural aspects of human life. The study is devoted to the uncommon relationship between spirituality and healing and

  4. Complications of mandibular fractures.

    Science.gov (United States)

    Zweig, Barry E

    2009-03-01

    Before any definitive treatment of mandibular fractures, the patient needs to be evaluated for more potentially life-threatening injuries. Complications can and do occur with treatment of mandibular fractures and can occur during any of the phases of treatment. The development of an accurate diagnosis and appropriate treatment plan is vital in achieving optimal success and decreasing complications. Knowledge of the anatomy and the principles of bone healing is also an important factor in preventing complications. To limit long-term untoward effects, complications should be recognized early and the appropriate treatment should be started before a minor complication becomes a complex one that is more difficult to manage.

  5. Relationship between grain size and fracture toughness in transition region of Mn-Mo-Ni low-alloy steels

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sang Ho; Lee, Sung Hak [Pohang Univ. of Science and Technology, Pohang (Korea, Republic of); Oh, Yong Jun [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2002-03-01

    The present study aims at interpreting the effect of grain size on fracture toughness in the transition region of Mn-Mo-Ni low-alloy steels. Three kinds of steels with different austenite grain sizes were fabricated, and their microstructures and mechanical properties were examined. Elastic-plastic cleavage fracture toughness, K{sub Jc}, was determined by 3-point bend tests of precracked Charpy V-notch (PCVN) specimens according to ASTM E1921 standard test method. When the austenite grain size decreased, the total number of carbides increased, while the size and the aspect ratio of carbides decreased. Local fracture stresses, estimated from a theoretical stress distribution in front of a crack tip, were found to be mainly determined by the 92%th size of carbides. Cross-sectional areas beneath fracture surfaces were observed to understand microstructural features to affect the cleavage crack propagation behavior. The results showed that measured cleavage fracture units were smaller than austenite grain sizes, indicating that packet boundaries as well as austenite grain boundaries played an important role in the cleavage crack propagation. Based on the electron back-scatter diffraction (EBSD) results, the cleavage fracture units could also be matched with the effective grain sizes determined by the misorientation tolerance angle of 25 degree.

  6. [Relationship of pharmacokinetics, changes of bone turnover markers and BMD/fractures efficacy during treatment with anabolic agents;Teriparatide daily and once weekly subcutaneous injections.

    Science.gov (United States)

    Miyauchi, Akimitsu

    Teriparatide(recombinant human PTH1-34, 20 μg daily subcutaneous injection)has been approved for osteoporosis patients at high risk of fracture in many countries including Japan. Teriparatide daily injection therapy has been reported to increase BMD, improve microarchitecture of bone, and reduce the risk of new vertebral fractures and that of non-vertebral fractures. Pharmakokinetic(PK)study after a single Teriparatide injection of the daily dose in healthy Japanese postmenopausal women(n=18)revealed very rapid achievement of peak blood level(median of tmax=0.25 hr)followed by fast disappearance from the blood(mean t1/2=0.708 hr, n=17). Consistent with these PK characteristics, a rapid increase in bone formation marker and later increase in bone resorption marker has previously been observed, which was described as a bone anabolic window. More recently, once weekly subcutaneous injection of teriparatide acetate(56.5 μg)has been reported to reduce the risk of new vertebral fractures compared with placebo and has been approved in Japan. PK study after injection of the higher weekly dose in healthy Japanese postmenopausal women(n=10)revealed a relatively slow achievement of the peak blood level(mean tmax=0.875 hr)compared to daily injections, followed by relatively slow disappearance from the blood(mean t1/2=1.295 hr). Consistent with these PK characteristics, an initial(<24 hr)transient decrease of bone formation markers(serum osteocalcin and P1NP)and transient increase of bone resorption markers(serum NTX and urinary CTX)were observed. However, afterword, the bone formation and resorption markers were increased and decreased, respectively, for longer than 1 week from the baseline levels. The relationship of pharmacokinetics, changes of bone turnover markers and BMD/fractures efficacy during daily versus weekly teriparatide treatment needs to be clarified.

  7. Suplementação de vitamina C não acelera o processo de consolidação de fratura da tíbia em ratos Supplementary vitamin C does not accelerate bone healing in a rat tibia fracture model

    Directory of Open Access Journals (Sweden)

    Vincenzo Giordano

    2012-01-01

    Full Text Available OBJETIVO: Investigar a função da suplementação de ácido ascórbico na consolidação de fraturas da tíbia de ratos. MÉTODOS: Trinta ratos Wistar machos foram aleatoriamente divididos nos grupos Vitamina C (Grupo A e sham (Grupo B, com 15 ratos em cada grupo. Ao grupo A foram administrados 200mg/kg de ácido ascórbico por dia intraperitonialmente e ao grupo B,5ml/kg de soro fisiológico intraperitonialmente uma vez ao dia. Os animais foram separados em duplas e colocados em gaiolas, com água e ração padrão ad libitum. As fraturas foram produzidas manualmente, não foram estabilizadas nem foi usado qualquer tipo de imobilização. Duas, quatro e seis semanas após a fratura, cinco ratos de cada grupo foram anestesiados e sacrificados por deslocamento cervical. O calo foi dissecado, preparado e analisado histologicamente. A análise histomorfológica foi realizada seis semanas após a fratura e o estágio de consolidação determinado a partir de escala de cinco pontos. RESULTADOS: Não houve diferenças histológicas e histomorfológicas entre os animais nos três diferentes estágios usados no experimento. Seis semanas após a fratura, os cinco animais de cada grupo apresentaram completa consolidação óssea. CONCLUSÃO: Nas condições estudadas, a suplementação de Vitamina C não acelerou o processo de consolidação de fraturas da tíbia de ratos. Nível de evidência II, estudo individual com delineamento experimental.OBJECTIVE: To investigate the role of ascorbic acid supplementation on bone healing after rat tibia fracture. METHODS: Thirty male Wistar rats were randomly divided into Vitamin C (Group A and sham (Group B groups (15 rats each. Group A received 200 mg intraperitoneally per kg per day of ascorbic acid and Group B was given saline 5 ml per kg per day intraperitoneally once a day. The animals were caged in pairs and allowed free access to tap water and a standard rodent chow ad libitum. Fractures were produced

  8. Lap shear strength and healing capability of self-healing adhesive containing epoxy/mercaptan microcapsules

    Energy Technology Data Exchange (ETDEWEB)

    Ghazali, Habibah; Ye, Lin [Centre for Advanced Materials Technology (CAMT), School of Aerospace, Mechanical and Mechatronic Engineering, The University of Sydney, NSW 2006 (Australia); Zhang, Ming-Qiu [Key Laboratory of Polymeric Composite and Functional Materials of Ministry of Education, Zhongshan University, Guangzhou 510275 (China)

    2016-03-09

    The aim of this work is to develop a self-healing polymeric adhesive formulation with epoxy/mercaptan microcapsules. Epoxy/mercaptan microcapsules were dispersed into a commercialize two-part epoxy adhesive for developing self-healing epoxy adhesive. The influence of different content of microcapsules on the shear strength and healing capability of epoxy adhesive were investigated using single-lap-joints with average thickness of adhesive layer of about 180 µm. This self-healing adhesive was used in bonding of 5000 series aluminum alloys adherents after mechanical and alkaline cleaning surface treatment. The adhesion strength was measured and presented as function of microcapsules loading. The results indicated that the virgin lap shear strength was increased by about 26% with addition of 3 wt% of self-healing microcapsules. 12% to 28% recovery of the shear strength is achieved after self-healing depending on the microcapsules content. Scanning electron microscopy was used to study fracture surface of the joints. The self-healing adhesives exhibit recovery of both cohesion and adhesion properties with room temperature healing.

  9. Lap shear strength and healing capability of self-healing adhesive containing epoxy/mercaptan microcapsules

    Science.gov (United States)

    Ghazali, Habibah; Ye, Lin; Zhang, Ming-Qiu

    2016-03-01

    The aim of this work is to develop a self-healing polymeric adhesive formulation with epoxy/mercaptan microcapsules. Epoxy/mercaptan microcapsules were dispersed into a commercialize two-part epoxy adhesive for developing self-healing epoxy adhesive. The influence of different content of microcapsules on the shear strength and healing capability of epoxy adhesive were investigated using single-lap-joints with average thickness of adhesive layer of about 180 µm. This self-healing adhesive was used in bonding of 5000 series aluminum alloys adherents after mechanical and alkaline cleaning surface treatment. The adhesion strength was measured and presented as function of microcapsules loading. The results indicated that the virgin lap shear strength was increased by about 26% with addition of 3 wt% of self-healing microcapsules. 12% to 28% recovery of the shear strength is achieved after self-healing depending on the microcapsules content. Scanning electron microscopy was used to study fracture surface of the joints. The self-healing adhesives exhibit recovery of both cohesion and adhesion properties with room temperature healing.

  10. Hindlimb unloading alters ligament healing

    Science.gov (United States)

    Provenzano, Paolo P.; Martinez, Daniel A.; Grindeland, Richard E.; Dwyer, Kelley W.; Turner, Joanne; Vailas, Arthur C.; Vanderby, Ray Jr

    2003-01-01

    We investigated the hypothesis that hindlimb unloading inhibits healing in fibrous connective tissue such as ligament. Male rats were assigned to 3- and 7-wk treatment groups with three subgroups each: sham control, ambulatory healing, and hindlimb-suspended healing. Ambulatory and suspended animals underwent surgical rupture of their medial collateral ligaments, whereas sham surgeries were performed on control animals. After 3 or 7 wk, mechanical and/or morphological properties were measured in ligament, muscle, and bone. During mechanical testing, most suspended ligaments failed in the scar region, indicating the greatest impairment was to ligament and not to bone-ligament insertion. Ligament testing revealed significant reductions in maximum force, ultimate stress, elastic modulus, and low-load properties in suspended animals. In addition, femoral mineral density, femoral strength, gastrocnemius mass, and tibialis anterior mass were significantly reduced. Microscopy revealed abnormal scar formation and cell distribution in suspended ligaments with extracellular matrix discontinuities and voids between misaligned, but well-formed, collagen fiber bundles. Hence, stress levels from ambulation appear unnecessary for formation of fiber bundles yet required for collagen to form structurally competent continuous fibers. Results support our hypothesis that hindlimb unloading impairs healing of fibrous connective tissue. In addition, this study provides compelling morphological evidence explaining the altered structure-function relationship in load-deprived healing connective tissue.

  11. Effects of naringin on bone healing of osteoporotic fracture in ovariectomized rats%柚皮苷对去势大鼠骨质疏松性骨折愈合的作用

    Institute of Scientific and Technical Information of China (English)

    李风波; 孙晓雷; 马剑雄; 张杨; 赵斌; 李艳军; 韩哲; 马信龙

    2015-01-01

    、柚皮苷组、雌激素组血骨钙素分别为(16.7±3.8)ng/L、(37.0±2.9)ng/L、(29.7±4.0) ng/L,任意两组比较差异均有统计学意义(P<0.05).术后2周对照组、柚皮苷组、雌激素组血清CTX-1分别为(4.1±0.6)ng/ml、(3.0±0.8) ng/ml、(3.4±0.4) ng/ml,任意两组比较差异均有统计学意义(P<0.05);术后8周对照组、柚皮苷组、雌激素组血清CTX-1分别为(3.0±0.7) ng/ml、(2.5±0.5)ng/ml、(2.7±0.3) ng/ml,柚皮苷组、雌激素组均较对照组比较差异有统计学意义(P<0.05).从2周到8周,所有组骨折的力学强度均随时间的增加而增强,且在2,8周柚皮苷组最用最强,优于对照组与雌激素组(P<0.05).结论 柚皮苷可提高大鼠骨质疏松骨折BMD、BV、BV/TV、Tb.Th,改善骨代谢,从而提高骨折愈合的力学强度.%Objective To investigate the effect of naringin on bone healing of osteoporotic fracture in ovariectomized rats and the possible mechanism.Methods Sixty female SD rats,3 months of age,were oophorectomized bilaterally before establishment of the osteoporotic model.Two months after the operation,transverse fracture of right tibia was induced.The rats were assigned to control group,naringin group and estrogen group according to the random number table,with 20 rats per group.Rats in naringin and estrogen groups were treated with naringin 100 mg/kg per day and 17-β-estradiol 22.5 μg/kg per day respectively.Instead,isotonic saline solution of the same volume was administered subcutaneously in control group.Animals in each group were killed at postoperative 2 and 8 weeks.The tibia was dissected to perform X-ray review,dual energy X-ray absorptiometry for measuring bone mineral density (BMD),and Micro-CT tomography for quantitative analysis of bone volume (BV),bone volume over total volume (BV/TV) and trabecula thickness (Tb.Th).Serum levels of osteocalcin and C-telopeptide of type Ⅰ collagen (CTX-1) were detected by the Elisa method.Maximum fracture load

  12. Finite element analysis of tibial fractures

    DEFF Research Database (Denmark)

    Wong, Christian Nai En; Mikkelsen, Mikkel Peter W; Hansen, Leif Berner

    2010-01-01

    INTRODUCTION: Fractures of the tibial shaft are relatively common injuries. There are indications that tibial shaft fractures share characteristics in terms of site, type and local fracture mechanisms. In this study, we aimed to set up a mathematical, computer-based model using finite element...... analysis of the bones of the lower leg to examine if such a model is adequate for prediction of fracture locations and patterns. In future studies, we aim to use these biomechanical results to examine fracture prevention, among others, and to simulate different types of osteosynthesis and the process...... of bony healing. The biomechanical results are the basis for fracture healing, biomechanical fall analysis and stability analysis of osteosynthesis. MATERIAL AND METHODS: A finite element model of the bony part of the lower leg was generated on the basis of computed tomography data from the Visible Human...

  13. Once Is Enough: A Guide to Preventing Future Fractures

    Science.gov (United States)

    ... fracture healing. In addition, studies have shown that elderly people with a hip fracture who do not have ... also may be damaging to your bones, and people who drink heavily tend to have more bone loss and fractures due to poor nutrition and an increased risk of falling. Where can ...

  14. [Development of novel self-healing and antibacterial resin composite containing microcapsules filled with polymerizable healing monomer].

    Science.gov (United States)

    Wu, Junling; Zhang, Qiang; Zhu, Ting; Ge, Jianhua; Zhou, Chuanjian

    2015-08-01

    To develop novel self- healing and antibacterial resin composite containing microcapsules filled with polymerizable healing monomer, and to measure its properties for further clinical application. Microcapsules filled with healing monomer of triethylene glycol dimethacrylate were synthesized according to methods introduced in the previous research. Microcapsules were added into novel resin composite containing nano-antibacterial silica fillers grafted with long chain alkyl quaternary ammonium at mass fractions of 0, 2.5%, 5.0%, 7.5% or 10.0%. A commercial resin composite (Tetric N-Ceram) was used as control. Flexural test was used to measure resin composite flexural strength and elastic modulus. The single edge V-notched beam method was used to measure fracture toughness and self-healing efficiency. Scanning electron microscope (SEM) was used to examine the fractured surface of selected specimen for investigation of fracture mechanisms. The flexural strength and elastic modulus of the resin composite were (96.4 ± 14.3) MPa and (6.2 ± 1.1) GPa respectively after incorporation of microcapsules up to 7.5%, and no significant difference was found between the experimental group and the control group [(99.1 ± 11.9) MPa and (6.1 ± 1.1) GPa] (P>0.05). The self-healing efficiency of (66.8 ± 7.0)% and (79.3 ± 9.7)% were achieved for resin composite with microcapsule mass fractions at 7.5% and 10.0%. SEM image showed that irregular films covered the fractured surface. Conclusions This novel self-healing and antibacterial resin composite containing microcapsules filled with polymerizable healing monomer exhibited a promising self- healing ability, which enabled itself well up for combating bulk fracture and secondary caries in clinical application.

  15. Bone graft substitutes and bone morphogenetic proteins for osteoporotic fractures: What is the evidence?

    NARCIS (Netherlands)

    E.M.M. van Lieshout (Esther); V. Alt (Volker)

    2016-01-01

    textabstractDespite improvements in implants and surgical techniques, osteoporotic fractures remain challenging to treat. Among other major risk factors, decreased expression of morphogenetic proteins has been identified for impaired fracture healing in osteoporosis. Bone grafts or bone graft

  16. Effects of Teriparatide Compared with Risedronate on Recovery After Pertrochanteric Hip Fracture

    DEFF Research Database (Denmark)

    Aspenberg, Per; Malouf, Jorge; Tarantino, Umberto;

    2016-01-01

    BACKGROUND: Osteoporosis drugs might affect fracture-healing. We therefore studied the effects of teriparatide in comparison with risedronate on recovery after pertrochanteric hip fractures. METHODS: The study was a randomized, multicenter, active-controlled, 78-week trial comparing teriparatide ...

  17. Bone graft substitutes and bone morphogenetic proteins for osteoporotic fractures: What is the evidence?

    NARCIS (Netherlands)

    E.M.M. van Lieshout (Esther); V. Alt (Volker)

    2016-01-01

    textabstractDespite improvements in implants and surgical techniques, osteoporotic fractures remain challenging to treat. Among other major risk factors, decreased expression of morphogenetic proteins has been identified for impaired fracture healing in osteoporosis. Bone grafts or bone graft substi

  18. Biomechanical assessment and clinical analysis of different intramedullary nailing systems for oblique fractures.

    Science.gov (United States)

    Alierta, J A; Pérez, M A; Seral, B; García-Aznar, J M

    2016-09-01

    The aim of this study is to evaluate the fracture union or non-union for a specific patient that presented oblique fractures in tibia and fibula, using a mechanistic-based bone healing model. Normally, this kind of fractures can be treated through an intramedullary nail using two possible configurations that depends on the mechanical stabilisation: static and dynamic. Both cases are simulated under different fracture geometries in order to understand the effect of the mechanical stabilisation on the fracture healing outcome. The results of both simulations are in good agreement with previous clinical experience. From the results, it is demonstrated that the dynamization of the fracture improves healing in comparison with a static or rigid fixation of the fracture. This work shows the versatility and potential of a mechanistic-based bone healing model to predict the final outcome (union, non-union, delayed union) of realistic 3D fractures where even more than one bone is involved.

  19. Operative strategy of acetabular fractures

    Institute of Scientific and Technical Information of China (English)

    WANG Yan; TANG Pei-fu; HUANG Peng

    2006-01-01

    Anatomic structure of acetabular fractures are complex and operative exposure and fixation are extremely difficult.For those obviously displaced acetabular fractures, close reduction is doomed to cause deformative healing. Open reduction with internal fixation (ORIF) not only results in anatomic reduction, but also brings complications. No matter which method will be adopted, traumatic arthritis or avascular necrosis of femoral head might occur. In order to treat acetabular fractures more effectively, orthopedic surgeons should be required to fully master the acetabular anatomy, biomechanics, classification and the necessary knowledge for complication prevention.

  20. A new self-healing epoxy with tungsten (VI) chloride catalyst.

    Science.gov (United States)

    Kamphaus, Jason M; Rule, Joseph D; Moore, Jeffrey S; Sottos, Nancy R; White, Scott R

    2008-01-06

    Using self-healing materials in commercial applications requires healing chemistry that is cost-effective, widely available and tolerant of moderate temperature excursions. We investigate the use of tungsten (VI) chloride as a catalyst precursor for the ring-opening metathesis polymerization of exo-dicyclopentadiene (exo-DCPD) in self-healing applications as a means to achieve these goals. The environmental stability of WCl6 using three different delivery methods was evaluated and the associated healing performance was assessed following fracture toughness recovery protocols. Both as-received and recrystallized forms of the WCl6 resulted in nearly complete fracture recovery in self-activated tests, where healing agent is manually injected into the crack plane, at 12wt% WCl6 loading. In situ healing using 15wt% microcapsules of the exo-DCPD produced healing efficiencies of approximately 20%.

  1. Prophylactic Nailing of Incomplete Atypical Femoral Fractures

    Directory of Open Access Journals (Sweden)

    Chang-Wug Oh

    2013-01-01

    Full Text Available Introduction. Recent reports have described the occurrence of low-energy subtrochanteric and femoral shaft fractures associated with long-term bisphosphonate use. Although information regarding the surgical treatment of these atypical femoral fractures is increasing, it is unclear if the preventive operation is useful in incomplete fractures. This study examined the results of preventive intramedullary nailing for incomplete atypical femoral fractures. Material and Methods. A retrospective search was conducted for patients older than 50 years receiving bisphosphonate therapy, with incomplete, nondisplaced fractures in either the subtrochanteric or diaphyseal area of the femur. Seventeen patients with a total of 20 incomplete, non-displaced lesions were included. The mean duration of bisphosphonate use was 50.5 months. Eleven of the 17 (64.7% patients had complete or incomplete fractures on the contralateral femur. All were treated with prophylactic fixation of an intramedullary (IM nail. The minimum followup was 12 months. Results. All cases healed with a mean period of 14.3 weeks. Nineteen of the 20 cases healed with the dissolution of incomplete fractures of the lateral aspect. A complete fracture developed at the time of nailing in one patient, but it healed with callus bridging. Conclusion. IM nailing appears to be a reliable way of preventing the progress of incomplete atypical femoral fractures.

  2. Effect of regular anti-osteoporosis treatment on bone mineral density and bone metabolism in patients with primary osteoporosis and its relationship with bone fractures

    Institute of Scientific and Technical Information of China (English)

    Xue-Feng Qian; Ping Cao; Shuan Liu; Hong-Ping Yang; Ming-Yong Zhang

    2016-01-01

    Objective:To analyze the effect of regular anti-osteoporosis treatment on bone mineral density and bone metabolism in patients with primary osteoporosis and its relationship with bone fractures.Methods:A total of 120 patients with primary osteoporosis were included in this study and randomly divided into observation group and control group (n=60). Control group received consistent treatment, observation group received individualized regular anti-osteoporosis treatment, and then the differences in bone mineral density, bone metabolism, trace elements, oxidative stress, fracture incidence, and so on were compared between two groups of patients 1 year after treatment.Results:Absolute BMD value of observation group after treatment was higher than that of control group; serum bone formation indexes ALP, BGP, PⅠNP and PⅠCP content were higher than those of control group; serum bone resorption indexesβ-CTX, sRANKL, TRACP, BAP and DPD content were lower than those of control group; serum trace elements iron and zinc content were higher than those of control group while calcium content was lower than that of control group; serum AOPP and MAOA content of observation group were significantly lower than those of control group while SOD and T-AOC content were significantly higher than those of control group;fracture incidence was significantly lower than that of control group during treatment.Conclusions:The regular anti-osteoporosis treatment can increase bone mineral density, optimize the overall condition and reduce the incidence of long-term fracture in patients with primary osteoporosis.

  3. Unusual presentation of a radial neck fracture in a child

    Directory of Open Access Journals (Sweden)

    Murali Poduval

    2013-01-01

    Full Text Available Fracture of the radial neck are uncommon injuries. In children, they may present as radial neck fractures, a components of forearm fracture dislocations, or as isolated fracture dislocations. Here, we present an unusual and previously undescribed variant of radial neck fracture with dislocation of the radial head to the medial side and ulnar nerve injury. The fracture dislocation was openly reduced and fixed with a small fragment plate. The fracture healed with some loss of rotational movements. At short followup of 6 months patient had useful elbow function but ulnar nerve did not recover.

  4. Wound Healing and Care

    Science.gov (United States)

    ... Right Sport for You Healthy School Lunch Planner Wound Healing and Care KidsHealth > For Teens > Wound Healing and Care Print A A A What's in ... mouth, or sunken eyes. There's good news about wound healing when you're a teen: Age is on ...

  5. Saliva and wound healing

    NARCIS (Netherlands)

    Brand, H.S.; Ligtenberg, A.J.M.; Veerman, E.C.I.; Ligtenberg, A.J.M.; Veerman, E.C.I.

    2014-01-01

    Oral wounds heal faster and with less scar formation than skin wounds. One of the key factors involved is saliva, which promotes wound healing in several ways. Saliva creates a humid environment, thus improving the survival and functioning of inflammatory cells that are crucial for wound healing. In

  6. Saliva and wound healing

    NARCIS (Netherlands)

    Brand, H.S.; Ligtenberg, A.J.M.; Veerman, E.C.I.; Ligtenberg, A.J.M.; Veerman, E.C.I.

    2014-01-01

    Oral wounds heal faster and with less scar formation than skin wounds. One of the key factors involved is saliva, which promotes wound healing in several ways. Saliva creates a humid environment, thus improving the survival and functioning of inflammatory cells that are crucial for wound healing. In

  7. Wound healing: an overview of acute, fibrotic and delayed healing.

    Science.gov (United States)

    Diegelmann, Robert F; Evans, Melissa C

    2004-01-01

    excessive matrix deposition and reduced remodeling. Often fibrotic lesions are associated with increased densities of mast cells. By understanding the functional relationships of these biological processes of normal compared to abnormal wound healing, hopefully new strategies can be designed to treat the pathological conditions.

  8. Fractures of the proximal humerus

    DEFF Research Database (Denmark)

    Brorson, Stig

    2013-01-01

    Fractures of the proximal humerus have been diagnosed and managed since the earliest known surgical texts. For more than four millennia the preferred treatment was forceful traction, closed reduction, and immobilization with linen soaked in combinations of oil, honey, alum, wine, or cerate....... The bandages were further supported by splints made of wood or coarse grass. Healing was expected in forty days. Different fracture patterns have been discussed and classified since Ancient Greece. Current classification of proximal humeral fractures mainly relies on the classifications proposed by Charles......, classification of proximal humeral fractures remains a challenge for the conduct, reporting, and interpretation of clinical trials. The evidence for the benefits of surgery in complex fractures of the proximal humerus is weak. In three systematic reviews I studied the outcome after locking plate osteosynthesis...

  9. Hip Fracture

    Science.gov (United States)

    Diseases and Conditions Hip fracture By Mayo Clinic Staff A hip fracture is a serious injury, with complications that can be life-threatening. The risk of hip fracture rises with age. Older people are at a ...

  10. Tikkun Olam: A Model for Healing the World.

    Science.gov (United States)

    Berman, Dene S.; Davis-Berman, Jennifer

    1999-01-01

    Discusses Tikkun Olam--the Jewish tenet of healing the world through individual good deeds--and its applicability to the practice of adventure therapy. Focuses on the therapeutic relationship, as it develops in group settings, and the role of adventure leaders and therapists in nourishing such relationships to provide a vehicle for healing or…

  11. Posterior arch bifocal fracture of the atlas vertebra: a variant of Jefferson fracture.

    Science.gov (United States)

    Abuamara, S; Dacher, J N; Lechevallier, J

    2001-07-01

    Fracture of the atlas vertebra is rare in children. We report two paediatric cases of bifocal pedicular fracture of the posterior arch of C1. Evaluation was performed by nonenhanced computed tomography scan, which successively confirmed both diagnosis and healing. In both cases, nonoperative management was successful.

  12. Fault Permeability and Strength Evolution Related to Fracturing and Healing Episodic Processes (Years to Millennia: the Role of Pressure Solution Évolution de la perméabilité et de la résistance des failles associée à des processus épisodiques de fracturation et colmatage (années - millénaires : le rôle de la dissolution cristallisation sous contrainte

    Directory of Open Access Journals (Sweden)

    Gratier J.-P.

    2011-02-01

    Full Text Available It is well known that fluids flow through faults and fractures but it is also demonstrated that fault zones act as impermeable barriers. Consequently, one must consider that faults are successively open and closed paths for fluids. On the human-activity time scale (years to millennia, studies of the seismic cycle offer the possibility of making a model of such evolution. According to this model, seismic (or hydraulic fracturing opens fluid paths almost instantaneously through the faults with associated weakening and post-fracturing creep processes. Fault healing processes then progressively close such fluid paths, associated with fault strengthening and fluid pressure recovery. Such transient behaviors have major consequences in the studies of: the evolution of permeability along faults with application tooil-field reservoir exploitation and fluid and waste storage; the evolution of fluid fluxes along faults with application to mass balance and climate evolution on the scale of the earth; the timing of earthquakes and the probability of their occurrence. The aim is to understand and evaluate the kinetics of the processes and the specific characteristic times of the fracturing and healing cycles. Results from laboratory experiments and natural fault studies are presented that show how pressure solution processes can explain both creep and sealing processes and the way they are associated in nature. The various fault-healing processes are discussed with their various characteristics in times from weeks to millennia. It is shown how they can be integrated into creep and sealing laws. Laboratory experiments give the values of some parameters of the laws (kinetics, thermodynamic. Other parameters must always be evaluated from the study of natural structures (geometry of path transfer, pressure and temperature conditions, nature of minerals and fluids. Consequently, the duration of the fracturing and sealing cycle is related to some extent to the

  13. Low dose erythropoietin stimulates bone healing in mice.

    Science.gov (United States)

    Garcia, P; Speidel, V; Scheuer, C; Laschke, M W; Holstein, J H; Histing, T; Pohlemann, T; Menger, M D

    2011-02-01

    Beyond its classical role in regulation of erythropoiesis, erythropoietin (EPO) has been shown to exert protective and regenerative actions in a variety of non-hematopoietic tissues. However, little is known about potential actions in bone regeneration. To analyze fracture healing in mice, a femoral 0.25 mm osteotomy gap was stabilized with a pin-clip technique. Animals were treated with 500 U EPO/kg bw per day or with vehicle only. After 2 and 5 weeks, fracture healing was analyzed biomechanically, radiologically and histologically. Expression of PCNA and NFκB was examined by Western blot analysis. Vascularization was analyzed by immunohistochemical staining of PECAM-1. Circulating endothelial progenitor cells were measured by flow-cytometry. Herein, we demonstrate that EPO-treatment significantly accelerates bone healing in mice. This is indicated by a significantly greater biomechanical stiffness and a higher radiological density of the periosteal callus at 2 and 5 weeks after fracture and stabilization. Histological analysis demonstrated significantly more bone and less cartilage and fibrous tissue in the periosteal callus. Endosteal vascularization was significantly increased in EPO-treated animals when compared to controls. The number of circulating endothelial progenitor cells was significantly greater in EPO-treated animals. The herein shown acceleration of healing by EPO may represent a promising novel treatment strategy for fractures with delayed healing and non-union formation.

  14. Effects of ultrashortwave and low frequency pulsed electromagnetic fields on the expression of vascular endothelial growth factor in fracture healing%超短波及低频脉冲磁疗对骨折愈合中血管内皮生长因子的影响

    Institute of Scientific and Technical Information of China (English)

    王珊珊; 毕然然; 崔宝娟; 代仁涛; 孙强三

    2009-01-01

    Objective To study the effects of uhrashortwave and low frequency pulsed electromagnetic fields on the expression of vascular endothelial growth factor(VEGF) in fracture healing. Methods Fifty-six New Zeal-and rabbits with artificial fractures were randomly divided into 4 groups:a control group,an ultrashortwave group,a low frequency pulsed electromagnetic field group and an ultrashortwave combined with low frequency pulsed electro-magnetic field group(combined group),with 14 in each group.Radiographic evaluation of callus formation and frac-ture healing,pathohistological examination and detection of VEGF expression through immunohistochemical staining were performed at the 1 st,2nd,4th and 6th week after the operation. Results Radiographic examination showed that there was significantly greater callus formation in the combined group than in the other groups throughout the healing process. Pathohistological examination also revealed significantly more cartilage islets and callus formation in the combined group.At the 1 st,2nd and 4th week after the operation,VEGF positive indexes in the combined group were significantly higher than in the other groups. Conclusion Uhrashortwave combined with low frequency pulsed electromagnetic field exposure can up-regulate the expression of VEGF and thus can accelerate fracture healing.%目的 观察超短波及低频脉冲磁疗对骨折愈合过程中血管内皮生长因子(VEGF)表达的影响.方法 选用新西兰大白兔56只,随机分为对照组、超短波治疗组(超短波组)、低频脉冲磁疗组(磁疗组)和超短波+低频脉冲磁疗组(联合组),每组14只.各组分别制备桡骨横断骨折模型.对照组不予干预,其余各组分别给予超短波及低频脉冲磁疗治疗.分别于术后第1,2,4,6周拍摄X线片,评价骨痂以及骨折愈合情况;于术后第1,2,4,6周取材行病理学检查,观察骨折愈合情况,并行免疫组织化学染色检测VEGF蛋白表达水平.结果 X

  15. Development of Composites with a Self-Healing Function

    Directory of Open Access Journals (Sweden)

    Andrey ANISKEVICH

    2015-03-01

    Full Text Available This research aimed to realize experimentally the facilevascular self-healing system in epoxy glass fibre reinforced composite. Using flexiblepolytetrafluoroethylene tubes as removable preforms, the channels were embeddedinto both neat epoxy resin and unidirectional glass-fibre reinforced epoxy laminate.Room temperature curable epoxy resin with a surfactant and an amine-basedhardener were the components of the binary healing agent. The specimens oftapered double cantilever beam geometry were subjected to Mode I fracture tests.Fracture of specimens released the healing agent from channels and triggeredself-healing process of the crack. Tested neat epoxy resin specimensdemonstrated recovery of fracture toughness ca. 70 % after 24 h of self-healingat 50°C. Unidirectional laminate specimens (250×23×1.2 mm were made by vacuuminfusion method from two layers of glass yarns with 5 embedded channels aligningto reinforcing fibers. The channels were alternately filled with components of thehealing agent and then sealed. It was revealed that the embedded vascularchannels in specimens had very little effect on their elastic modulus. Theexperimental program included multiple three-point bending tests of specimensfor their initial damage and self-healing of specimens during their heat treatmentand following exposure at room temperature. Static and dynamic flexural moduli ofelasticity were determined by three-point bending and cantilever beam vibrationat all stages of the test program. The healing efficiency was evaluated as a relativechange of elastic modulus. The efficiency ca. 30 % was reached during 24 h at50°C and additionally increased up ca. 40 % after more than 3 weeks of roomtemperature exposure. The sealed healing agent was capable of maintaining thecapacity for self-healing for at least six months. The research resultsdemonstrated capacity of the macro-channel approach for self-healing realizationin multifunctional polymer composite materials

  16. Pulpal healing following acute dental trauma: clinical and radiographic review.

    Science.gov (United States)

    Andreasen, F M

    2001-05-01

    Successful treatment of tooth luxations, crown fractures, and root fractures is often compromised by the emergency nature of the injury. Precise radiographic and clinical evaluation is required to facilitate healing and treatment selection. While traditional treatment protocols indicate that dental injuries implying pulpal ischemia require immediate endodontic therapy to avoid healing complications, the clinical investigations discussed herein suggest that a variety of etiologies for pulp survival/pulp necrosis exist. This article discusses the long-term prognosis of pulp necrosis following traumatic dental injuries, and clinical and radiographic criteria for its diagnosis.

  17. Repeated self-healing of microvascular carbon fibre reinforced polymer composites

    Science.gov (United States)

    Coope, T. S.; Wass, D. F.; Trask, R. S.; Bond, I. P.

    2014-11-01

    A self-healing, high performance, carbon fibre reinforced polymer (CFRP) composite is demonstrated by embedding a Lewis-acid catalytic curing agent within a laminate, manufactured using out of autoclave (OOA) composite manufacturing methods. Two configurations of healing agent delivery, pre-mixed and autonomous mixing, are investigated via injection of a healing agent through bio-inspired microvascular channels exposed on Mode I fractured crack planes. Healing is effected when an epoxy resin-solvent healing agent mixture reaches the boundary of embedded solid-state scandium(III) triflate (Sc(OTf)3) catalyst, located on the crack plane, to initiate the ring-opening polymerisation (ROP) of epoxides. Tailored self-healing agents confer high healing efficiency values after multiple healing cycles (69-108%) to successfully mitigate against crack propagation within the composite microstructure.

  18. Current concepts in pediatric femur fracture treatment.

    Science.gov (United States)

    Kanlic, Enes; Cruz, Miguel

    2007-12-01

    Femoral neck fractures require urgent evacuation of intracapsular hematoma, anatomic reduction, and secure fixation with screws and cast immobilization. Extracapsular trochanteric and subtrochanteric fractures are best treated by fixed angle devices (locked plates or dynamic screw and side plate). "Length stable" low energy shaft fractures with minimal displacement or fractures are treated operatively. Transverse or short oblique shaft fractures in patients fractures. Children > 12 years have less risk of vascular disturbance to the proximal physis, and should have lateral transtrochanateric entry locked rigid nails. Fractures with severe soft tissue injuries could be temporized with external fixation. Distal physis and epiphyseal injuries require anatomical reduction and smooth wires and/or screw fixation (placed in such a way as to minimize further damage to the physis) and need to be augmented with a brace. Leg-length discrepancy is not a significant clinical problem in operatively treated patients. We recommend hardware removal after complete fracture healing, usually in 6 to 12 months. Implants left in the growing child could become buried deep inside of the bone, or cause "periprosthetic" fractures and/or eventually impede adult reconstruction. Minimal risks are reported for hardware removal in healthy patients with healed fractures (4 cortices bridged).

  19. Hoffa fracture associated with ipsilateral femoral shaft fracture: clinical feature and treatment.

    Science.gov (United States)

    Gong, Yu-Bao; Li, Qing-Song; Yang, Chen; Li, Shu-Qiang; Liu, Jian-Guo; Qi, Xin

    2011-01-01

    Hoffa fracture associated with ipsilateral femoral shaft fracture is very rare. Three cases of this rare type of injury were retrospectively reviewed. The sites of femoral shaft fractures and Hoffa fractures were documented. All femoral shaft fractures were managed with internal fixation. The rate of misdiagnosis for the Hoffa fractures was documented. Functions of the affected knees were evaluated according to the modified Hospital for Special Surgery (HSS) scores at two years follow-up. Femoral fractures were either transverse or composite in all three cases. Ipsilateral Hoffa fractures occurred at medial condyle in two cases, and lateral condyle in one case. Only one Hoffa fracture was identified preoperatively. All the femoral shaft fractures healed uneventfully. In the patient whose Hoffa fracture was correctly diagnosed, the modified HSS score was 94. In another patient, whose Hoffa fracture was treated by a second operation, the modified HSS score was 93. And in the third case, who refused additional operation for the Hoffa fracture, the modified HSS score was only 70. Conclusively femoral shaft fracture can be associated with ipsilateral Hoffa fracture, especially in motorcycle accident. This type of injury is very rare and misdiagnosis is common.

  20. Hoffa fracture associated with ipsilateral femoral shaft fracture: clinical feature and treatment

    Institute of Scientific and Technical Information of China (English)

    GONG Yu-bao; LI Qing-song; YANG Chen; LI Shu-qiang; LIU Jian-guo; QI Xin

    2011-01-01

    Hoffa fracture associated with ipsilateral femoral shaft fracture is very rare.Three cases of this rare type of injury were retrospectively reviewed.The sites of femoral shaft fractures and Hoffa fractures were documented.All femoral shaft fractures were managed with internal fixation.The rate of misdiagnosis for the Hoffa fractures was documented.Functions of the affected knees were evaluated according to the modified Hospital for Special Surgery (HSS) scores at two years follow-up.Femoral fractures were either transverse or composite in all three cases.Ipsilateral Hoffa fractures occurred at medial condyle in two cases,and lateral condyle in one case.Only one Hoffa fracture was identified preoperatively.All the femoral shaft fractures healed uneventfully.In the patient whose Hoffa fracture was correctly diagnosed,the modified HSS score was 94.In another patient,whose Hoffa fracture was treated by a second operation,the modified HSS score was 93.And in the third case,who refused additional operation for the Hoffa fracture,the modified HSS score was only 70.Conclusively femoral shaft fracture can be associated with ipsilateral Hoffa fracture,especially in motorcycle accident.This type of injury is very rare and misdiagnosis is common.

  1. The healing Buddha.

    Science.gov (United States)

    Chen, Thomas S N; Chen, Peter S Y

    2004-11-01

    The iconography of the healing Buddha embraces two healing traditions, symbolized by the healing stone lapis lazuli from Central Asia and by the myrobalan fruit from the ayurvedic medicine of ancient India. The first mention of the healing Buddha is in Buddhist texts of the first century BC, and the earliest extant icons date from the fourth century AD. This suggests the cult of the healing Buddha was a relatively late development in the history of Buddhism. Worshippers sought his help in alleviating spiritual, mental and physical suffering, as well as for medical cures. In China followers believed he was also a cosmic Buddha, to whom one appealed for longevity and protection from disasters. This form of faith-based healing remains vibrant in China, Japan and Tibet to this day.

  2. Effects of gamma ray and sub-cracks on ethanol-assisted crack healing in poly(methyl methacrylate)

    Energy Technology Data Exchange (ETDEWEB)

    Lin, P.Y.; Lin, Y.T. [Department of Materials Science and Engineering, National Tsing Hua University, Hsinchu 300, Taiwan (China); Yang, Fuqian [Department of Chemical and Materials Engineering, University of Kentucky, Lexington KY 40506 (United States); Lee, Sanboh, E-mail: sblee@mx.nthu.edu.tw [Department of Materials Science and Engineering, National Tsing Hua University, Hsinchu 300, Taiwan (China)

    2015-07-15

    The effects of gamma ray and sub-cracks on ethanol-assisted crack healing in poly(methyl methacrylate) (PMMA) were investigated. The transport of ethanol in the gamma-irradiated PMMA was analyzed, using the Harmon model. Both the cracked-gamma-irradiated PMMA and the cracked PMMA with sub-cracks were ethanol-treated at a temperature above the effective glass transition point of the corresponding bulk PMMA. The crack closure rate, which followed the modified Arrhenius equation, increased with increasing gamma ray dose at a given temperature. The fracture strength of the healed PMMA increased with increasing gamma ray dose for short healing time at a given healing temperature, while long healing time led to the decrease of the fracture strength of the healed PMMA with increasing gamma ray dose. The fracture strength of the healed PMMA increased with increasing number of sub-cracks. These results provide the potential to develop self-healing polymeric materials in which structural damage can activate an autonomous healing process without any external stimuli. - Highlights: • The process of sorption and desorption of ethanol in PMMA can heal crack. • Crack closure rate is controlled by Case I diffusion in gamma-irradiated PMMA. • Mechanical strength versus healing time follows the power law with exponent 1/4. • Gamma irradiation degrades solvent healing while sub-cracks enhance.

  3. MANAGEMENT OF FRACTURE OF MUSCULOSCELETAL TRAUMA

    Directory of Open Access Journals (Sweden)

    Gde Rastu Adi Mahartha

    2013-03-01

    Full Text Available Fracture is a loss of continuity of bone, either total or partial, is usually caused by trauma. Overall incidence of fractures was 11.3 in 1,000 per year, in males was 11.67 in 1000 per year, whereas in 10.65 in 1,000 women per year. The classic symptom is a history of trauma fracture, pain and swelling in the broken bones, deformity, musculoskeletal dysfunction, breaking the continuity of the bone, and neurovascular disorders. Principles of fracture treatment is to restore the position of the fracture to its original position (reposition and held that position during the healing of fractures (immobilization. Special in open fractures, must be considered the danger of infection, either general or local infection.

  4. Management of Mandibular Fracture in a Peripheral Health Setting ...

    African Journals Online (AJOL)

    Hp 630 Dual Core

    the dentate mandible, reduction must aim to restore good functional ... precise reduction may be acceptable if sections of the body of the mandible are edentulous or ... Appearance of the patient after healing of fracture occurred intra orally.

  5. PATOPHYSIOLOGY OF WOUND HEALING

    OpenAIRE

    NOVINŠČAK, TOMISLAV; FILIPOVIĆ, MARINKO

    2015-01-01

    Wound healing is a basic, highly complex, logical and well orchestrated physiologic process of interaction of various speciic molecules and cells in normal tissue function and structure restoration. In essence, genetically deined and by reined physical and chemical forces driven process, in most living beings wound healing leads to imperfect but suficient tissue repair. Some rare exceptions in wound healing, like salamander or human fetus, that can achieve complete and perfect regeneration pr...

  6. Factors Affecting Wound Healing

    OpenAIRE

    Guo, S.; DiPietro, L A

    2010-01-01

    Wound healing, as a normal biological process in the human body, is achieved through four precisely and highly programmed phases: hemostasis, inflammation, proliferation, and remodeling. For a wound to heal successfully, all four phases must occur in the proper sequence and time frame. Many factors can interfere with one or more phases of this process, thus causing improper or impaired wound healing. This article reviews the recent literature on the most significant factors that affect cutane...

  7. Self-healing materials.

    Science.gov (United States)

    Hager, Martin D; Greil, Peter; Leyens, Christoph; van der Zwaag, Sybrand; Schubert, Ulrich S

    2010-12-14

    Self-healing materials are able to partially or completely heal damage inflicted on them, e.g., crack formation; it is anticipated that the original functionality can be restored. This article covers the design and generic principles of self-healing materials through a wide range of different material classes including metals, ceramics, concrete, and polymers. Recent key developments and future challenges in the field of self-healing materials are summarised, and generic, fundamental material-independent principles and mechanism are discussed and evaluated.

  8. Serum EGF and NGF levels of patients with brain injury and limb fracture

    Institute of Scientific and Technical Information of China (English)

    Yan-Feng Zhuang; Jie Li

    2013-01-01

    Objective: To explore the expression and sign if icance of human epidermal growth factor (EGF) and nerve growth factor (NGF) in patients with knee osteoarthritis. Methods: RT-PCR and enzyme-linked immunosorbent assay were used to measure the serum EGF and NGF expression levels of patients with limb fracture and brain trauma injurry after 1 d, 3 d, 7 d, 14 d and the relationship between them was analyzed. The level was compared among the simple fracture group, traumatic brain injury group and the normal control group, with 40 cases in each group. Results: The serum NGF levels were significantly different among three groups. Serum NGF, EGF mRNA and protein levels gradually decreased with the increasing injury time in the limb fracture combined with brain injury group, traumatic brain injury group, the simple fracture group and the health control group (P<0.05). Conclusions: The serum of NGF, EGF levels significantly increased when limb fracture combined with brain injury, so EGF and NGF may be involved in the process of fracture healing.

  9. 髌骨缝合线双荷包缝合法结合张力带缝合法治疗髌骨骨折%The methods of patellar suture with double ring suture band combining with tension band to heal patella fracture

    Institute of Scientific and Technical Information of China (English)

    李志君; 郑玉鹏; 王坤; 宋秀峰

    2012-01-01

    Objective To discuss the technique and effect of the methods of patellar suture with double ring suture band combining with tension band to heal patella fracture by straight incision in the front of knee. Methods 206 patients patella fracture, by early slit for recovery site, the methods of double ring suture band combining with tension band for stated healing and assistant early functional practice after operation. Results All patients were followed up from 12 months to 24 months, average 19 months. All fracture were healable. As the level of LU Yu-pu,the excellent results is 168,the good results is 16,th middle results is 3.The rate of excellent and good is 98.4%. Conclusions The methods of patellar suture with double ring suture band combining with tension band to heal patella fracture by straight incision in the front of knee, has enough surgical field in small incision and not injury saphenous nerve and artery of patellar descending branch. The principle of the method consists with biomechanics and tension band principle. Patellar suture has histocompatibility. By early activity after operation and little postoperative complications, the patients recover fastly by low-cost, the effect is specific and the internal fixation need not hand out by operation.%目的探讨膝前正中直切口髌骨缝合线双荷包法结合张力带缝合法治疗髌骨骨折的疗效.方法对206例髌骨骨折,采用膝前正中直切口髌骨缝合线荷包缝合结合张力带缝合法治疗,并辅以术后早期功能锻炼.结果187例随访12~24个月,平均19个月.骨折愈合时间8~12周,无内固定松动及再骨折.按陆裕朴等功能评定标准:优168例,良16例,可3例,优良率达到98.4%.结论膝前正中直切口髌骨缝合线双荷包结合张力带缝合法治疗髌骨骨折显露充分,切口小,不损伤隐神经和膝降动脉髌下支,操作简单,缝合方法符合生物学固定方法及张力带原则,丝线组织相容

  10. Reverse LISS plating for intertrochanteric Hip Fractures in elderly patients

    Directory of Open Access Journals (Sweden)

    Chen SB

    2010-07-01

    Full Text Available Abstract Background Fractures of the intertrochanteric hip are common and the treatment of unstable fractures generally requires an operative approach. In elderly patients, osteoporosis makes internal fixation problematic and frequently contributes to failed fixation and poor clinical results. We have attempted to apply the Less Invasive Stabilization System (LISS in reverse position for the repair of intertrochanteric hip fractures in elderly patients with osteoporotic bones. A retrospective review is presented of the cases of 28 elderly patients with stable and unstable fractures of the intertrochanteric hip treated using the reverse LISS. Methods We treated 28 elderly patients with a mean age of 82.3 years. According to the Evens classification, there were 2 Type I fractures, 2 Type II fractures, 3 Type III fractures, 13 Type IV fractures, 6 Type V fractures and 2 Type R fractures. All fractures were treated using the reverse LISS. Radiographic and clinical evidence of functional outcome and complications were evaluated. Results Mean perioperative blood loss was 92.4 milliliters (range 35 to 245 milliliters, and the mean postoperative hospital stay was 8.7 days (range 3 to 14 days. Complications included one minor wound hematoma. Radiographically, no collapses, screw cutouts, or head penetrations were seen. All surviving patients (28 of 28; 100 percent had uneventful fracture healing with union achieved by six months in all patients. Conclusions Use of the Reverse LISS plating for intertrochanteric hip fractures resulted in event-free fracture healing.

  11. Mode I fracture toughness of coal

    Energy Technology Data Exchange (ETDEWEB)

    Bhagat, R.B.

    1985-10-01

    This investigation was undertaken to determine the fracture toughness and tensile strength of coal and to correlate these with the grindability of the coals in order to understand the fracture mechanics behaviour of coal. Results showed statistical relationships for the dependence of fracture toughness on the tensile strength of coal and between the fracture toughness and the Hardgrove Grindability Index. Softer coals have a lower fracture toughness value as coal is a brittle material. 16 references.

  12. Rigid internal fixation of zygoma fractures: A comparison of two-point and three-point fixation

    Directory of Open Access Journals (Sweden)

    Parashar Atul

    2007-01-01

    Full Text Available Background: Displaced fractures of the zygomatic bone can result in significant functional and aesthetic sequelae. Therefore the treatment must achieve adequate and stable reduction at fracture sites so as to restore the complex multidimensional relationship of the zygoma to the surrounding craniofacial skeleton. Many experimental biophysical studies have compared stability of zygoma after one, two and three-point fixation with mini plates. We conducted a prospective clinical study comparing functional and aesthetic results of two-point and three-point fixation with mini plates in patients with fractures of zygoma. Materials and Methods: Twenty-two patients with isolated zygomatic fractures over a period of one year were randomly assigned into two-point and three-point fixation groups. Results of fixation were analyzed after completion of three months. This included clinical, radiological and photographic evaluation. Results: The three-point fixation group maintained better stability at fracture sites resulting in decreased incidence of dystopia and enophthalmos. This group also had better malar projection and malar height as measured radiologically, when compared with the two-point fixation group. Conclusion: We recommend three-point rigid fixation of fractured zygoma after accurate reduction so as to maintain adequate stabilization against masticatory forces during fracture healing phase.

  13. Transport efficiency and dynamics of hydraulic fracture networks

    Science.gov (United States)

    Sachau, Till; Bons, Paul; Gomez-Rivas, Enrique

    2015-08-01

    Intermittent fluid pulses in the Earth's crust can explain a variety of geological phenomena, for instance the occurrence of hydraulic breccia. Fluid transport in the crust is usually modeled as continuous darcian flow, ignoring that sufficient fluid overpressure can cause hydraulic fractures as fluid pathways with very dynamic behavior. Resulting hydraulic fracture networks are largely self-organized: opening and healing of hydraulic fractures depends on local fluid pressure, which is, in turn, largely controlled by the fracture network. We develop a crustal-scale 2D computer model designed to simulate this process. To focus on the dynamics of the process we chose a setup as simple as possible. Control factors are constant overpressure at a basal fluid source and a constant 'viscous' parameter controlling fracture-healing. Our results indicate that at large healing rates hydraulic fractures are mobile, transporting fluid in intermittent pulses to the surface and displaying a 1/fα behavior. Low healing rates result in stable networks and constant flow. The efficiency of the fluid transport is independent from the closure dynamics of veins or fractures. More important than preexisting fracture networks is the distribution of fluid pressure. A key requirement for dynamic fracture networks is the presence of a fluid pressure gradient.

  14. Transport efficiency and dynamics of hydraulic fracture networks

    Directory of Open Access Journals (Sweden)

    Till eSachau

    2015-08-01

    Full Text Available Intermittent fluid pulses in the Earth's crust can explain a variety of geological phenomena, for instance the occurrence of hydraulic breccia. Fluid transport in the crust is usually modeled as continuous darcian flow, ignoring that sufficient fluid overpressure can cause hydraulic fractures as fluid pathways with very dynamic behavior. Resulting hydraulic fracture networks are largely self-organized: opening and healing of hydraulic fractures depends on local fluid pressure, which is, in turn, largely controlled by the fracture network. We develop a crustal-scale 2D computer model designed to simulate this process. To focus on the dynamics of the process we chose a setup as simple as possible. Control factors are constant overpressure at a basal fluid source and a constant 'viscous' parameter controlling fracture-healing. Our results indicate that at large healing rates hydraulic fractures are mobile, transporting fluid in intermittent pulses to the surface and displaying a 1/fα behavior. Low healing rates result in stable networks and constant flow. The efficiency of the fluid transport is independent from the closure dynamics of veins or fractures. More important than preexisting fracture networks is the distribution of fluid pressure. A key requirement for dynamic fracture networks is the presence of a fluid pressure gradient.

  15. Saliva and wound healing

    NARCIS (Netherlands)

    Brand, H.S.; Veerman, E.C.I.

    2013-01-01

    Wounds in the oral cavity heal faster and with less scarring than wounds in other parts of the body. One of the factors implicated in this phenomenon is the presence of saliva, which promotes the healing of oral wounds in several ways. Saliva creates a humid environment, which improves the survival

  16. Saliva and wound healing

    NARCIS (Netherlands)

    Brand, H.S.; Veerman, E.C.I.

    2013-01-01

    Wounds in the oral cavity heal faster and with less scarring than wounds in other parts of the body. One of the factors implicated in this phenomenon is the presence of saliva, which promotes the healing of oral wounds in several ways. Saliva creates a humid environment, which improves the survival

  17. Scaphoid fracture in the elite athlete.

    Science.gov (United States)

    Belsky, Mark R; Leibman, Matthew I; Ruchelsman, David E

    2012-08-01

    Scaphoid fracture remains a common, potentially devastating, injury that can impair upper extremity function. Early recognition with proper imaging and treatment provides the best opportunity to heal and return to a normal activity level. Surgical treatment offers the patient a quicker return to the rehabilitation of the extremity and therefore an earlier return to elite play. There is evidence that healing occurs faster if the fractured scaphoid is fixed with internal fixation. Absolute compliance by the athlete and the training program that surrounds the athlete is critical to protect the wrist while maintaining the necessary conditioning of an elite athlete.

  18. Self healing of damage in Fe-based alloys

    NARCIS (Netherlands)

    Zhang, S.

    2015-01-01

    Steel components can exhibit premature and low-ductility creep fracture, when exposed to high temperatures for long times. The failure arises from the formation, growth and coalescence of ultra-fine cracks and cavities. Self healing of damage is a promising new approach to enhance the lifetime of th

  19. Self healing of damage in Fe-based alloys

    NARCIS (Netherlands)

    Zhang, S.

    2015-01-01

    Steel components can exhibit premature and low-ductility creep fracture, when exposed to high temperatures for long times. The failure arises from the formation, growth and coalescence of ultra-fine cracks and cavities. Self healing of damage is a promising new approach to enhance the lifetime of

  20. 骨折愈合评估方法的研究进展及其法医学意义%Advancement in Methods of Evaluation on Bone Fracture Healing and Its Application in Forensic Medicine

    Institute of Scientific and Technical Information of China (English)

    黎宇飞

    2011-01-01

    在法医学鉴定中经常需要对骨折形成时间进行鉴定,因此,研究和探讨骨折形成时间的评定方法有着重要的临床及法医学意义.本文综述了超声测量、脉冲测定、数字影像学技术和骨密度检测技术等在评估骨折愈合程度中的应用及其价值.认为综合利用多种评定手段,能为骨折形成时间的法医学鉴定提供科学依据.%It is frequently encountered to identify the time of bone fracture in forensic medicine. Hence it is important to develop the methods for evaluating the time of bone fracture. This article reviews the applications and values of the methods such as ultrasonic evaluation, impulse measurement, digital imaging technology and bone mineral density testing technology, etc. It is proposed that to use these methods jointly may provide more scientific evidence in determine the time of bone fracture.

  1. Iloprost inhibits fracture repair in rats.

    Science.gov (United States)

    Doğan, Ali; Duygun, Fatih; Kalender, A Murat; Bayram, Irfan; Sungur, Ibrahim

    2014-01-01

    Previous studies have shown that prostaglandins (PGs) dramatically stimulate healing processes in bone. However, the effect of prostaglandin I2 (PGI2) on fracture healing remains unclear. To investigate the effect of PGI2, a study on fracture healing process in closed tibia fractures was designed. Thirty-six Sprague-Dawley male rats were randomized into two groups. On the first day, their right tibias were fractured by three-point bending technique. The study group (n = 18) received a single injection of 10 µg/kg iloprost for 5 days, while the control group (n = 18) received saline solution in the same way. On the 7th, 14th and 28th days following the fracture, six rats were sacrificed and their right legs were harvested in each group. The progression of fracture healing was assessed for each specimen by the scores of radiography (by Lane-Sandhu) and histology (by Huo et al). On the 7th day, the radiographic and histologic scores were equal. On the 14th day radiographic total score was 6 and histologic total score was 23 in the iloprost group, whereas radiographic total score was 11 and histologic total score was 33 in the control group. On the 14th day radiographic and histologic scores were significantly decreased in the iloprost group compared to the control group (P iloprost group, whereas radiographic total score was 15 and histologic total score was 40 in the control group. On the 28th day although there was a decrease in radiographic and histologic scores of the iloprost group acording to control group, it was not statistically significant (P > 0.05). Iloprost delays fracture healing in early stage in rats.

  2. Iloprost inhibits fracture repair in rats

    Institute of Scientific and Technical Information of China (English)

    Ali Do(g)an; Fatih Duygun; A.Murat Kalender; Irfan Bayram; Ibrahim Sungur

    2014-01-01

    Background Previous studies have shown that prostaglandins (PGs) dramatically stimulate healing processes in bone.However,the effect of prostaglandin l2 (PGI2) on fracture healing remains unclear.To investigate the effect of PGI2,a study on fracture healing process in closed tibia fractures was designed.Methods Thirty-six Sprague-Dawley male rats were randomized into two groups.On the first day,their right tibias were fractured by three-point bending technique.The study group (n=18) received a single injection of 10 μg/kg iloprost for 5 days,while the control group (n=18) received saline solution in the same way.On the 7th,14th and 28th days following the fracture,six rats were sacrificed and their right legs were harvested in each group.The progression of fracture healing was assessed for each specimen by the scores of radiography (by Lane-Sandhu) and histology (by Huo et al).Results On the 7th day,the radiographic and histologic scores were equal.On the 14th day radiographic total score was 6 and histologic total score was 23 in the iloprost group,whereas radiographic total score was 11 and histologic total score was 33 in the control group.On the 14th day radiographic and histologic scores were significantly decreased in the iloprost group compared to the control group (P <0.05).On the 28th day radiographic total score was 12 and histologic total score was 37 in the iloprost group,whereas radiographic total score was 15 and histologic total score was 40 in the control group.On the 28th day although there was a decrease in radiographic and histologic scores of the iloprost group acording to control group,it was not statistically significant (P >0.05).Conclusion Iloprost delays fracture healing in early stage in rats.

  3. SOLAR THERAPY: A BOON FOR NON-HEALING ULCERS

    Directory of Open Access Journals (Sweden)

    Varunjikar

    2014-04-01

    Full Text Available : Compound fractures are common following road traffic accidents. It leads to open wound which needs treatment by plastic repairs such as rotation flaps, cross leg flaps, and skin grafting. Similarly, raw wounds and non-healing ulcers especially in osteomyelitis is a challenge to Orthopaedicians. Wounds with infection heal slowly and this often results in prolonged hospitalization. Standard treatment includes dressing and use of antibiotics which leads to financial burden on poor patients. Irrational use of antibiotics has lead to increasing resistance of bacteria to antibiotics. So far, sunlight has been utilized in treatment of rickets and osteomalacia. We have tried to utilize this mode of ecological treatment in an alternate way. Infected, non-healing wounds and ulcers were treated with exposure to sunlight which lead to scab formation and epithelisation leading to healing of wound due to UV rays. The purpose of this study was to determine the effects of ultraviolet radiation (UVR on the healing of ulcers. METHODS: Our patients having non healing ulcers were subjected to this type of treatment. RESULTS: In selected patients having non- healing ulcers on extremities of various sizes were treated previously with routine line of treatment such as dressing and oral or parenteral antibiotics. Patients were explained mode of treatment and underwent solar therapy after receiving informed consent. Epithelisation on ulcer took place following UV therapy within average duration of 23 days. CONCLUSION: It was concluded that ultraviolet radiation had significant effects in destroying bacteria and also promoting wound healing

  4. STUDY ON FRACTURE TOUGHNESS OF SELF-HEALING POLYMERIC MATERIALS WITH EPOXY-CONTAINING MICROCAPSULES AND LATENT CURING AGENT%环氧树脂微胶囊与潜伏性固化剂自修复体系断裂韧性的研究

    Institute of Scientific and Technical Information of China (English)

    刘金明; 胡宏林; 王荣国; 刘文博

    2011-01-01

    微胶囊二元自修复系统对聚合物基复合材料在使用中产生的微小裂纹具有修复作用,但微胶囊和固化剂的加入会对基体材料的断裂韧性产生影响.本文研究了环氧树脂微胶囊和咪唑类潜伏性固化剂对聚合物基复合材料基体材料的断裂韧性的影响.采用环氧树脂E-51作为基体材料,三乙烯四胺为常温固化剂,咪唑类衍生物2MZ-Azine和实验室自制的包含环氧树脂芯材的微胶囊为材料制作断裂韧性拉伸试样.实验结果表明,当微胶囊的含量达到一定比例之前,基体材料的断裂韧性随着微胶囊含量的增加而增强,当微胶囊含量超过此比例后,基体材料的断裂韧性随着微胶囊含量的增加而减小,潜伏性固化剂的加入会增大基体材料的断裂韧性.这与环氧树脂材料增韧理论相符合.%Self-healing polymeric materials have attracted more and more attention because of their advanced application in the field of astronautics and aviation. Microcracks generated during the use of polymer-based composites can be repaired by binary self-healing system consisting of microcapsules and latent hardener. But microcap-sules and latent hardener in the matrix greatly influence on the fracture toughness of substrate material. The effect of weight ratio of microcapsules and latent hardener on the fracture toughness of composite was investigated in this paper. Tensile samples were fabricated using epoxy resin as substrate material, using triethylenetetramine as room temperature curing agent, and using imidazoline derivatives latent hardener and epoxy-containing microcapsules as materials. The results shows that fracture toughness enhances with the increase of weight ratio in a range of certain proportion. However, the fracture toughness of composite will reduce while the content of microcapsules continues increasing. Moreover, the fracture toughness increases with the enhancement of weight ratio of latent hardener

  5. Factors Affecting Wound Healing

    Science.gov (United States)

    Guo, S.; DiPietro, L.A.

    2010-01-01

    Wound healing, as a normal biological process in the human body, is achieved through four precisely and highly programmed phases: hemostasis, inflammation, proliferation, and remodeling. For a wound to heal successfully, all four phases must occur in the proper sequence and time frame. Many factors can interfere with one or more phases of this process, thus causing improper or impaired wound healing. This article reviews the recent literature on the most significant factors that affect cutaneous wound healing and the potential cellular and/or molecular mechanisms involved. The factors discussed include oxygenation, infection, age and sex hormones, stress, diabetes, obesity, medications, alcoholism, smoking, and nutrition. A better understanding of the influence of these factors on repair may lead to therapeutics that improve wound healing and resolve impaired wounds. PMID:20139336

  6. [Atlas fractures].

    Science.gov (United States)

    Schären, S; Jeanneret, B

    1999-05-01

    Fractures of the atlas account for 1-2% of all vertebral fractures. We divide atlas fractures into 5 groups: isolated fractures of the anterior arch of the atlas, isolated fractures of the posterior arch, combined fractures of the anterior and posterior arch (so-called Jefferson fractures), isolated fractures of the lateral mass and fractures of the transverse process. Isolated fractures of the anterior or posterior arch are benign and are treated conservatively with a soft collar until the neck pain has disappeared. Jefferson fractures are divided into stable and unstable fracture depending on the integrity of the transverse ligament. Stable Jefferson fractures are treated conservatively with good outcome while unstable Jefferson fractures are probably best treated operatively with a posterior atlanto-axial or occipito-axial stabilization and fusion. The authors preferred treatment modality is the immediate open reduction of the dislocated lateral masses combined with a stabilization in the reduced position using a transarticular screw fixation C1/C2 according to Magerl. This has the advantage of saving the atlanto-occipital joints and offering an immediate stability which makes immobilization in an halo or Minerva cast superfluous. In late instabilities C1/2 with incongruency of the lateral masses occurring after primary conservative treatment, an occipito-cervical fusion is indicated. Isolated fractures of the lateral masses are very rare and may, if the lateral mass is totally destroyed, be a reason for an occipito-cervical fusion. Fractures of the transverse processes may be the cause for a thrombosis of the vertebral artery. No treatment is necessary for the fracture itself.

  7. Self-healing efficiency of cementitious materials containing microcapsules filled with healing adhesive: mechanical restoration and healing process monitored by water absorption.

    Science.gov (United States)

    Li, Wenting; Jiang, Zhengwu; Yang, Zhenghong; Zhao, Nan; Yuan, Weizhong

    2013-01-01

    Autonomous crack healing of cementitious composite, a construction material that is susceptible to cracking, is of great significance to improve the serviceability and to prolong the longevity of concrete structures. In this study, the St-DVB microcapsules enclosing epoxy resins as the adhesive agent were embedded in cement paste to achieve self-healing capability. The self-healing efficiency was firstly assessed by mechanical restoration of the damaging specimens after being matured. The flexural and compressive configurations were both used to stimulate the localized and distributed cracks respectively. The effects of some factors, including the content of microcapsules, the curing conditions and the degree of damage on the healing efficiency were investigated. Water absorption was innovatively proposed to monitor and characterize the evolution of crack networks during the healing process. The healing cracks were observed by SEM-EDS following. The results demonstrated that the capsule-containing cement paste can achieve the various mechanical restorations depending on the curing condition and the degree of damage. But the voids generated by the surfactants compromised the strength. Though no noticeable improved stiffness obtained, the increasing fracture energy was seen particularly for the specimen acquiring 60% pre-damage. The sorptivity and amount of water decreased with cracks healing by the adhesive, which contributed to cut off and block ingress of water. The micrographs by SEM-EDS also validated that the cracks were bridged by the hardened epoxy as the dominated elements of C and O accounted for 95% by mass in the nearby cracks.

  8. 锌与慢性创面修复的相关研究进展%Research Progress of the Relationship between Zinc and Chronic Wounds Healing

    Institute of Scientific and Technical Information of China (English)

    李峰(综述); 杨红岩(审校)

    2016-01-01

    不同程度的营养不良常伴发于各类压疮、糖尿病足等慢性创面患者,有效的营养支持是处置慢性创面的基础。锌是人体必需营养物质,具有广泛的生理作用。大量的临床实践发现,改善全身或创面局部锌营养状态可促进不同类型的创面修复,其机制至少包括:改善食欲和加强营养物质吸收、拮抗创面过氧化损伤、抑制修复细胞凋亡、激活相关生长因子表达及信号通路等。%Different degrees of malnutrition are often associated with the patients with various chronic wounds such as pressure ulcer and diabetic foot.Effective nutritional support is the basis for the treatments of chronic wounds.Zinc is one of the essential trace elements with extensive physiological functions .It has been proved by a lot of clinical practices that improvement of overall zinc nutrition status or wound surface could pro-mote wounds healing.The mechanisms include at least the following:enhancing appetite,alleviating oxidative impairments,inhabiting apoptosis,and activating expression of related growth factors and signaling pathway.

  9. The relationship between hip fracture and diet in the postmenopausal women%绝经后妇女髋骨骨折与膳食因素关系

    Institute of Scientific and Technical Information of China (English)

    石雁川; 徐格晟; 黄国伟; 康静; 刘莉; 宁培民

    2001-01-01

    Objective:In order to investigate the relationship between diet and hip fracture in the postmenopausal women. Methods: Eligible as cases were women who were diagnosed as first hip fracture by Tianjin Hospital, those who had not hip fracture were defined as controls.30 cases and 60 controls were selected. Food frequency questionnaire was used in dietary survey, BMD was detected by DEXA, and the data were analyzed by t test. Results: the intake of carbohydrate, protein, energy, magnesium and zinc in the cases were higher than that in the controls, whereas, the calcium intake of the cases were lower than that of the controls, and there was significant difference between the two groups. BMD also had significant difference between two groups. Conclusion: The results indicate that the higher animal protein consumption may increase the risk of osteoporotic hip fracture, and dairy products have a protective effect for hip fracture. So it is recommended that postmenopausal women should increase the milk consumption.%目的:探讨绝经后妇女髋骨骨折与膳食因素的关系。方法:病例组选取初发的骨质疏松性髋骨骨折的女患[摘要]目的:探讨绝经后妇女髋骨骨折与膳食因素的关系。方法:病例组选取初发的骨质疏松性髋骨骨折的女患者30名,年龄66±6.5岁,对照组为无骨折的正常女性60名,年龄65.6±6.5岁,应用频数法调查研究对象近la内的膳食情况,并进行统计分析。结果:病例组摄入的热能、蛋白质、碳水化合物明显高于对照组,差异有显著性意义(P<0.05),而钙的摄入明显低于对照组,尤其是乳类钙,病例组乳类钙占总钙的百分比为15.05%,对照组为36.09%,差异有显著性意义(P<0.05),两组的骨密度也存在显著性差异(P<0.05)。结论:绝经后妇女每日要保证一定量奶及奶制品的摄入,适宜摄取动物蛋白,并坚持适量的户外活动。

  10. Bilateral distal radius fracture in third trimester of pregnancy with accelerated union: a rare case report.

    Science.gov (United States)

    Tv, Ravikumar; P, Rahul; Grover, Amit; Samorekar, Bheemsingh

    2015-04-01

    Bilateral distal radius fracture is a rare entity. There is no literature reporting a bilateral distal radius fracture in pregnancy. Fracture healing is influenced by hormones. Hormonal changes of pregnancy will affect the healing of a fracture. A 28-year-old female at 34 wk of pregnancy sustained a bilateral distal radius fracture after a self fall. One side was managed conservatively and open reduction was done for the other side. Both fractures united at four weeks. This case is unique in three ways. First distal radius fractures commonly occur in elderly postmenopausal females due to oestrogen deficiency. In this case a distal radius fracture occurred following a self fall in third trimester of pregnancy - a hyperestrogenic state. Second the time taken for union was only four weeks signifying the hormonal effects on pregnancy on fracture healing. Third the occurrence of bilateral distal radius fracture itself is very rare in adults. In pregnancy there is a faster rate of fracture healing due to effects of oestrogen and increased cardiac output. Fractures in pregnancy require special attention. Surgical intervention should be done with a multidisciplinary approach. While management of fractures in pregnancy, effect of hormonal and physiological changes should be kept in mind.

  11. Identifying Fracture Types and Relative Ages Using Fluid Inclusion Stratigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Dilley, Lorie M.; Norman, David; Owens, Lara

    2008-06-30

    Enhanced Geothermal Systems (EGS) are designed to recover heat from the subsurface by mechanically creating fractures in subsurface rocks. Understanding the life cycle of a fracture in a geothermal system is fundamental to the development of techniques for creating fractures. Recognizing the stage of a fracture, whether it is currently open and transmitting fluids; if it recently has closed; or if it is an ancient fracture would assist in targeting areas for further fracture stimulation. Identifying dense fracture areas as well as large open fractures from small fracture systems will also assist in fracture stimulation selection. Geothermal systems are constantly generating fractures, and fluids and gases passing through rocks in these systems leave small fluid and gas samples trapped in healed microfractures. Fluid inclusions trapped in minerals as the fractures heal are characteristic of the fluids that formed them, and this signature can be seen in fluid inclusion gas analysis. Our hypothesis is that fractures over their life cycle have different chemical signatures that we can see in fluid inclusion gas analysis and by using the new method of fluid inclusion stratigraphy (FIS) the different stages of fractures, along with an estimate of fracture size can be identified during the well drilling process. We have shown with this study that it is possible to identify fracture locations using FIS and that different fractures have different chemical signatures however that signature is somewhat dependent upon rock type. Open, active fractures correlate with increase concentrations of CO2, N2, Ar, and to a lesser extent H2O. These fractures would be targets for further enhancement. The usefulness of this method is that it is low cost alternative to current well logging techniques and can be done as a well is being drilled.

  12. Clinical analysis of the rap stress stimulator applied for crus fracture after skeletal external fixation.

    Science.gov (United States)

    Zhuang, Ping; Hong, Jiayuan; Chen, Wei; Wu, Jin; Ding, Zhenqi

    2015-06-19

    Open crus fracture is still difficult in clinical treatment because of the delayed fracture union and high rate of nonunion after the operation. A consensus has been reached that mechanical stress can promote fracture healing. We independently developed a stress stimulator, which can provide longitudinal pressure for the fixed fracture end of the lower legs to promote fracture healing. The purpose of this study is to explore the advantages and clinical effect of the rap stress stimulator applied for open crus fracture after skeletal external fixation. One hundred and sixty-five patients (183 limbs) who suffered from open tibia and fibula fracture received skeletal external fixation, of which 108 limbs were treated with the rap stress stimulator after external fixation and 75 limbs were treated with regular functional exercises of muscle contraction and joint activity only. Then the fracture healing time and rate of nonunion were compared between the two groups. The mean fracture healing time and rate of nonunion in the group treated with the rap stress stimulator were 138.27 ±4.45 days and 3.70% respectively, compared to 153.43 ±4.89 days and 10.67% in the group treated without the stimulator. The rap stress stimulator significantly shortened the fracture healing time and reduced the rate of nonunion for treating open tibia and fibula fractures.

  13. Rotary self-locking intramedullary nail for long tubular bone fractures

    Institute of Scientific and Technical Information of China (English)

    HUANG Zhong-lian; YANG Hai-long; XU Jian-kun; XIA Xue; WANG Xin-jia; SONG Jian-xin; HU Jun

    2013-01-01

    Background Intramedullary nails had been widely used in the treatment of long-bone fractures because of less interference of fractures and center bearing biomechanical advantage.However,it had been also found many shortcomings such as broken nails,delayed healing and was modified in order to achieve better efficacy and reduce complications.The aim of the present study is to compare the efficacy of rotary self-locking intramedullary nails (RSIN) with that of interlocking intramedullary nails (IIN) in the treatment of long-bone fractures.Methods A retrospective study investigated 129 cases with long-bone fractures (36 with femoral fracture,81 with tibial fracture,and 12 with humeral fracture).The fractures were fixed using either an RSIN or IIN.All patients underwent followup for 12-30 months.Results All patients in both groups achieved a clinical fracture healing standard and the postoperative affected limb muscle strength and joint function were well restored.The RSIN group required a shorter operative time and the fracture healed faster.There was no significant difference in the hospital stay,intraoperative blood loss or postoperative complications between the two groups.Conclusions RSIN is used to treat long-bone fractures.Its healing efficacy is equivalent to the IIN.Moreover,the RSIN method is simpler and causes less tissue damage than the IIN,therefore having the advantage of accelerated healing.

  14. Nutritional Aspects of Gastrointestinal Wound Healing

    Science.gov (United States)

    Mukherjee, Kaushik; Kavalukas, Sandra L.; Barbul, Adrian

    2016-01-01

    Significance: Although the wound healing cascade is similar in many tissues, in the gastrointestinal tract mucosal healing is critical for processes such as inflammatory bowel disease and ulcers and healing of the mucosa, submucosa, and serosal layers is needed for surgical anastomoses and for enterocutaneous fistula. Failure of wound healing can result in complications including infection, prolonged hospitalization, critical illness, organ failure, readmission, new or worsening enterocutaneous fistula, and even death. Recent Advances: Recent advances are relevant for the role of specific micronutrients, such as vitamin D, trace elements, and the interplay between molecules with pro- and antioxidant properties. Our understanding of the role of other small molecules, genes, proteins, and macronutrients is also rapidly changing. Recent work has elucidated relationships between oxidative stress, nutritional supplementation, and glucose metabolism. Thresholds have also been established to define adequate preoperative nutritional status. Critical Issues: Further work is needed to establish standards and definitions for measuring the extent of wound healing, particularly for inflammatory bowel disease and ulcers. In addition, a mounting body of evidence has determined the need for adequate preoperative nutritional supplementation for elective surgical procedures. Future Directions: A large portion of current work is restricted to model systems in rodents. Therefore, additional clinical and translational research is needed in this area to promote gastrointestinal wound healing in humans, particularly those suffering from critical illness, patients with enterocutaneous fistula, inflammatory bowel disease, and ulcers, and those undergoing surgical procedures. PMID:27867755

  15. Ritual healing and mental health in India.

    Science.gov (United States)

    Sax, William

    2014-12-01

    Ritual healing is very widespread in the Indian state of Uttarakhand, and is by far the most common option for those with serious behavioral disturbances. Although ritual healing thus accounts for a very large part of the actual health care system, the state and its regulatory agencies have, for the most part, been structurally blind to its existence. A decade of research on in this region, along with a number of shorter research trips to healing shrines and specialists elsewhere in the subcontinent, and a thorough study of the literature, suggest that such techniques are often therapeutically effective. However, several considerations suggest that ritual healing may not be usefully combined with mainstream "Western" psychiatry: (a) psychiatry is deeply influenced by the ideology of individualism, which is incompatible with South Asian understandings of the person; (b) social asymmetries between religious healers and health professionals are too great to allow a truly respectful relationship between them; and (c) neither the science of psychiatry nor the regulatory apparatus of the state can or will acknowledge the validity of "ritual therapy"--and even if they did so, regulation would most likely destroy what is most valuable about ritual healing. This suggests that it is best if the state maintain its structural blindness to ritual healing.

  16. 信号选择性甲状旁腺素模拟肽促进去势雄性小鼠的骨折愈合%Effects of signaling-selective parathyroid hormone peptide analog on fracture healing in orchiectomized mouse models

    Institute of Scientific and Technical Information of China (English)

    袁亮; 林振; 付兆宗; 孟越; 黄志平; 吴秀华; 杨德鸿; 江建明

    2013-01-01

    Objective To assess the effect of intermittent subcutaneous injections of signal-selective parathyroid hormone (PTH) peptide analog on fracture healing in orchiectomized mouse models. Methods Thirty-six 7-week-old C57/BL male mice were orchiectomized and injected with hPTH(l-34), the signal-selective PTH peptide analog [Gly1, Arg19]hPTH (1-34), or an identical volume of vehicle 1 week after induction of femoral fracture. At 14 and 28 days after the operation, the mice were sacrificed for measurement of bone mineral density (BMD) and bone mineral content (BMC) of the callus using by dual energy X-ray absorptiometry. The bone healing was evaluated by radiography, biomechanical testing, micro-computed tomography (Micro-CT) and histological examination. Results At 14 days after the operation, BMD in PTH peptide analog group was significantly increased (P<0.05). The mouse models treated with the PTH peptide analog showed significantly lower ultimate bending force and bending rigidity than those with hPTH(l-34) treatment. X-ray and Micro-CT scanning showed that callus transformation and remodeling was better in PTH peptide analog group than in the vehicle control group but poorer than in hPTH(l-34) group. Conclusion The signaling-selective PTH peptide analog G1, R19 (1-28) can accelerate fracture healing in orchiectomized mouse models, in which process cAMP/PKA pathway plays an important role.%目的 观察间断皮下注射信号选择性甲状旁腺素(PTH)模拟肽对去势雄性小鼠骨折愈合的影响.方法 36只7周龄C57/BL雄性小鼠去势,1周后制作股骨中段骨折模型,术后用人重组甲状旁腺素(hPTH(1-34)),信号选择性PTH模拟肽[Gly1,Arg19] hPTH (1-34)(G1,R19(1-28))和等量溶解剂注射,于术后14d和28 d处死,双能X线骨密度仪测量骨痂区骨密度以及骨矿物含量;术侧骨折愈合情况通过X线、显微CT、生物力学和组织学显示.结果 术后14d,G1,R19(1-28)组骨密度显著高于对照组(P<0.05).

  17. [Triple fracture of the shoulder suspensory complex].

    Science.gov (United States)

    Tamimi Mariño, I; Martin Rodríguez, I; Mora Villadeamigo, J

    2013-01-01

    The superior suspensory complex of the shoulder (SSCS) is a ring shaped structure composed of bones and soft tissues that play a fundamental role in the stability of the shoulder joint. Isolated injuries of the SSCS are relatively common, but injuries that affect 3 components are extremely unusual. We present a triple injury of the SSCS in a 26 year old patient with a Neer type ii clavicular fracture, a Kuhn type iii acromion fracture and an Ogawa type i coracoid fracture. An open reduction and stabilization of the clavicle was performed with 2 Kirschner nails. The acromial fracture was synthesized with 2 cannulated screws, and the coracoid fracture was treated conservatively. After 24 months of follow up the patient had an excellent functional outcome according to the Constat-Murley shoulder score and QuickDASH scoring system, and all the fractures healed correctly. Copyright © 2013 SECOT. Published by Elsevier Espana. All rights reserved.

  18. Saliva and wound healing.

    Science.gov (United States)

    Brand, Henk S; Ligtenberg, Antoon J M; Veerman, Enno C I

    2014-01-01

    Oral wounds heal faster and with less scar formation than skin wounds. One of the key factors involved is saliva, which promotes wound healing in several ways. Saliva creates a humid environment, thus improving the survival and functioning of inflammatory cells that are crucial for wound healing. In addition, saliva contains several proteins which play a role in the different stages of wound healing. Saliva contains substantial amounts of tissue factor, which dramatically accelerates blood clotting. Subsequently, epidermal growth factor in saliva promotes the proliferation of epithelial cells. Secretory leucocyte protease inhibitor inhibits the tissue-degrading activity of enzymes like elastase and trypsin. Absence of this protease inhibitor delays oral wound healing. Salivary histatins in vitro promote wound closure by enhancing cell spreading and cell migration, but do not stimulate cell proliferation. A synthetic cyclic variant of histatin exhibits a 1,000-fold higher activity than linear histatin, which makes this cyclic variant a promising agent for the development of a new wound healing medication. Conclusively, recognition of the many roles salivary proteins play in wound healing makes saliva a promising source for the development of new drugs involved in tissue regeneration.

  19. Stress Fractures

    Science.gov (United States)

    Stress fractures Overview Stress fractures are tiny cracks in a bone. They're caused by repetitive force, often from overuse — such as repeatedly jumping up and down or running long distances. Stress fractures can also arise from normal use of ...

  20. Expression of PPARγ and Cbfα1 mRNA in bone marrow cells in Type 2 diabetic rats and its correlation with impaired fracture healing%2型糖尿病大鼠骨髓腔内PPARγ和Cbfα1 mRNA的表达与骨折愈合障碍的关系

    Institute of Scientific and Technical Information of China (English)

    徐诣; 陈先礼; 刘宝恒; 丑克; 刘振东; 邓俭良

    2009-01-01

    Objective To investigate the relationship between impaired fracture healing and the expression of peroxisome proliferator activated-receptor gamma (PPARγ) and core binding factor alpha 1 (Cbfα1) mRNA in the bone marrow of Type 2 diabetic rats.Methods Thirty male Sprague-Dawley rats were divided into a control group (n=15, normal diet) and an experiment group (n=20, high fat and sucrosum diet). After 8 weeks, one eyeball was culled for blood collection. The experiment group was intraperitoneally injected with streptozotocin and the control group received citrate buffer. After another 2 weeks, the other eyeball was culled again to collect blood. The model of distraction osteogenesis in the left tibias of the rats was established. After 14 days, we sacrificed all the rats and collected the blood and left tibias. Both femurs were harvested with germ free. We observed the callus formation in the distraction gap by X-ray and the formation of primary matrix front and microcolumn by histological examination. We observed adipocytes in adjacent bone marrow of left tibia and computed the percentage of adipocytes accounting for the area of bone cavity. We measured the expression of PPARγ and Cbfα1 mRNA in femurs marrow by RT-PCR.Results In the experimental rats, the level of triglyceride was obviously elevated (P<0.01), so was the total cholesterol (P<0.05), while the level of fasting blood glucose and serum insulin did not obviously differ (P>0.05) after 8 weeks. The level of fasting blood glucose and triglyceride was obviously elevated (P<0.01), and so was the total cholesterol (P<0.05), while the level of serum insulin was not obviously different in the experiment group after 10 and 12 weeks. Callus formation in the distraction gap was obviously diminished by X-ray in the experimental rats. The array of microcolumn formation was disordered and the area of primary matrix front was catachromasis in the controls by histology examination. The number of adipocytes

  1. Rodent animal models of delayed bone healing and non-union formation: a comprehensive review

    Directory of Open Access Journals (Sweden)

    P Garcia

    2013-07-01

    Full Text Available Despite the growing knowledge on the mechanisms of fracture healing, delayed healing and non-union formation remain a major clinical challenge. Animal models are needed to study the complex process of normal and impaired fracture healing and to develop new therapeutic strategies. Whereas in the past mainly large animals have been used to study normal and impaired fracture healing, nowadays rodent models are of increasing interest. New osteosynthesis techniques for rat and mice have been developed during the last years, which allowed for the first time stable osteosynthesis in these animals comparable to the standards in large animals and humans. Based on these new implants, different models in rat and mice have been established to study delayed healing and non-union formation. Although in humans the terms delayed union and non-union are well defined, in rodents definitions are lacking. However, especially in scientific studies clear definitions are necessary to develop a uniform scientific language and allow comparison of the results between different studies. In this consensus report, we define the basic terms “union”, “delayed healing” and “non-union” in rodent animal models. Based on a review of the literature and our own experience, we further provide an overview on available models of delayed healing and non-union formation in rats and mice. We further summarise the value of different approaches to study normal and delayed fracture healing as well as non-union formation, and discuss different methods of data evaluation.

  2. Relationship of Bone Metabolism Biomarkers and Periodontal Disease: The Osteoporotic Fractures in Men (MrOS) Study

    Science.gov (United States)

    Turner, Ryan; Wang, Ying; Chao, Raylien; Schulze, P. Christian; Phipps, Kathy; Orwoll, Eric; Dam, Thuy-Tien

    2015-01-01

    Context: Periodontitis is an inflammatory disease of tooth-supporting tissue leading to bone destruction and tooth loss. Periodontitis affects almost 50% of adults greater than 30 years of age. Objective: This study evaluated the association between biomarkers linked to bone formation and resorption with the occurrence and progression of periodontal disease in older men (≥65 y). Design: The Osteoporotic Fractures in Men (MrOS) study is a prospective, observational study among men 65 years of age and older. Setting: This ancillary study, Oral and Skeletal Bone Loss in Older Men, was conducted at two of the six MrOS study sites (Birmingham, AL and Portland, OR). Patients: Patients underwent medical and dental evaluation. Diagnoses of periodontitis were based on clinical attachment loss, pocket depth, calculus, plaque, and bleeding on a random half-mouth. Bone metabolism biomarkers included serum levels of calcium, phosphate (Pi), alkaline phosphatase, albumin, carboxy-terminal collagen crosslinks (CTX), N-terminal propeptides of type I procollagen, isoform 5b of tartrate-resistant acid phosphatase, and urine alpha- carboxy-terminal collagen crosslinks (alpha-CTX) and beta-CTX and serum levels of calciotropic hormones vitamin D (25(OH)D) and PTH. Main Outcome Measures: The aim of this study is to correlate bone metabolism biomarkers with prevalence and progression of periodontal disease in older men. Results: Patients with more severe periodontitis had significantly higher levels of PTH (P trend = .0004), whereas 25(OH)D was lower (P trend = .001). In a subset of men reevaluated at a second dental visit, improvement of periodontitis was associated with lower alpha-CTX, beta-CTX, and CTX levels at baseline after adjusting for age, site, and body mass index. Conclusion: This study suggests that a distinct set of biomarkers of bone metabolism are associated with more severe periodontal disease (PTH, 25(OH)D) and periodontal progression (alpha-CTX, beta-CTX, and CTX

  3. Is human fracture hematoma inherently angiogenic?

    LENUS (Irish Health Repository)

    Street, J

    2012-02-03

    This study attempts to explain the cellular events characterizing the changes seen in the medullary callus adjacent to the interfragmentary hematoma during the early stages of fracture healing. It also shows that human fracture hematoma contains the angiogenic cytokine vascular endothelial growth factor and has the inherent capability to induce angiogenesis and thus promote revascularization during bone repair. Patients undergoing emergency surgery for isolated bony injury were studied. Raised circulating levels of vascular endothelial growth factor were seen in all injured patients, whereas the fracture hematoma contained significantly higher levels of vascular endothelial growth factor than did plasma from these injured patients. However, incubation of endothelial cells in fracture hematoma supernatant significantly inhibited the in vitro angiogenic parameters of endothelial cell proliferation and microtubule formation. These phenomena are dependent on a local biochemical milieu that does not support cytokinesis. The hematoma potassium concentration is cytotoxic to endothelial cells and osteoblasts. Subcutaneous transplantation of the fracture hematoma into a murine wound model resulted in new blood vessel formation after hematoma resorption. This angiogenic effect is mediated by the significant concentrations of vascular endothelial growth factor found in the hematoma. This study identifies an angiogenic cytokine involved in human fracture healing and shows that fracture hematoma is inherently angiogenic. The differences between the in vitro and in vivo findings may explain the phenomenon of interfragmentary hematoma organization and resorption that precedes fracture revascularization.

  4. Plate osteosynthesis of simple forearm fractures : LCP versus DC plates

    NARCIS (Netherlands)

    Stevens, Charles Tjerk; Ten Duis, Henk Jan

    2008-01-01

    The aim of this study was to compare the time to radiological bony union of simple A-type fractures of the forearm, treated with either a locking compression plate (LCP) or a dynamic compression plate (DCP). For each fracture, the relation between the use of compression and radiological healing time

  5. Plate osteosynthesis of simple forearm fractures : LCP versus DC plates

    NARCIS (Netherlands)

    Stevens, Charles Tjerk; Ten Duis, Henk Jan

    The aim of this study was to compare the time to radiological bony union of simple A-type fractures of the forearm, treated with either a locking compression plate (LCP) or a dynamic compression plate (DCP). For each fracture, the relation between the use of compression and radiological healing time

  6. Effect of calcitonin on the expression of collagen gene during the healing process of osteoporotic fractures%降钙素对骨质疏松性骨折修复过程胶原基因表达的影响

    Institute of Scientific and Technical Information of China (English)

    肖强; 刘静莉; 漆启华; 陆欢; 邓亮; 董谢平

    2013-01-01

    目的:探索降钙素对骨质疏松性骨折愈合过程中基质Ⅰ、Ⅱ、Ⅲ型胶原 mRNA表达的影响,阐明降钙素促进骨质疏松性骨折愈合的机制。方法选用96只2个月龄SD雌性大鼠,64只行双侧卵巢切除( OVX)后,随机平分为降钙素组和对照组,其余32只为假手术组;10周后所有大鼠在右侧桡骨下端制作1 mm骨缺损的骨折愈合模型。降钙素组从骨折术前1 w至术后8 w连续每天皮下注射鲑鱼降钙素2 IU/kg,另2组注射等量生理盐水。采用原位杂交技术分析7 d,14 d,28 d,56 d,4个时间、点降钙素对骨折修复过程中基质Ⅰ、Ⅱ、Ⅲ型胶原mRNA表达的影响。结果降钙素治疗下,骨基质Ⅰ型胶原mRNA表达的量与对照组比较有显著性差异,假手术组>降钙素组>对照组;Ⅲ型胶原mRNA的表达变化则与之相反。降钙素组软骨性骨痂向骨性骨痂转换时间较对照组缩短。结论降钙素能影响胶原mRNA的表达,明显促进骨质疏松性骨折的愈合。%Objective To investigate the effect of calcitonin on the mRNA expression of matrix type I , II, and III collagen during the healing process of osteoporotic fractures , and to illuminate the mechanism of calcitonin in promoting the healing of osteoporotic fractures.Methods A total of 96 2-month female SD rats were selected.Of which, 64 rats received bilateral ovariectomy (OVX), and they were randomly divided into calcitonin therapy group and control group .The other 32 rats were divided into sham operation group.Ten weeks later , all the rats made into fracture models with about 1mm width of the bone defect at the end of the right radius . Rats in the calcitonin therapy group received a subcutaneous injection of 2 IU/kg salmon calcitonin once a day from 1 week before the operation to 8 weeks after the operation .Rats in the other 2 groups were injected with same volume of normal saline .The effect of calcitonin on the m

  7. Thrombin related peptide TP508 promoted fracture repair in a mouse high energy fracture model

    Directory of Open Access Journals (Sweden)

    Pan Xiao-Hua

    2009-01-01

    Full Text Available Abstract Background Thrombin related peptide (TP508 is a 23 amino-acid synthetic peptide that represents a portion of the receptor-binding domain of thrombin molecule. Previous studies have shown that TP508 can accelerate musculoskeletal tissue repair including fracture healing. Objectives The aim of this study was to investigate the effect of TP508 on fracture healing in a murine fracture model representing high energy fracture situation. Methods Eighty CD 1 mice underwent controlled quadriceps muscle crush and open transverse mid diaphyseal femoral fracture that was then fixed with an external fixator. Animals were randomised into four groups to receive an intra-operative dose of either 100 μg TP508 into the fracture gap; 100 μg TP508 into the surrounding damaged muscle tissues; 10 μg TP508 into the fracture gap, or control equal amount of saline into the fracture gap. Radiographic assessment was performed weekly for 5 weeks; histological analysis was at 3 and 5 weeks post fracture and biomechanical testing of the fractured bone was performed at 5 weeks post fracture. Results Mechanical testing data showed that the fracture stiffness was significantly higher in the group receiving 100 μg TP508 into the fracture gap than other groups. Histological and radiographic analysis revealed a trend of increase in bone formation in the 100 μg TP508 injected into the fracture gap group compared to the saline control group. It was noted that the scar tissues was significantly less in Group II comparing with the saline control group and there was increased blood vessel formation in the crushed muscles and fracture gap areas in the groups receiving TP508 comparing to the saline control group. Conclusion The results from this study demonstrated the use of thrombin related peptide TP508 in the situation of a high energy fracture can promote fracture healing and reduce the potential complications such as muscle fibrosis and fracture delayed or non-union.

  8. Relative permeability through fractures

    Energy Technology Data Exchange (ETDEWEB)

    Diomampo, Gracel, P.

    2001-08-01

    The mechanism of two-phase flow through fractures is of importance in understanding many geologic processes. Currently, two-phase flow through fractures is still poorly understood. In this study, nitrogen-water experiments were done on both smooth and rough parallel plates to determine the governing flow mechanism for fractures and the appropriate methodology for data analysis. The experiments were done using a glass plate to allow visualization of flow. Digital video recording allowed instantaneous measurement of pressure, flow rate and saturation. Saturation was computed using image analysis techniques. The experiments showed that gas and liquid phases flow through fractures in nonuniform separate channels. The localized channels change with time as each phase path undergoes continues breaking and reforming due to invasion of the other phase. The stability of the phase paths is dependent on liquid and gas flow rate ratio. This mechanism holds true for over a range of saturation for both smooth and rough fractures. In imbibition for rough-walled fractures, another mechanism similar to wave-like flow in pipes was also observed. The data from the experiments were analyzed using Darcy's law and using the concept of friction factor and equivalent Reynold's number for two-phase flow. For both smooth- and rough-walled fractures a clear relationship between relative permeability and saturation was seen. The calculated relative permeability curves follow Corey-type behavior and can be modeled using Honarpour expressions. The sum of the relative permeabilities is not equal one, indicating phase interference. The equivalent homogeneous single-phase approach did not give satisfactory representation of flow through fractures. The graphs of experimentally derived friction factor with the modified Reynolds number do not reveal a distinctive linear relationship.

  9. Biomimetic Self-Healing

    Science.gov (United States)

    2015-07-21

    as well as the storage and delivery of liquid reagents, new materials have been developed with extended longevity that are capable of restoring...may involve high-temperature curing. The capsule Figure 3. Autonomous self-healing rubber. Reproduced with permis- sion from the CNRS image bank ...EPON 828; diglycidyl ether of bisphenol A (DGEBA)) matrix embedded with 1st gen- eration Grubbs catalyst.[64] Upon crack damage, the liquid healing

  10. Diabetes and wound healing

    OpenAIRE

    Svendsen, Rikke; Irakunda, Gloire; Knudsen List, Karoline Cecilie; Sønderstup-Jensen, Marie; Hölmich Rosca, Mette Maria

    2014-01-01

    Diabetes is a disease where the glucose level in the blood is high, due to either insulin resistance, impaired insulin sensitivity or no insulin production. The high glucose level causes several complications, one of them being an impaired wound healing process, which might lead to chronic wounds, ulcers. Several factors play a role in the development of ulcers, and recent research indicates that microRNA might play a significant role in skin development and wound healing. The purpose of this...

  11. Finite Element-Derived Surrogate Models of Locked Plate Fracture Fixation Biomechanics.

    Science.gov (United States)

    Wee, Hwabok; Reid, J Spence; Chinchilli, Vernon M; Lewis, Gregory S

    2017-03-01

    Internal fixation of bone fractures using plates and screws involves many choices-implant type, material, sizes, and geometric configuration-made by the surgeon. These decisions can be important for providing adequate stability to promote healing and prevent implant mechanical failure. The purpose of this study was to develop mathematical models of the relationships between fracture fixation construct parameters and resulting 3D biomechanics, based on parametric computer simulations. Finite element models of hundreds of different locked plate fixation constructs for midshaft diaphyseal fractures were systematically assembled using custom algorithms, and axial, torsional, and bending loadings were simulated. Multivariate regression was used to fit response surface polynomial equations relating fixation design parameters to outputs including maximum implant stresses, axial and shear strain at the fracture site, and construct stiffness. Surrogate models with as little as three regressors showed good fitting (R (2) = 0.62-0.97). Inner working length was the strongest predictor of maximum plate and screw stresses, and a variety of quadratic and interaction terms influenced resulting biomechanics. The framework presented in this study can be applied to additional types of bone fractures to provide clinicians and implant designers with clinical insight, surgical optimization, and a comprehensive mathematical description of biomechanics.

  12. Establishing the Relationship between Fracture-Related Dolomite and Primary Rock Fabric on the Distribution of Reservoirs in the Michigan Basin

    Energy Technology Data Exchange (ETDEWEB)

    G. Michael Grammer

    2006-09-30

    This topical report covers the year 2 of the subject 3-year grant, evaluating the relationship between fracture-related dolomite and dolomite constrained by primary rock fabric in the 3 most prolific reservoir intervals in the Michigan Basin (Ordovician Trenton-Black River Formations; Silurian Niagara Group; and the Devonian Dundee Formation). The characterization of select dolomite reservoirs has been the major focus of our efforts in Phase II/Year 2. Fields have been prioritized based upon the availability of rock data for interpretation of depositional environments, fracture density and distribution as well as thin section, geochemical, and petrophysical analyses. Structural mapping and log analysis in the Dundee (Devonian) and Trenton/Black River (Ordovician) suggest a close spatial relationship among gross dolomite distribution and regional-scale, wrench fault related NW-SE and NE-SW structural trends. A high temperature origin for much of the dolomite in the 3 studied intervals (based upon initial fluid inclusion homogenization temperatures and stable isotopic analyses,) coupled with persistent association of this dolomite in reservoirs coincident with wrench fault-related features, is strong evidence for these reservoirs being influenced by hydrothermal dolomitization. For the Niagaran (Silurian), a comprehensive high resolution sequence stratigraphic framework has been developed for a pinnacle reef in the northern reef trend where we had 100% core coverage throughout the reef section. Major findings to date are that facies types, when analyzed at a detailed level, have direct links to reservoir porosity and permeability in these dolomites. This pattern is consistent with our original hypothesis of primary facies control on dolomitization and resulting reservoir quality at some level. The identification of distinct and predictable vertical stacking patterns within a hierarchical sequence and cycle framework provides a high degree of confidence at this point

  13. Low-intensity pulsed ultrasound treatment for postoperative delayed union or nonunion of long bone fractures.

    Science.gov (United States)

    Jingushi, Seiya; Mizuno, Kosaku; Matsushita, Takashi; Itoman, Moritoshi

    2007-01-01

    Postoperative delayed union and nonunion is the most common complication in fracture treatment. Recent studies have shown an accelerating effect of low-intensity pulsed ultrasound (LIPUS) on fracture repair. However, the indications for delayed union and nonunion are not clear. To clarify the factors which influence the effects of LIPUS, the data from a previous prospective multicenter study on LIPUS treatment for postoperative delayed union and nonunion of long bone fractures were reanalyzed. Seventy-two cases of long bone fracture, including those of the femur, tibia, humerus, radius, and ulna, were analyzed. The mean time from the most recent operation to the beginning of LIPUS treatment was 11.5 (3-68) months. The relationship between the background factors and the union rate was analyzed using a logistic regression method. In addition, long bone fractures in an upper extremity or in a lower extremity were analyzed separately. The union rate was 75% in all the cases of long bone fracture. There was a significant relationship between the union rate and the period from the most recent operation to the beginning of LIPUS treatment in all cases and in those that had long bone fracture of an upper extremity. There was also a significant relationship between the union rate and the time when a radiological improvement was first observed after the beginning of the treatment in all cases and in those with fractures in a lower extremity. When LIPUS treatment was started within 6 months of the most recent operation, 89.7% of all fractures healed. When an improvement in the radiological changes at the fracture site was observed after 4 months in those cases, then the sensitivity and specificity for union were more than 90%. LIPUS treatment should be started within 6 months of the most recent operation. Because LIPUS has been shown to be effective without causing either serious invasiveness or any undue risk to the patient, it may be considered the treatment of first choice

  14. Salter-Harris fractures 骺离骨折

    Institute of Scientific and Technical Information of China (English)

    初建平

    2012-01-01

    @@ Salter-Harris fractures,.pediatric fractures invo-lving the growth plate (physis) of bones.The majority heal without growth impairment, however some lead to clinically important shortening and angulation.Growth disorders are a result of a destruction of the epiphyseal circulation (inhibits physeal growth) or by formation of a bone bridge across the physis.TypeⅠ:transverse fracture through physis (increased physeal width) (6% ncidence).Healing is rapid,usually within 2~3 weeks, complications are rare.TypeⅡ: Through physis and metaphysic (most common type) (75% incidence).Healing is rapid,and growth is rarely disturbed; an exception to this are fractures of the distal emur and tibia.

  15. 低钠血症与骨质疏松及骨折的关系%Relationship of hyponatremia with osteoporosis and fractures

    Institute of Scientific and Technical Information of China (English)

    张雪晗; 王鸥; 陈丽萌

    2016-01-01

    低钠血症是临床最常见的电解质紊乱.除神经系统并发症外,低钠血症的其他并发症没有得到足够重视.轻度、慢性低钠血症常导致患者的步态不稳、跌倒,并能增加骨质疏松和骨折风险.本文拟对低钠血症与骨代谢的密切关系、可能机制及临床意义进行综述.%Hyponatremia is the most common electrolyte imbalance.Other than neurological complications,other complications of hyponatremia have not received due attention.Mild,chronic hyponatremia can result in subtle symptoms such as gait disturbance and falls,and increase the risks of osteoporosis and fractures.This paper reviewed the emerging relationship between hyponatremia and bone metabolism,its possible mechanisms and clinical implications.

  16. [Acetabular fractures].

    Science.gov (United States)

    Gänsslen, A; Oestern, H J

    2011-12-01

    Treatment of acetabular fractures requires extensive knowledge of the bony anatomy, the amount of possible exposure of the bone with the selected approaches and fracture type-dependent indications of operative treatment. Classification of the fracture with detailed analysis of the fracture morphology is the basis for decision making and planning. The primary treatment aim is the anatomic reconstruction of the acetabulum which results in optimal long-term results.The basis of this overview is the presentation of standard treatment concepts in acetabular fracture surgery. Beside characteristics of the acetabular bony anatomy, biomechanical and pathomechanical principles and the relevant radiological anatomy, the treatment options, both conservative and operative and basic principles of the indications for standard surgical approaches will be discussed.The special fracture type is discussed in detail regarding incidence, injury mechanism, concomitant injuries, options for conservative and operative treatment, quality of operative reduction and long-term results.Furthermore, epidemiological data on typical postoperative complications are evaluated.

  17. Biologically inspired autonomous structural materials with controlled toughening and healing

    Science.gov (United States)

    Garcia, Michael E.; Sodano, Henry A.

    2010-04-01

    The field of structural health monitoring (SHM) has made significant contributions in the field of prognosis and damage detection in the past decade. The advantageous use of this technology has not been integrated into operational structures to prevent damage from propagating or to heal injured regions under real time loading conditions. Rather, current systems relay this information to a central processor or human operator, who then determines a course of action such as altering the mission or scheduling repair maintenance. Biological systems exhibit advanced sensory and healing traits that can be applied to the design of material systems. For instance, bone is the major structural component in vertebrates; however, unlike modern structural materials, bone has many properties that make it effective for arresting the propagation of cracks and subsequent healing of the fractured area. The foremost goal for the development of future adaptive structures is to mimic biological systems, similar to bone, such that the material system can detect damage and deploy defensive traits to impede damage from propagating, thus preventing catastrophic failure while in operation. After sensing and stalling the propagation of damage, the structure must then be repaired autonomously using self healing mechanisms motivated by biological systems. Here a novel autonomous system is developed using shape memory polymers (SMPs), that employs an optical fiber network as both a damage detection sensor and a network to deliver stimulus to the damage site initiating adaptation and healing. In the presence of damage the fiber optic fractures allowing a high power laser diode to deposit a controlled level of thermal energy at the fractured sight locally reducing the modulus and blunting the crack tip, which significantly slows the crack growth rate. By applying a pre-induced strain field and utilizing the shape memory recovery effect, thermal energy can be deployed to close the crack and return

  18. Electrosprayed Multi-Core Alginate Microcapsules as Novel Self-Healing Containers

    Science.gov (United States)

    Hia, Iee Lee; Pasbakhsh, Pooria; Chan, Eng-Seng; Chai, Siang-Piao

    2016-10-01

    Alginate microcapsules containing epoxy resin were developed through electrospraying method and embedded into epoxy matrix to produce a capsule-based self-healing composite system. These formaldehyde free alginate/epoxy microcapsules were characterized via light microscope, field emission scanning electron microscope, fourier transform infrared spectroscopy and thermogravimetric analysis. Results showed that epoxy resin was successfully encapsulated within alginate matrix to form porous (multi-core) microcapsules with pore size ranged from 5–100 μm. The microcapsules had an average size of 320 ± 20 μm with decomposition temperature at 220 °C. The loading capacity of these capsules was estimated to be 79%. Under in situ healing test, impact specimens showed healing efficiency as high as 86% and the ability to heal up to 3 times due to the multi-core capsule structure and the high impact energy test that triggered the released of epoxy especially in the second and third healings. TDCB specimens showed one-time healing only with the highest healing efficiency of 76%. The single healing event was attributed by the constant crack propagation rate of TDCB fracture test. For the first time, a cost effective, environmentally benign and sustainable capsule-based self-healing system with multiple healing capabilities and high healing performance was developed.

  19. Electrosprayed Multi-Core Alginate Microcapsules as Novel Self-Healing Containers

    Science.gov (United States)

    Hia, Iee Lee; Pasbakhsh, Pooria; Chan, Eng-Seng; Chai, Siang-Piao

    2016-01-01

    Alginate microcapsules containing epoxy resin were developed through electrospraying method and embedded into epoxy matrix to produce a capsule-based self-healing composite system. These formaldehyde free alginate/epoxy microcapsules were characterized via light microscope, field emission scanning electron microscope, fourier transform infrared spectroscopy and thermogravimetric analysis. Results showed that epoxy resin was successfully encapsulated within alginate matrix to form porous (multi-core) microcapsules with pore size ranged from 5–100 μm. The microcapsules had an average size of 320 ± 20 μm with decomposition temperature at 220 °C. The loading capacity of these capsules was estimated to be 79%. Under in situ healing test, impact specimens showed healing efficiency as high as 86% and the ability to heal up to 3 times due to the multi-core capsule structure and the high impact energy test that triggered the released of epoxy especially in the second and third healings. TDCB specimens showed one-time healing only with the highest healing efficiency of 76%. The single healing event was attributed by the constant crack propagation rate of TDCB fracture test. For the first time, a cost effective, environmentally benign and sustainable capsule-based self-healing system with multiple healing capabilities and high healing performance was developed. PMID:27694922

  20. 高能震波对老年桡骨远端骨折愈合及骨密度的影响%The Effects of High Energy Shock Waves on the Healing and the Bone Mineral Density of Elders′ Distal Radius Fracture

    Institute of Scientific and Technical Information of China (English)

    聂玮; 李晓林; 张博; 曾炳芳

    2011-01-01

    Objective The purpose of this study was to evaluate the effect and observe the clinical efficacy of the high energy shock waves treatment on the distal radius fracture of the elders. Methods Seventy five patients with distal radius fracture were selected and randomly divided into two groups: the control group,with 38 patients who were received only the manual reduction and cast immobilization;the HESW group ,with 37 patients who were treated with HESW(0.5~0.6 mJ/mm2 energy flux density with 4000 impulses) after the manual reduction and cast immobilization. The rate of clinical healing after four weeks, the rate of bone union after ten weeks, bone mineral density (BMD) during the treatment and the wrist function,PRWE results after bone union were assessed as measurements. Results While the bone mineral density (BMD) values in four weeks between the two groups were not statistically significant(P=0. 694),but the BMD values of the HESW group were significantly higher (P<0.05) than the control group at eight weeks/twelve weeks after fractured. And the HESW group' BMD values after twelve weeks show significantly different from that before treatment (P<0.05). With regard to the rate of clinical healing after four weeks, the rate of bone union after ten weeks,the VAS scores,wrist function scores and PRWE scores,there were significantly different between the two groups. Conclusion HESW,with effective effects on the treatment on the distal radius fracture of the elders, could promote the healing of fractures effectively. It is efficacious against regional osteoporosis, joint stiffness and persistent pain. Good functional outcomes and the high quality of life could be obtained by the patients.%目的 观察高能震波(high energy shock waves,HESW)对老年桡骨远端骨折愈合过程中的作用及其临床意义.方法 筛选75 例桡骨远端骨折患者,随机分为震波组(37 例)和对照组(38 例);震波组应用高能震波仪对石膏固定患者进行治

  1. Sports fractures.

    OpenAIRE

    DeCoster, T. A.; Stevens, M. A.; Albright, J. P.

    1994-01-01

    Fractures occur in athletes and dramatically influence performance during competitive and recreational activities. Fractures occur in athletes as the result of repetitive stress, acute sports-related trauma and trauma outside of athletics. The literature provides general guidelines for treatment as well as a variety of statistics on the epidemiology of fractures by sport and level of participation. Athletes are healthy and motivated patients, and have high expectations regarding their level o...

  2. Far cortical locking screws in distal femur fractures.

    Science.gov (United States)

    Adams, John D; Tanner, Stephanie L; Jeray, Kyle J

    2015-03-01

    Distal femur fractures routinely heal by secondary bone healing, which relies on interfragmentary motion. Periarticular locking plates are commonly used for fixation in distal femur fractures but are associated with a high nonunion rate, likely due to the stiffness of the constructs. Far cortical locking (FCL) screws are designed to allow micromotion at the near cortex while maintaining purchase in only the far cortex. Although clinical data are limited, these screws have been shown in biomechanical studies to provide excellent interfragmentary motion, and animal models have shown increased callus formation compared with traditional locking screws. The purpose of this study was to examine the clinical effects that FCL screws have on healing in distal femur fractures treated with locked constructs. In this retrospective case series, 15 patients with a distal femur fracture treated with MotionLoc screws (Zimmer, Warsaw, Indiana) were analyzed. Serial radiographs were evaluated for callus presence and time to union. All fractures were either 33-A3 or 33-C2 according to the AO classification system, and 5 (33%) were open. Bone loss was recorded in 2 patients. There were no nonunions, and average time to union was 24 weeks. There were no implant failures, and all 5 open fractures, including the 2 with bone loss, healed without intervention. There was 1 reoperation due to painful hardware. Although this is a small case series, these results are promising. Far cortical locking screws may provide the answer to the high nonunion rate associated with distal femur fractures treated with traditional locked constructs.

  3. Hamate fractures.

    Science.gov (United States)

    Sarabia Condés, J M; Ibañez Martínez, L; Sánchez Carrasco, M A; Carrillo Julia, F J; Salmerón Martínez, E L

    2015-01-01

    The purpose of this paper is to present our experience in the treatment of the fractures of the hamate and to make a review of the literature on this topic. We retrospectively reviewed 10 patients treated in our clinic between 2005-2012 suffering from fractures of the hamate. Six cases were fractures of the body and four were fractures of the hamate. Five cases were of associated injuries. Diagnostic delay ranged from 30 days to 2 years. Patient follow-up ranged from 1 to 10 years. Patient satisfaction was evaluated using the DASH questionnaire. Five patients with a fracture of the body underwent surgery, and one was treated conservatively. Two patients with fracture of the hook of the hamate were treated with immobilization, and two more patients had the fragment removed. The grip strength and the digital clip were reduced in 2 cases. Flexion and extension of the wrist was limited in 3 cases. The mobility of the fingers was normal in all the cases, except in one. The results obtained from the DASH questionnaire were normal in all the cases, except in one case of fracture of the hamate, and in two cases of fracture of the body. The surgical treatment should reduce the dislocation and stabilize the injuries with osteosynthesis. The fractures of the hamate are usually diagnosed late, and the most recommended treatment is removal of the fragment, although it cannot be deduced from this study. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

  4. Colles Fracture

    OpenAIRE

    Sánchez León, Belisario; Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú

    2014-01-01

    Our expertise is the study of more than 2,000 cases of Colles' fractures. Colles name should in this case to synthesize the type of fractures of the lower end of the radius. There have been various proposed classifications according to the different fracture lines can be demonstrated radiologically in the region of the wrist. We believe that these ratings should only be retained if the concept of the articular fracture or not in the classical sense, since it has great value in the functional ...

  5. Wound healing in urology.

    Science.gov (United States)

    Ninan, Neethu; Thomas, Sabu; Grohens, Yves

    2015-03-01

    Wound healing is a dynamic and complex phenomenon of replacing devitalized tissues in the body. Urethral healing takes place in four phases namely inflammation, proliferation, maturation and remodelling, similar to dermal healing. However, the duration of each phase of wound healing in urology is extended for a longer period when compared to that of dermatology. An ideal wound dressing material removes exudate, creates a moist environment, offers protection from foreign substances and promotes tissue regeneration. A single wound dressing material shall not be sufficient to treat all kinds of wounds as each wound is distinct. This review includes the recent attempts to explore the hidden potential of growth factors, stem cells, siRNA, miRNA and drugs for promoting wound healing in urology. The review also discusses the different technologies used in hospitals to treat wounds in urology, which make use of innovative biomaterials synthesised in regenerative medicines like hydrogels, hydrocolloids, foams, films etc., incorporated with growth factors, drug molecules or nanoparticles. These include surgical zippers, laser tissue welding, negative pressure wound therapy, and hyperbaric oxygen treatment.

  6. Physical Activity During Therapy of Self- Disorder Among Patients with Schizophrenia.A Phenomenological Understanding of the Relationship Between Healing and Physical Activity

    Directory of Open Access Journals (Sweden)

    Toft Jim

    2015-03-01

    Full Text Available Studies indicate that physical activity has a positive effect both physiologically and socially for psychologically ill and vulnerable people, and that this effect is the same or greater for psychologically well-functioning people. In spite of this, treatment sites often hesitate to include sports and physical activity as part of the treatment offered. This article argues that there is a strong correlation between the body and mind, but from a different point of view than that adopted by the prevalent scientific research in the field. Specifically, I elucidate how the mind-body relationship and self-consciousness are influenced by physical activity for people with schizophrenia, and argue that symptoms are relieved as a result of physical activity. Consciousness has a bodily component that, for people with schizophrenia, is less well-integrated in the consciousness than for psychologically well-functioning people, and sports and physical activity can help facilitate this integration. My argument is based partly on phenomenological concepts and partly on an empirical research project concerning physical activity for people with schizophrenia. The conclusion is that their level of functioning and self-assessed quality of life increased markedly through physical activity. The purpose of the present article is thus partly to qualify the treatment chosen for people with schizophrenia, and partly to qualify the theoretical discussion concerning the role played by the body and physical activity in connection with consciousness and relief.

  7. Toughening and healing of continuous fibre reinforced composites with bis-maleimide based pre-pregs

    Science.gov (United States)

    Kostopoulos, V.; Kotrotsos, A.; Tsantzalis, S.; Tsokanas, P.; Christopoulos, A. C.; Loutas, T.

    2016-08-01

    Unidirectional (UD) pre-pregs containing self-healing materials based on Diels-Alder reaction bis-maleimide (BMI) polymers were successfully incorporated on the mid-plane of UD carbon fibre reinforced polymers. The fracture toughness of these composites and the introduced healing capability were measured under mode I loading. The interlaminar fracture toughness was enhanced considerably, since the maximum load (P max) of the modified composite increased approximately 1.5 times and the mode I fracture energy (G IC) displayed a significant increase of almost 3.5 times when compared to the reference composites. Furthermore the modified composites displayed a healing efficiency (HE) value of about 30% for P max and 20% for G IC after the first healing, appearing to be an almost stable behaviour after the third healing cycle. The HE displayed a decrease of 20% and 15% for P max and G IC values, respectively, after the fifth healing cycle. During the tests, the monitored acoustic emission (AE) activity of the samples showed that there is no significant difference due to the presence of BMI polymer in terms of AE hits. Moreover, optical microscopy not only showed that the epoxy matrix at the interface is partly infiltrated by the BMI polymer, but it also revealed the presence of pulled out fibres at the fractured surface, indicating ductile behaviour.

  8. Efficacy of Dragon's blood cream on wound healing: A randomized, double-blind, placebo-controlled clinical trial

    OpenAIRE

    Namjoyan, Foroogh; Kiashi, Fatemeh; Moosavi, Zahra Beigom; Saffari, Fatemeh; Makhmalzadeh, Behzad Sharif

    2015-01-01

    The blood-red sap of Dragon's blood has been used in folk medicine for fractures, wounds, inflammation, gastrointestinal disorders, rheumatism, blood circulation dysfunctions, and cancer. Existing in vitro and in vivo bioactivity of this herb on different mechanisms of healing shows strong potential of this sap in wound healing. This clinical trial study was designated to evaluate the wound healing effect of Dragon's blood on human wounds. Sixty patients, between the ages of 14–65 years, who ...

  9. Advances and Perspectives on Tissue Repair and Healing

    Science.gov (United States)

    Pinheiro, Antonio L. B.; Marques, Aparecida M. C.; de Sousa, Ana Paula C.; Aciole, Jouber M. S.; Soares, Luiz G. P.

    2011-08-01

    Wound healing involves local and systemic responses that reflect the etiology of the lesion, type of tissue, systemic condition and others. Despite being essentially the same for different wounds, the pattern of healing may change due to intrinsic and/or extrinsic factors. The type of tissue has also to be considered. Several therapeutic approaches have been used to improve healing including phototherapies such as Laser, LEDs and Lamps. Their effects on soft and mineralized tissues are well reported. The choice of appropriated parameters is essential for the results of the treatment and includes wavelength, power density, energy, duration and frequency of application and others. We studied the effects of different types of light on the healing of both soft and mineralized tissues using different models. We found that the use of Laser and polarized light are effective on improving the healing of diabetic and undernourished animals. We also found that Laser light is capable of improving the healing of drug-induced impairment and on increasing the survival rate of flaps on both diabetic and non-diabetic animals. We have also studied and shown the influence of the laser parameters on the healing of surgical and laser wounds. Lately we verified the positive effect of LEDs on healing. We used Laser/LED light for improving bone healing in conditions such as in dental implants, autologous grafts, biomaterials and fractures. From these reports and our own experience we have no doubt whatsoever that the use of phototherapies, carried out with appropriate parameters, promotes quicker tissue repair.

  10. Kirschner wire fixation of Salter-Harris type IV fracture of the lateral aspect of the humeral condyle in growing dogs. A retrospective study of 35 fractures.

    Science.gov (United States)

    Cinti, Filippo; Pisani, Guido; Vezzoni, Luca; Peirone, Bruno; Vezzoni, Aldo

    2017-01-16

    To evaluate the use of Kirschner wires for treatment of fractures of the lateral aspect of the humeral condyle in growing dogs. Retrospective analysis of 35 elbow fractures (33 dogs) of the lateral aspect of the humeral condyle treated by insertion of multiple transcondylar and one anti-rotational Kirschner wires. Radiographic and clinical re-evaluations were carried out immediately after surgery, at four weeks and, when required, at eight weeks postoperatively. Long-term follow-up was planned after a minimum of six months. The relationship between different implant configurations and clinical outcome was analysed statistically. Complete functional recovery was seen in 31 elbows (30 dogs), three elbows (2 dogs) had reduction in the range of motion, and one elbow (1 dog) had persistent grade 1 lameness two months postoperatively. Major complications occurred in eight elbows (8 dogs) and all were resolved by implant removal. Implant configuration did not affect outcome. Long-term evaluation in 12 cases with a mean follow-up of four years showed absence of lameness, normal function and no or mild radiographic evidence of osteoarthritis in 11 cases. Fracture of the lateral aspect of the humeral condyle in growing dogs can be successfully treated by multiple transcondylar convergent or parallel Kirschner wires, resulting in adequate fracture healing.

  11. BIOTECHNOLOGY BIOPRODUCTS "HEALING-1"

    Directory of Open Access Journals (Sweden)

    S. I. Artiukhova

    2014-01-01

    Full Text Available Summary. The article presents data on the development of technology and qualitative research, bio-products «Healing-1». One of the promising directions in food biotechnology is the development of new integrated starter-based consortia of microorganisms, which have higher activity compared with cultures prepared using pure cultures. So it was interesting studies on the development of new biotechnology and bio-based microbial consortium of lactic acid bacteria. Based on the analysis of biotechnological properties of native cultures created a new consortium of microorganisms containing lactic acid streptococci and bacilli, allowing the maximum extent possible to implement the physiological, biochemical and technological potential of microorganisms. Scientifically substantiated and experimentally developed a new biotechnology production of bioproducts «Healing-1», obtained on the basis of microbial consortium with broad spectrum antimicrobial activity. Experimentally investigated quality parameters of organic food «Healing-1» using a new microbial consortium as freshly prepared and during storage. Found that antagonistic activity of microflora bio «Healing-1» with respect to pathogenic and conditionally pathogenic bacteria, as well as its resistance to substances in the gastrointestinal tract of man is more pronounced compared to bioproducts obtained using a separate starter, members of the microbial consortium. It should be noted a more pronounced synthesis of exopolysaccharides in bioproduct «Healing-1», which leads to increased viscosity of the system and improves the consistency of bio. New bioproducts have good organoleptic characteristics and contain a high number of viable cells of lactic acid bacteria. High stability and survival of lactic acid bacteria during storage. In the study of attacked proteins bioproducts digestive proteinases «in vitro» found that the fermentation of milk microbial consortium increases the digestibility

  12. Interacting Cracks in an Environmentally Assisted Fracture

    Science.gov (United States)

    Levandovsky, Artem; Balazs, Anna

    2006-03-01

    We perform the study of environmentally assisted fracture within the framework of a lattice model. Formation of an ensemble of environmentally assisted microcracks, their coalescence and formation of crack ``avalanches'' lead to a very rich dynamical picture. Under specific condition crack healing can occur due to cohesive forces, which hold material together and tend to pull atoms together even if they are separated by a crack over several lattice units. We investigate the dynamical interplay between crack formation, arrest, healing and re-cracking. The goal here is to provide an understanding of the conditions leading to the phenomena of crack healing that happens along with the crack formation. We study the morphology of crack patterns with the intentions to establish a way to enhance the healing property of a material sample.

  13. The relationship between sports activities and permanent incisor crown fractures in a group of school children aged 7-9 and 11-13 in Ankara, Turkey.

    Science.gov (United States)

    Cetinbaş, Tuğba; Yildirim, Gözde; Sönmez, Hayriye

    2008-10-01

    The objective of the study was to determine the distribution, aetiology of the crown fractures of permanent anterior teeth in children aged 7-9 and 11-13 years and to identify the role of participation in sports associated with crown fractures. The study population comprised 2570 students from 10 primary schools randomly selected from five municipalities in Ankara, Turkey. Two paediatric dentists examined all permanent maxillary and mandibular incisors for evidence of fracture and completed a standardized examination form to obtain information on the age, gender, severity of incisor injury and frequency and type of sports participation for each child, as well as whether or not children used mouthguards during sports activities. Chi-square and z-tests were used to determine differences. A total of 191 (7.43%) of the 2570 subjects examined were affected by dental trauma. The proportion of fractured incisors was significantly higher in males than in females among older children (P < 0.01). Out of a total of 222 fractured teeth, 84% involved the maxillary central incisors. Bicycling caused significantly higher rates of crown fractures than other types of sports (P < 0.05). The percentage of incisal fractures caused by sports-related accidents was 14.14%. The number of children interested in sports is high, and the sports chosen are generally contact sports. The high rate (14.14%) of crown injuries caused by sports activities supports these findings.

  14. Fracture Mechanics

    CERN Document Server

    Zehnder, Alan T

    2012-01-01

    Fracture mechanics is a vast and growing field. This book develops the basic elements needed for both fracture research and engineering practice. The emphasis is on continuum mechanics models for energy flows and crack-tip stress- and deformation fields in elastic and elastic-plastic materials. In addition to a brief discussion of computational fracture methods, the text includes practical sections on fracture criteria, fracture toughness testing, and methods for measuring stress intensity factors and energy release rates. Class-tested at Cornell, this book is designed for students, researchers and practitioners interested in understanding and contributing to a diverse and vital field of knowledge. Alan Zehnder joined the faculty at Cornell University in 1988. Since then he has served in a number of leadership roles including Chair of the Department of Theoretical and Applied Mechanics, and Director of the Sibley School of Mechanical and Aerospace Engineering.  He teaches applied mechanics and his research t...

  15. The Relationship between Fractures and Tectonic Stress Field in the Extra Low-Permeability Sandstone Reservoir at the South of Western Sichuan Depression

    Institute of Scientific and Technical Information of China (English)

    Zeng Lianbo; Qi Jiafu; Li Yuegang

    2007-01-01

    The formation and distribution of fractures are controlled by paleotectonic stress field, and their preservative status and effects on development are dominated by the modern stress field. Since Triassic, it has experienced four tectonic movements and developed four sets of tectonic fractures in the extra low-permeability sandstone reservoir at the south of western Sichuan depression. The strikes of fractures are in the S-N, NE-SW, E-W, and NW-SE directions respectively. At the end of Triassic, under the horizontal compression tectonic stress field, for which the maximum principal stress direction was NW-SE,the fractures were well developed near the S-N faults and at the end of NE-SW faults, because of their stress concentration. At the end of Cretaceous, in the horizontal compression stress fields of the NE-SW direction,the stress was obviously lower near the NE-SW faults, thus, fractures mainly developed near the S-N faults.At the end of Neogene-Early Pleistocene, under the horizontal compression tectonic stress fields of E-W direction, stress concentrated near the NE-SW faults and fractures developed at these places, especially at the end of the NE-SE faults, the cross positions of NE-SW, and S-N faults. Therefore, fractures developed mostly near S-N faults and NE-SW faults. At the cross positions of the above two sets of faults, the degree of development of the fractures was the highest. Under the modern stress field of the NW-SE direction, the NW-SE fractures were mainly the seepage ones with tensional state, the best connectivity, the widest aperture, the highest permeability, and the minimum opening pressure.

  16. [Horizontal root fracture repaired by cementum--a case report].

    Science.gov (United States)

    Lin, K R; Kuo, J S

    1989-09-20

    Horizontal root fractures are rare among dental trauma. According to Dr. Andreasen's report there are four types of repairs after root fractures. They are 1. healing with calcified tissue; 2. interposition of connective tissue; 3. interposition of connective and bony tissue; 4. interposition of granulation tissue. This report presented a case of horizontal root fracture in a 27 years old female patient. The patient had a trauma in the front teeth about 15 years ago. Spontaneous healing occurred without dental treatment at that moment. However, symptoms appeared recently as a dento-alveolar abscess. Radiograph revealed a horizontal fracture at the middle third of the root portion of the left upper central incisor, and irregular hard tissue over the fractured area. Histologically, the main component of repair tissue is cementum.

  17. Fracture Union in Closed Interlocking Nail in Humeral Shaft Fractures

    Institute of Scientific and Technical Information of China (English)

    Ramji Lal Sahu; Rajni Ranjan; Ajay Lal

    2015-01-01

    Background:Fracture shaft humerus is a major cause of morbidity in patients with upper extremity injuries.The aim of this study was to evaluate the outcome of interlocking nail in humeral shaft fractures.Methods:This study was conducted in the Department of Orthopedic Surgery in SMS and R Sharda University from January 2010 to November 2013.Seventy-eight patients were recruited from emergency and out-patient department having a close fracture of humerus shaft.All patients were operated under general anesthesia and closed reamed interlocking nailing was done.All patients were followed for 9 months.Results:Out of 78 patients,69 patients underwent union in 90-150 days with a mean of 110.68 days.Complications found in four patients who had nonunion,and five patients had delayed union,which was treated with bone grafting.All the patients were assessed clinically and radiologically for fracture healing,joint movements and implant failure.The results were excellent in 88.46% and good in 6.41% patients.Complete subjective,functional,and clinical recovery had occurred in almost 100% of the patients.Conclusions:The results of the present study indicates that in the presence of proper indications,reamed antegrade intramedullary interlocked nailing appears to be a method of choice for internal fixation of osteoporotic and pathologic fractures.

  18. Effect of bovine bone morphogenetic proteins on radius fracture healing in rabbits Efeito de proteínas morfogenéticas ósseas de origem bovina na consolidação de fraturas induzidas no rádio de coelhos

    Directory of Open Access Journals (Sweden)

    Alfredo Feio da Maia Lima

    2007-08-01

    Full Text Available PURPOSE: To investigate the effect of bovine bone morphogenetic proteins (bBMPs bound to hydroxyapatite plus collagen in the healing of unstable radius fractures. METHODS: A transverse fracture was induced at the mid of the diaphysis in both radii on 15 Norfolk rabbits with average age of 5.5 months and 3.5kg. A mixture of bBMPs bound to thin powdered hydroxyapatite (bBMP-HA and bovine collagen as agglutinant was applied to the right radius fracture site. The left radius fracture was considered control and no treatment was used. After 30, 60 and 90 days (5 rabbits/period the rabbits were euthanized and the radii were collected for histological analysis. RESULTS: The descriptive histological analysis revealed that repair was similar for both forelimbs. The histomorphometric analysis showed that the mean area of newly formed bone was 867442.16 mm², 938743.00 mm² and 779621.06 mm² for the control forelimbs, and 841118.47 mm², 788038.76mm² and 618587.24 mm² for the treated forelimbs at 30, 60 and 90 days, respectively. Thus the newly formed bone area was 12.17% larger in the forelimbs treated with bBMP-HA/collagen than in the control forelimbs (pOBJETIVO: Investigar a influência de Proteínas Morfogenéticas Ósseas de origem bovina (bBMPs ligadas a hidroxiapatita mais colágeno na consolidação de fraturas instáveis do rádio. MÉTODOS: Em 15 coelhos com aproximadamente 5,5 meses de idade e peso médio de 3,5kg foi realizada uma fratura transversa na porção média da diáfise do rádio de ambos os membros. Na fratura do rádio direito foi aplicada mistura de bBMPs ligadas à hidroxiapatita (bBMP-HA e colágeno bovino como aglutinante e na do rádio esquerdo, considerada controle, nenhum tratamento foi usado. Os coelhos (cinco por período foram submetidos à eutanásia aos 30, 60 e 90 dias após a cirurgia para realização do processamento histológico e análise microscópica. RESULTADOS: A análise histológica descritiva revelou que

  19. Fibronectin and wound healing.

    Science.gov (United States)

    Grinnell, F

    1984-01-01

    I have tried to briefly review the evidence (summarized in Table II) indicating that fibronectin is important in cutaneous wound healing. Fibronectin appears to be an important factor throughout this process. It promotes the spreading of platelets at the site of injury, the adhesion and migration of neutrophils, monocytes, fibroblasts, and endothelial cells into the wound region, and the migration of epidermal cells through the granulation tissue. At the level of matrix synthesis, fibronectin appears to be involved both in the organization of the granulation tissue and basement membrane. In terms of tissue remodeling, fibronectin functions as a nonimmune opsonin for phagocytosis of debris by fibroblasts, keratinocytes, and under some circumstances, macrophages. Fibronectin also enhances the phagocytosis of immune-opsonized particles by monocytes, but whether this includes phagocytosis of bacteria remains to be determined. In general, phagocytosis of bacteria has not appeared to involve fibronectin. On the contrary, the presence of fibronectin in the wound bed may promote bacterial attachment and infection. Because of the ease of experimental manipulations, wound healing experiments have been carried out on skin more frequently than other tissues. As a result, the possible role of fibronectin has not been investigated thoroughly in the repair of internal organs and tissues. Nevertheless, it seems reasonable to speculate that fibronectin plays a central role in all wound healing situations. Finally, the wound healing problems of patients with severe factor XIII deficiencies may occur because of their inability to incorporate fibronectin into blood clots.

  20. Microdeformation in wound healing.

    Science.gov (United States)

    Wiegand, Cornelia; White, Richard

    2013-01-01

    Mechanical forces greatly influence cellular organization and behavior. Cells respond to applied stress by changes in form and composition until a suitable state is reestablished. However, without any mechanical stimuli cells stop proliferating, discontinue migration, go into cell-cycle arrest, and eventually die. Hence, one can assume that pathologies closely depending on cell migration like cancer or atherosclerosis might be governed by biophysical parameters. Moreover, mechanical cues will have fundamental effects in wound healing. Especially negative pressure wound therapy has the potential to endorse wound healing by induction of both macrodeformation (wound contraction) and microdeformation (tissue reactions at microscopic level). So far, the capacity for researchers to study the link between mechanical stimulation and biological response has been limited by the lack of instrumentation capable of stimulating the tissue in an appropriate manner. However, first reports on application of micromechanical forces to wounds elucidate the roles of cell stretch, substrate stiffness, and tissue deformation during cell proliferation and differentiation. This review deals with their findings and tries to establish a link between the current knowledge and the questions that are essential to clinicians in the field: What is the significance of mirodeformations for wound healing? Does "dead space" impede propagation of mechanical cues? How can microdeformations induce cell proliferation? What role do fibroblasts, myofibroblasts, and mesenchymal stem cells play in chronic wounds with regard to micromechanical forces? © 2013 by the Wound Healing Society.

  1. Healing Invisible Wounds

    Science.gov (United States)

    Adams, Erica J.

    2010-01-01

    As many as 9 in 10 justice-involved youth are affected by traumatic childhood experiences. According to "Healing Invisible Wounds: Why Investing in Trauma-Informed Care for Children Makes Sense," between 75 and 93 percent of youth currently incarcerated in the justice system have had at least one traumatic experience, including sexual…

  2. Phytochemicals in Wound Healing

    OpenAIRE

    Thangapazham, Rajesh L.; Sharad, Shashwat; Radha K Maheshwari

    2016-01-01

    Significance: Traditional therapies, including the use of dietary components for wound healing and skin regeneration, are very common in Asian countries such as China and India. The increasing evidence of health-protective benefits of phytochemicals, components derived from plants is generating a lot of interest, warranting further scientific evaluation and mechanistic studies.

  3. Healing Invisible Wounds

    Science.gov (United States)

    Adams, Erica J.

    2010-01-01

    As many as 9 in 10 justice-involved youth are affected by traumatic childhood experiences. According to "Healing Invisible Wounds: Why Investing in Trauma-Informed Care for Children Makes Sense," between 75 and 93 percent of youth currently incarcerated in the justice system have had at least one traumatic experience, including sexual…

  4. Local injection of simvastatin for repair of mild-to-moderate unstable humeral fractures:effects on bone healing and bone density%局部注射辛伐他汀修复轻中度不稳定肱骨骨折:对骨愈合及骨密度的影响

    Institute of Scientific and Technical Information of China (English)

    刘建; 田宝方; 王文珠; 郑卫东; 冯立; 杜宝印; 田大为

    2015-01-01

    背景:研究显示疏松骨骼单次注射小剂量辛伐他汀可显著改善骨骼微结构,促进股骨髁部骨小梁改建。目的:临床验证局部注射辛伐他汀增强轻中度不稳定肱骨骨折预后效果的影响。  方法:选取轻中度不稳定肱骨骨折患者93例,采用抛硬币法随机分成注射组(49例)和常规组(44例)。常规组采用常规物理疗法治疗,注射组在给予常规物理治疗的基础上,局部注射辛伐他汀疗法治疗,对比分析两组患者骨密度及骨折愈合时间。  结果与结论:两组患者治疗后2周内骨密度值差异无显著性意义(P>0.05);治疗结束后的一两个月,注射组患者骨密度值明显高于常规组(P0.05), but the bone mineral density was significantly higher in the injection group than the normal group at 1-2 months after treatment (P<0.05). In addition, the injection group was superior to the normal group in the fol owing aspects:incidence of complications, excel ent-good rate of joint function recovery, and hospital stay. These findings indicate that the local injection of simvastatin based on conventional physical therapy can shorten the time of fracture healing, increase bone mineral density and improve the prognosis of patients with mild-to-moderate unstable proximal humeral fractures.

  5. Self-healing supramolecular nanocomposites

    NARCIS (Netherlands)

    Liu, Z.

    2015-01-01

    The aim of this thesis is to execute a bottom-up design of the intrinsically self-healing nanocomposites. We briefly introduced the self-healing materials in chapter 1, covering classification and basic self-healing mechanism. In chapter 2, we have synthesized polyborosiloxane (PBS) according to th

  6. Self-healing supramolecular nanocomposites

    NARCIS (Netherlands)

    Liu, Z.

    2015-01-01

    The aim of this thesis is to execute a bottom-up design of the intrinsically self-healing nanocomposites. We briefly introduced the self-healing materials in chapter 1, covering classification and basic self-healing mechanism. In chapter 2, we have synthesized polyborosiloxane (PBS) according to

  7. [Insufficiency fractures after irradiation therapy - case series].

    Science.gov (United States)

    Braun, Karl F; Pohlig, Florian; Lenze, Ulrich; Netter, Clemens; Hadjamu, Miriam; Rechl, Hans; von Eisenhart-Rothe, Rüdiger

    2015-07-01

    Radiation therapy plays an essential part in modern treatment regimes of musculoskeletal tumors. Nevertheless damage to the surrounding tissue does occur inevitably. Postradiogenic changes of bone are associated with decreased stability and an increased fracture rate. The orthopedic surgeon therefore faces a challenging situation with altered bone metabolism, changes in perfusion and soft tissue problems. We present 3 cases of radiation induced fractures during the treatment of soft tissue tumors, all of which received radiation doses of > 58 Gy. All fractures occurred over 1 year after the exposure to radiation in otherwise uneventful follow ups. Postoperative follow up showed fracture healing or in the case of the arthroplasty, osseous integration without further complications. Radiation doses of ≥ 58 Gy are a major risk factor for pathological fractures in long bones. Regardless of their low incidence, fracture rates between 1,2 and 6,4 % prove their importance. Local tumor control has therefore to be weighed against the resulting decrease in bone quality and stability. Treatment options should always take into consideration the increased risk for complications such as infection, pseudarthroses and wound healing disorders. Our results show that substitution of vitamin D and calcium as well as the the use of reamed intramedullary implants benefits the outcome.

  8. Double Plating of Distal Fibula Fractures.

    Science.gov (United States)

    Vance, Danica D; Vosseller, J Turner

    2017-02-01

    Distal fibula fractures are common orthopaedic injuries that often require open reduction internal fixation (ORIF) to anatomically reduce the fracture and minimize the risk of posttraumatic arthritis. In certain clinical situations, stouter fixation may be advantageous to decrease the risk of fixation failure. In this study, the authors report on 12 patients who underwent distal fibula ORIF with 2 one-third tubular plates. Twelve consecutive patients who underwent distal fibula ORIF with 2 one-third tubular plates were retrospectively reviewed. Clinical and radiographic outcomes were reviewed, and functional outcomes were obtained using the Foot and Ankle Outcome Score (FAOS). Institutional review board approval was obtained. All 12 fractures healed clinically and radiographically. One patient was lost to follow-up after healing of the fracture. One patient had removal of fibular hardware at 15 months after surgery. Ten patients had no hardware related pain and good ankle function. FAOS scores were obtained at a mean of 25.6 months after surgery and were as follows: pain (87.6, SD = 9.5), activities of daily living (90.4, SD = 14.5), symptoms (93.3, SD = 9.5), sports (89.5, SD = 18.1), and quality of life (57.4, SD = 21.3). Double plating of distal fibula fractures is a viable technique for problem fractures that potentially provides a readily accessible, low-cost alternative to other means of enhancing fixation. Level IV.

  9. Role of the Lateral Pterygoid Muscle in the Sagittal Fracture of Mandibular Condyle (SFMC) Healing Process%翼外肌在髁突矢状骨折愈合过程中对髁突形态改建的影响

    Institute of Scientific and Technical Information of China (English)

    刘平; 刘昌奎; 邓天阁; 江欣; 程鹏; 胡开进

    2012-01-01

    Objective: To examine the effect of the lateral peterygoid muscle in the reconstruct the condylar shape during the sagittal fracture of mandibular condyle (SFMC) healing process. Methods: Twenty梖our adult sheep were divided into 2 groups . All sheep had a unilateral operation on the right side of cuting anterior and posterior attachments of the the discs, and an oblique vertical osteotomy was made from the lateral pole of the condyle to the medial side of the condylar neck. One group (groupl) of twelve sheep's lateral pterygoid muscle were cut. The other group (group2) weren't cut the lateral pterygoid muscle. Each group sheep was sacrificed at 4 weeks (2 sheep) , 12 weeks (4 sheep), and 24 weeks (4 sheep) after surgery. Computed tomograms (CT) were taken after sacrificed, and the three imensional compute tomographic reconstruction was used to observe condylar shape. Results: In the group without cut the lateral peterygoid muscle, the joints showed greater overgrows of new bone and more advanced ankylosis. Conclusion: This study shows that the lateral pterygoid muscle plays an important part in reconstructing the condylar shape during the sagittal fracture of mandibular condyle (SFMC) healing process.%目的:本实验的目的是检查翼外肌在髁突矢状骨折愈合过程中,对髁突形态改建的影响.方法:20只1岁龄成年绵羊,随机分为两组,每组10只动物,所有绵羊都用超声骨刀造成髁突矢状骨折,剪断关节盘前后附着并将其推向内侧,其中组1动物切断翼外肌,组2动物保留翼外肌功能.每组动物分别在术后4周(各2只)、12周(各4只)、24周(各4只)处死.处死后行CT检查,CT三维重建观察髁突形态,并解剖颞颌关节(TMJ)以观察髁突形态.结果:组2即保留翼外肌功能组,较组1髁突有更多新骨形成,髁突形态改变更严重.结论:翼外肌在髁突矢状骨折愈合过程中对髁突形态改建的影响起非常重要的作用.

  10. CT of pelvic fractures

    Energy Technology Data Exchange (ETDEWEB)

    Falchi, Marco E-mail: marcofalchi@yahoo.it; Rollandi, Gian Andrea

    2004-04-01

    Although magnetic resonance imaging has become the dominant modality for cross-sectional musculo-skeletal imaging, the widespread availability, speed, and versatility of computed tomography (CT) continue to make it a mainstay of emergency room (ER) diagnostic imaging. Pelvic ring and acetabular fractures occur as the result of significant trauma secondary to either a motor vehicle accident or a high-velocity fall. These injuries are correlated with significant morbidity and mortality, both from the complications of pelvic ring fractures and from commonly associated injuries. The most commonly used classification of pelvic and acetabular fractures has been based on conventional radiographs that are, in the majority of cases, sufficient to determine the type of injury. However, because of the complexity of pelvic and acetabular fractures, precise pathological anatomy is not easily demonstrated by routine radiographs and in many cases details of fractures are not visible. Moreover, the insufficient co-operation of the patient or the difficulty of maintaining special positions can be overcome by using computed tomography. Spiral computed tomography provides information regarding the extent of the fractures and is complementary to radiography for ascertaining the spatial arrangement of fracture fragments. Spiral computed tomography is an effective tool for understanding complex fracture patterns, particularly when combined with multi-planar reconstruction two-dimensional (MPR 2D) reformatted images or three-dimensional images (3D) images. Including these techniques of reconstruction in routine pelvic imaging protocols can change management in a significant number of cases. Subtle fractures, particularly those oriented in the axial plane, are better seen on MPR images or 3D volume-rendered images. Complex injuries can be better demonstrated with 3D volume-rendered images, and complicated spatial information about the relative positions of fracture fragments can be easily

  11. EXPERIMENTAL STUDY OF DECOMPRESSION, PERMEABILITY AND HEALING OF SILICATE ROCKS IN FAULT ZONES

    Directory of Open Access Journals (Sweden)

    V. Ya. Medvedev

    2015-09-01

    Full Text Available The article presents results of petrophysical laboratory experiments in studies of decompression phenomena associated with consequences of abrupt displacements in fault zones. Decompression was studied in cases of controlled pressure drop that caused sharp changes of porosity and permeability parameters, and impacts of such decompression were analyzed. Healing of fractured-porous medium by newly formed phases was studied. After experiments with decompression, healing of fractures and pores in silicate rock samples (3×2×2 cm, 500 °C, 100 MPa took about 800–1000 hours, and strength of such rocks was restored to 0.6–0.7 of the original value. In nature, fracture healing is influenced by a variety of factors, such as size of discontinuities in rock masses, pressure and temperature conditions, pressure drop gradients, rock composition and saturation with fluid. Impacts of such factors are reviewed.

  12. Animal experimental study on the role of the lateral pterygoid muscles in healing process of the sagittal fracture of mandibular condyles%翼外肌在髁突矢状骨折愈合过程中对髁突形态改建影响的动物实验研究

    Institute of Scientific and Technical Information of China (English)

    刘昌奎; 胡开进; 刘平; 邓天阁; 江欣; 程鹏

    2012-01-01

    目的 观察翼外肌在髁突矢状骨折愈合过程中对髁突形态的改建是否有影响以及是否会进一步导致关节强直的发生.方法 将12只健康成年绵羊随机分为2组,均以右侧颞下颌关节作为手术实验侧,人为手术造成髁突矢状骨折.一组保留翼外肌在髁突内极的附丽,行使其功能,另一组切断翼外肌在髁突内极的附丽,阻断其功能,术后即刻行MRI检查,确定翼外肌是否离断.术后1周对动物模型行CT三维检查,测量髁突骨折块的移位距离及髁突内外径的改变,术后4周、12周及24周时处死动物,再次行CT检查,多平面重建后对髁突形态相关参数测量,以观察髁突的形态变化.结果 通过CT三维测量,两组髁突内外径的改变有明显的差异(P<0.05),证实翼外肌对髁突游离骨折端有牵拉作用,保留翼外肌功能组,对髁突矢状骨折后髁突形态的影响更明显.结论 此动物模型的建立,证实翼外肌对髁突矢状骨折后髁突形态改建的确有影响,为进一步研究“翼外肌牵张成骨在创伤性颞下颌关节强直发生中的作用研究”提供研究平台.%Objective To examine whether they may further cause joint ankylosis lateral pterygoid muscles influence the condyle morphology in the healing process of sagittal fracture of mandibular condyles ( SFMC ) . Methods Twelve healthy adult sheep were included in our study, and all the animals were treated with surgery to make the condyles fracture on the right side of the temporomandibu-lar joint. The animals were randomly divided into two groups: the pterygoids of sheep in one group were cut and not able to function. The others in the other group were not cut. They were still on the internal poles of the fractured condyles and their functions remained. We immediately examined whether the pterygoid muscles were cut ( or not) by MRI after the operation. 3D computed tomograms ( CT) were taken 1,4,12 and 24 weeks after the operation

  13. 下肢骨折后膝关节的功能锻炼%Functional training of knee joint after fracture of lower limb

    Institute of Scientific and Technical Information of China (English)

    张超

    2003-01-01

    @@ BACKGROUND:In treatment of fracture of lower limb, clinical healing of fracture needs a long time after replace and immobilization. But clinical healing does not represent complete recovery of joint function.Knee ankylosis or stiffness could happen if not treated properly in this term.

  14. [Advances in the effects of pH value of micro-environment on wound healing].

    Science.gov (United States)

    Tian, Ruirui; Li, Na; Wei, Li

    2016-04-01

    Wound healing is a complex