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BioMed Research International 2014The low-density lipoprotein receptor-related protein 5 gene (LRP5) was identified to be linked to the variation in bone mineral density and types of bone diseases. The... (Meta-Analysis)
Meta-Analysis Review
The low-density lipoprotein receptor-related protein 5 gene (LRP5) was identified to be linked to the variation in bone mineral density and types of bone diseases. The present study was aimed at examining the association of LRP5 rs3736228 C>T gene with bone fracture and osteoporosis by meta-analysis. A systematic electronic search of literature was conducted to identify all published studies in English or Chinese on the association of the LRP5 gene with bone fracture and osteoporosis risks. All analyses were calculated using the Version 12.0 STATA software. Odds ratios (ORs) and their corresponding 95% confidence interval (95% CI) were calculated. An updated meta-analysis was currently performed, including seven independent case-control studies. Results identified that carriers of rs3736228 C>T variant in the LRP5 gene were associated with an increased risk of developing osteoporosis and fractures under 4 genetic models but not under the dominant model (OR = 1.19, 95% CI = 0.97~1.46, and P = 0.103). Ethnicity-subgroup analysis implied that LRP5 rs3736228 C>T mutation was more likely to develop osteoporosis and fractures among Asians and Caucasians in majority of subgroups. These results suggest that there is a modest effect of the LRP5 rs3736228 C>T on the increased susceptibility of bone fracture and osteoporosis.
Topics: Bone Density; Fractures, Bone; Genetic Association Studies; Humans; Low Density Lipoprotein Receptor-Related Protein-5; Osteoporosis; Polymorphism, Single Nucleotide
PubMed: 25580429
DOI: 10.1155/2014/290531 -
International Journal For Numerical... Jul 2022In this study, a coupled computational modelling framework for bone fracture repair is presented that enables predictions of both healing and remodelling phases of the...
In this study, a coupled computational modelling framework for bone fracture repair is presented that enables predictions of both healing and remodelling phases of the fracture region and is used to investigate the role of an internal fixation plate on the long-term healing performance of a fracture tibia under a range of different conditions. It was found that introduction of a titanium plate allowed the tibia to undergo successful healing at higher loading conditions and fracture gaps, compared with the non-plated versions. While these plated cases showed faster rates of repair in the healing phase, their performance was substantially different once they entered the remodelling phase, with substantial regions of stress shielding predicted. This framework is one of the few implementations of both fracture healing and remodelling phases of bone repair and includes several innovative approaches to smoothing, time-averaging and time incrementation in its implementation, thereby avoiding any unwanted abrupt changes between tissue phenotypes. This provides a better representation of tissue development in the fracture site when compared with fracture healing models alone and provides a suitable platform to investigate the long-term performance of orthopaedic fixation devices. This would enable the more effective design of permanent fixation devices and optimisation of the spatial and temporal performance of bioabsorbable implants.
Topics: Biomechanical Phenomena; Bone Plates; Fracture Fixation, Internal; Fracture Healing; Fractures, Bone; Humans; Tibia
PubMed: 35485134
DOI: 10.1002/cnm.3609 -
International Journal For Numerical... Jul 2021Bone fracture treatments using Ilizarov circular fixator (ICF) involve dealing with uncertainties about a range of critical factors that control the mechanical...
Bone fracture treatments using Ilizarov circular fixator (ICF) involve dealing with uncertainties about a range of critical factors that control the mechanical microenvironment of the fracture site such as ICF configuration, fracture gap size, physiological loading etc. To date, the effects of the uncertainties about these critical factors on the mechanical microenvironment of the fracture site have not been fully understood. The purpose of this study is to tackle this challenge by using computational modelling in conjunction with engineering reliability analysis. Particularly, the effects of uncertainties in fracture gap size (GS), level of weight-bearing (P), ICF wire pretension (T) and wire diameter (WD) on the fracture site mechanical microenvironment at the beginning of the reparative phase of healing was investigated in this study. The results show that the mechanical microenvironment of fracture site stabilised with ICF is very sensitive to the uncertainties in P and GS. For example, an increase in the coefficient of variation of P (COV ) from 0.1 to 0.9 (i.e., an increase in the uncertainty in P) could reduce the probability of achieving a favourable mechanical microenvironment within the fracture site (i.e., Probability of Success, PoS) by more than 50%, while an increase in the coefficient of variation of GS (COV ) from 0.1 to 0.9 could decrease PoS by around 30%. In contrast, an increase in the uncertainties in T and WD (COV increase from 0.1 to 0.9) has little influence on the fracture site mechanical microenvironment (PoS changes <5%).
Topics: Animals; Bony Callus; External Fixators; Fracture Healing; Fractures, Bone; Ilizarov Technique; Models, Statistical; Regression Analysis; Sheep
PubMed: 33864429
DOI: 10.1002/cnm.3466 -
Bone Feb 2015Bone can be viewed as a nano-fibrous composite with complex hierarchical structures. Its deformation and fracture behaviors depend on both the local structure and the...
Bone can be viewed as a nano-fibrous composite with complex hierarchical structures. Its deformation and fracture behaviors depend on both the local structure and the type of stress applied. In contrast to the extensive studies on bone fracture under compression and tension, there is a lack of knowledge on the fracture process under shear, a stress state often exists in hip fracture. This study investigated the mechanical behavior of human cortical bone under shear, with the focus on the relation between the fracture pattern and the microstructure. Iosipescu shear tests were performed on notched rectangular bar specimens made from human cortical bone. They were prepared at different angles (i.e. 0°, 30°, 60° and 90°) with respect to the long axis of the femoral shaft. The results showed that human cortical bone behaved as an anisotropic material under shear with the highest shear strength (~50MPa) obtained when shearing perpendicular to the Haversian systems or secondary osteons. Digital image correlation (DIC) analysis found that shear strain concentration bands had a close association with long bone axis with an average deviation of 11.8° to 18.5°. The fracture pattern was also greatly affected by the structure with the crack path generally following the direction of the long axes of osteons. More importantly, we observed unique peripheral arc-shaped microcracks within osteons, using laser scanning confocal microscopy (LSCM). They were generally long cracks that developed within a lamella without crossing the boundaries. This microcracking pattern clearly differed from that created under either compressive or tensile stress: these arc-shaped microcracks tended to be located away from the Haversian canals in early-stage damaged osteons, with ~70% developing in the outer third osteonal wall. Further study by second harmonic generation (SHG) and two-photon excitation fluorescence (TPEF) microscopy revealed a strong influence of the organization of collagen fibrils on shear microcracking. This study concluded that shear-induced microcracking of human cortical bone follows a unique pattern that is governed by the lamellar structure of the osteons.
Topics: Aged; Biomechanical Phenomena; Bone Density; Female; Femoral Fractures; Fractures, Bone; Haversian System; Humans; Male; Microscopy, Confocal; Middle Aged; Shear Strength; Stress, Mechanical; Weight-Bearing
PubMed: 25305520
DOI: 10.1016/j.bone.2014.10.001 -
International Journal of Gynaecology... Nov 2013To assess the incidence and outcome of neonatal long-bone fractures at a tertiary teaching hospital.
OBJECTIVE
To assess the incidence and outcome of neonatal long-bone fractures at a tertiary teaching hospital.
METHODS
A retrospective study of all neonates with long-bone fractures delivered at Jordan University Hospital between January 1, 2000, and December 31, 2010.
RESULTS
Among a total of 34 519 live births, 8 neonates had a long-bone fracture (incidence 0.23/1000 live births); of these, 6 had a femur fracture (0.17/1000 live births) and 2 had a humerus fracture (0.05/1000 live births). The route of delivery was emergency cesarean delivery for 6 infants, elective cesarean delivery for 1 infant, and the vaginal route for 1 infant. The mean birth weight was 2723g. All neonates weighed more than 2200g and their gestational age was more than 35weeks, with the exception of 1 neonate born at 31weeks weighing 1500g. The mean time interval from birth to fracture diagnosis was 1.5days. All fractures healed with no residual deformity.
CONCLUSION
Emergency cesarean delivery carries a higher risk of long-bone fracture than vaginal delivery. Prematurity, malpresentation, abnormal lie, and multiple pregnancies may predispose to long-bone fractures. The prognosis of birth-associated long-bone fractures is good.
Topics: Adult; Birth Injuries; Birth Weight; Cesarean Section; Delivery, Obstetric; Female; Femoral Fractures; Fracture Healing; Gestational Age; Hospitals, Teaching; Humans; Humeral Fractures; Incidence; Infant, Newborn; Jordan; Male; Middle Aged; Pregnancy; Prognosis; Retrospective Studies; Risk Factors; Time Factors; Young Adult
PubMed: 23992623
DOI: 10.1016/j.ijgo.2013.05.013 -
Der Chirurg; Zeitschrift Fur Alle... Oct 2015Delayed fracture healing for more than 6-8 months is defined as non-union (pseudarthrosis). Non-unions are classifiable as septic, aseptic, hypertrophic and atrophic... (Review)
Review
Delayed fracture healing for more than 6-8 months is defined as non-union (pseudarthrosis). Non-unions are classifiable as septic, aseptic, hypertrophic and atrophic non-unions. In case of septic non-unions the infection is treated primarily followed by treatment of the delayed fracture healing. Aseptic non-unions may be treated non-operatively (e.g. shock wave therapy and/or ultrasound) or by various surgical strategies to stimulate bone regeneration and healing.
Topics: Combined Modality Therapy; Fracture Fixation, Internal; Fracture Healing; Fractures, Bone; Germany; Humans; Postoperative Complications; Pseudarthrosis; Reoperation; Risk Factors
PubMed: 26201543
DOI: 10.1007/s00104-015-0050-8 -
The American Journal of Forensic... Dec 2007Hyoid bone fractures secondary to blunt trauma other than strangulation are rare. Only 27 cases have been reported in the literature. They have few, if any,... (Review)
Review
Hyoid bone fractures secondary to blunt trauma other than strangulation are rare. Only 27 cases have been reported in the literature. They have few, if any, complications, such as dysphagia, hypoxia, cardiorespiratory collapse, laceration of the pharynx, mandibular fracture, thyroid cartilage fracture, and facial fracture. No report of hyoid bone fracture associated with spinal column injury was reported in the English literature. The authors reported a 46-year-old male patient who complained of neck pain and odynophagia after a traffic accident. After systemic examination and cervical CT scan, the diagnosis of hyoid bone fracture at the right great horn and atlantoaxial subluxation was made. The patient was observed in ICU for 48 hours. A nasogastric tube was inserted for feeding. Fifteen milligrams of dexamethasone was given once a day for 3 days to reduce the swelling and pain. We performed a cutaneous traction for the subluxation and carefully watched the hyoid bone and the patient's respiration. No lethal complications occurred. Two weeks later, the patient was allowed to ambulate with cervical collar protection and to resume oral intake. Three months later, he was asymptomatic. This case, with hyoid fracture and atlantoaxial subluxation, is the only case reported in the literature. The importance of hyoid fracture, however, rests not with the rarity of it, but with the lethal potential of missing diagnosis. Nonsurgical management may be effective in most of the cases.
Topics: Accidents, Traffic; Deglutition Disorders; Diagnosis, Differential; Fractures, Bone; Humans; Hyoid Bone; Male; Middle Aged; Neck Pain; Tomography, X-Ray Computed
PubMed: 18043024
DOI: 10.1097/PAF.0b013e31814250a1 -
BMJ Case Reports Jul 2021The hyoid bone fracture has traditionally been attributed to strangulation and hanging. Although rare, ensuing its vague presentation, hyoid bone fracture is oftentimes...
The hyoid bone fracture has traditionally been attributed to strangulation and hanging. Although rare, ensuing its vague presentation, hyoid bone fracture is oftentimes overlooked and missed, leading to delayed complications. Herein, we are reporting an overlooked hyoid bone fracture in a man who attempted suicide by strangulating himself, whereby Valsalva manoeuvre performed during bedside flexible nasopharyngolaryngoscopy revealed the fractured segment. As the patient was stable and asymptomatic, he was successfully managed conservatively. We would like to highlight the awareness of the Valsalva manoeuvre, which could elicit hyoid bone fracture as missing or overlooking the fracture may lead to devastating complications which may ensue, such as respiratory distress.
Topics: Fractures, Bone; Humans; Hyoid Bone; Male; Neck Injuries; Pharynx; Valsalva Maneuver
PubMed: 34257127
DOI: 10.1136/bcr-2021-243756 -
Diabetes & Metabolism Oct 2019To evaluate the association between sodium-glucose cotransporter-2 (SGLT2) inhibitors and risk of bone fractures in patients with type 2 diabetes mellitus (T2DM). (Meta-Analysis)
Meta-Analysis
AIM
To evaluate the association between sodium-glucose cotransporter-2 (SGLT2) inhibitors and risk of bone fractures in patients with type 2 diabetes mellitus (T2DM).
METHODS
A systematic literature search conducted of PubMed, Embase, the Cochrane Library and Web of Science from inception up to 31 August 2018 identified all eligible randomized controlled trials (RCTs). The following data were extracted from each study: first author; year of publication; sample size; patient characteristics; study design; intervention drug; control drug; follow-up durations; and incident bone-fracture events. A meta-analysis was performed using Review Manager 5.3 software to calculate odds ratios (ORs) and 95% confidence intervals (CI) for dichotomous variables.
RESULTS
A total of 30 studies involving 23,372 patients with T2DM were included in our analysis. There were 387 incident bone-fracture cases (245 in the SGLT2 inhibitor group, 142 in the control group). Compared with patients who received placebo, those receiving SGLT2 inhibitor treatment had a pooled OR of bone fracture of 0.86 (95% CI: 0.70-1.06). Also, there was no evidence that individual SGLT2 inhibitors across different doses were associated with any increased risk of bone fracture. After stratification by follow-up duration, an SGLT2 inhibitor treatment period of ≤ 52 weeks appeared to have beneficial effects against bone fracture; however, when the treatment period exceeded 52 weeks, these beneficial effects for preventing bone fracture disappeared.
CONCLUSION
Our meta-analysis has indicated that SGLT2 inhibitors do not increase risk of bone fracture compared with placebo in patients with T2DM. However, these findings now need to be confirmed in well-designed RCT studies.
Topics: Diabetes Mellitus, Type 2; Fractures, Bone; Humans; Incidence; Randomized Controlled Trials as Topic; Risk; Sodium-Glucose Transporter 2 Inhibitors
PubMed: 30738154
DOI: 10.1016/j.diabet.2019.01.010 -
IEEE Transactions on Ultrasonics,... 2008Quantitative ultrasound has attracted significant interest in the evaluation of bone fracture healing. Animal and clinical studies have demonstrated that the propagation... (Review)
Review
Quantitative ultrasound has attracted significant interest in the evaluation of bone fracture healing. Animal and clinical studies have demonstrated that the propagation velocity across fractured bones can be used as an indicator of healing. Researchers have recently employed computational methods for modeling wave propagation in bones, aiming to gain insight into the underlying mechanisms of wave propagation and to further enhance the monitoring capabilities of ultrasound. In this paper, we review the relevant literature and present the current status of knowledge.
Topics: Algorithms; Computer Simulation; Densitometry; Fracture Healing; Fractures, Bone; Humans; Image Interpretation, Computer-Assisted; Models, Biological; Scattering, Radiation; Ultrasonography
PubMed: 18599412
DOI: 10.1109/TUFFC.2008.787